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Diagnostic value of the serum-specific IgE ratio of ω-5 gliadin to wheat in adult patients with wheat-induced anaphylaxis

Authors
Park, HJ; Kim, JH; Kim, JE; Jin, HJ; Choi, GS; Ye, YM; Park, HS
Citation
International archives of allergy and immunology, 157(2):147-150, 2012
Journal Title
International archives of allergy and immunology
ISSN
1018-24381423-0097
Abstract
BACKGROUND: Wheat is an important food allergen associated with severe allergic reactions, including wheat-dependent exercise-induced anaphylaxis (WDEIA) and wheat-induced anaphylaxis (WIA). To diagnose WDEIA, an exercise challenge test following wheat ingestion is performed, which is time-consuming and unsafe. The compound ω-5 gliadin has been identified as a major allergen for WDEIA and WIA. We evaluated the diagnostic value of serum immunoglobulin E (IgE) ratios of ω-5 gliadin to wheat in adult patients with WDEIA or WIA.



METHODS: In total, 27 patients were enrolled and classified into 2 groups according to the severity of their allergic reactions to wheat. Serum IgE, specific to wheat and ω-5 gliadin, was measured using the ImmunoCAP system. To evaluate the diagnostic value, receiver operator characteristic curves were produced.



RESULTS: Group 1 included 17 patients with a history of anaphylaxis and group 2 included 10 patients having urticaria or atopic dermatitis. Serum IgE specific to wheat was increased in 47% of group 1 and 100% of group 2. However, all patients in group 1 had high serum IgE specific to ω-5 gliadin, whereas only 20% of group 2 showed increased levels. To identify a better diagnostic value, the log-transformed IgE ratio of ω-5 gliadin to wheat was calculated, with the cutoff value at 0.3. Based on these criteria, we found 100% sensitivity and specificity.



CONCLUSIONS: This study confirms that the serum IgE ratio of ω-5 gliadin to wheat may be a useful marker for the diagnosis of WDEIA and WIA.
MeSH terms
AdolescentAdultAllergens/*immunologyAnaphylaxis/*diagnosis/immunologyAntibody Specificity/*immunologyAntigens, PlantFemaleGliadin/*immunologyHumansImmunoglobulin E/*blood/immunologyMaleMiddle AgedSensitivity and SpecificityTriticum/*immunologyWheat Hypersensitivity/*diagnosis/immunologyYoung Adult
DOI
10.1159/000327549
PMID
21985845
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Allergy
AJOU Authors
진, 현정예, 영민박, 해심
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