Department of Health Promotion, Faculty Health of Sciences, Medical University of Lublin, Staszica 4/6, 20-081 Lublin, Poland.
Polish-Ukrainian Foundation of Medicine Development, Nałęczowska 14, 20-701 Lublin, Poland.
Nutrients. 2023 Feb 16;15(4):995. doi: 10.3390/nu15040995.
In order to answer the question if an IgE-mediated allergy (A-IgE) may occur in subjects with celiac disease (CD), a systematic review was performed of available publications collected in the United States National Institute for Biotechnology Information/National Institutes of Health/National Library of Medicine/PubMed database up to 28 December 2022, with the use of the following keywords "allergy&celiac/coeliac", "sensitization&celiac/coeliac", and "anaphylaxis&celiac/coeliac" compared in the form of a conjunction. In total, the search returned 2013 publications from these keywords in any section of the article. As numerous review articles included the above-mentioned entries in the abstract, we decided to focus on the publications with the entries only in the title (n = 63). After rejecting studies unrelated to the topic, narrative reviews, book chapters, conference abstracts, symposium reports, letters to the editor, or non-English articles, 18 publications (6 observational original studies and 12 case reports describing a total of 15 cases of A-IgE developed after a diagnosis of CD) were included to this review. Our study is the first systematic review on allergy occurrence in CD patients. The analysis indicated that the possibility of a coexistence of A-IgE with any food and inhalant allergens in subjects diagnosed with CD should be considered. A sensitization to wheat was the most frequently described in subjects with CD. The clinical manifestation of A-IgE in CD was similar to that in subjects without CD; e.g., with possible atopic dermatitis, vomiting, urticaria, angioedema, or anaphylactic shock. Screening for allergies in subjects with CD should be considered, especially in those cases where symptoms persist after introducing a gluten-free diet. The elimination of wheat from the diet of patients with CD may lead to a loss of immune tolerance and to the development of sensitization, which may even manifest as anaphylaxis. In conclusion, although there are few studies assessing the occurrence of A-IgE in subjects with CD, they show the possibility of a coexistence of both diseases and the high clinical significance of this phenomenon, which indicates the need for further studies.
为了回答乳糜泻（CD）患者是否会发生 IgE 介导的过敏（A-IgE）的问题，对截至 2022 年 12 月 28 日在美国国立生物技术信息研究所/美国国立卫生研究院/美国国立医学图书馆/PubMed 数据库中收集的可用文献进行了系统评价，使用了以下关键词“过敏与乳糜泻/乳糜泻”、“致敏与乳糜泻/乳糜泻”和“过敏与乳糜泻/乳糜泻”，以连词的形式进行比较。总共，从文章的任何部分使用这些关键词搜索返回了 2013 篇出版物。由于许多综述文章在摘要中包含了上述条目，因此我们决定专注于仅在标题中包含这些条目的出版物（n=63）。在排除与主题无关的研究、叙述性综述、书籍章节、会议摘要、专题报告、社论、非英文文章后，纳入了 18 篇出版物（6 项观察性原始研究和 12 项描述 CD 诊断后共 15 例 A-IgE 发展的病例报告）进行综述。我们的研究是第一项关于 CD 患者过敏发生的系统评价。分析表明，应考虑在诊断为 CD 的患者中存在 A-IgE 与任何食物和吸入性过敏原共存的可能性。对小麦的致敏是 CD 患者最常描述的。CD 患者 A-IgE 的临床表现与非 CD 患者相似；例如，可能出现特应性皮炎、呕吐、荨麻疹、血管性水肿或过敏性休克。应考虑对 CD 患者进行过敏筛查，尤其是在引入无麸质饮食后症状仍持续存在的情况下。从 CD 患者的饮食中消除小麦可能导致免疫耐受丧失和致敏发展，甚至可能表现为过敏反应。总之，尽管评估 CD 患者 A-IgE 发生的研究很少，但它们表明两种疾病同时存在的可能性以及这种现象的高临床意义，这表明需要进一步研究。
