Allergy Research Group, Department of Dermatology, University Medical Center, Freiburg, Germany.
Allergy. 2012 Nov;67(11):1457-60. doi: 10.1111/all.12020. Epub 2012 Sep 15.
Wheat-dependent exercise-induced anaphylaxis (WDEIA) is characterized by anaphylactic reactions after wheat ingestion and physical exercise. IgE antibodies to recombinant ω(5) -gliadin are detectable in a majority of WDEIA patients, but other wheat allergens may also play a role in elicitation of WDEIA. Here, we performed a comprehensive analysis of IgE reactivity to different wheat proteins in 17 patients with confirmed WDEIA by ImmunoCAP research prototypes and a semi-quantitative microarray immunoassay with α/β/γ-gliadin, high-molecular-weight (HMW) glutenin, alpha-amylase inhibitor (AAI) dimer, and wheat lipid transfer protein (LTP). By ImmunoCAP, IgE to recombinant ω(5) -gliadin was detectable in 14/17 patients (82%), to α/β/γ-gliadin in 82% including the three patients lacking IgE to ω(5) -gliadin, and to HMW glutenin in 59%. The microarray revealed specifically γ-gliadin as the second most important allergen. These results demonstrate the additional diagnostic value of α/β- and γ-gliadin in particular in ω(5) -gliadin-negative patients in the diagnosis of WDEIA.
小麦依赖运动诱发的过敏反应（WDEIA）的特征是在摄入小麦和进行体育锻炼后发生过敏反应。在大多数 WDEIA 患者中，可检测到针对重组 ω(5)-麦醇溶蛋白的 IgE 抗体，但其他小麦过敏原也可能在引发 WDEIA 中起作用。在这里，我们通过 ImmunoCAP 研究原型和半定量微阵列免疫分析，对 17 例经证实的 WDEIA 患者的不同小麦蛋白的 IgE 反应进行了全面分析，该分析使用了 α/β/γ-麦醇溶蛋白、高分子量（HMW）麦谷蛋白、α-淀粉酶抑制剂（AAI）二聚体和小麦脂质转移蛋白（LTP）。通过 ImmunoCAP，在 14/17 例患者（82%）中可检测到重组 ω(5)-麦醇溶蛋白的 IgE，在包括 3 例缺乏 ω(5)-麦醇溶蛋白 IgE 的患者在内的 82%的患者中可检测到 α/β/γ-麦醇溶蛋白的 IgE，在 59%的患者中可检测到 HMW 麦谷蛋白的 IgE。微阵列特别显示 γ-麦醇溶蛋白是第二重要的过敏原。这些结果表明，在 ω(5)-麦醇溶蛋白阴性患者中，α/β-和 γ-麦醇溶蛋白在诊断 WDEIA 中具有额外的诊断价值。
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