Zheng Wanqi, Wai Christine Yee Yan, Sit Jason Ka Chun, Cheng Nam Sze, Leung Christy Wing Man, Leung Ting Fan
Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong.
Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Shatin, Hong Kong.
Biomedicines. 2024 Jul 12;12(7):1549. doi: 10.3390/biomedicines12071549.
Wheat, a component of the staple diet globally, is a common food allergen in children. The symptoms of wheat allergy (WA) range from skin rash to shortness of breath, significantly impairing quality of life. Following initial clinical suspicion, individuals may undergo routinely used allergy tests such as a wheat allergen-specific skin prick test (SPT), a blood test for specific immunoglobulin E (sIgE) levels, or oral food challenge. Conventional management of WA lies in wheat avoidance, yet accidental consumption may be inevitable owing to the ubiquity of wheat in various food products. This article aims to provide an overview of the immunologic pathway of WA, followed by its emerging diagnostic methods, namely alcohol-soluble SPT extracts, component-resolved diagnosis, and the basophil activation test (BAT). The mechanisms underlying wheat allergen-specific oral immunotherapy (OIT) as well as a summary of the efficacy, tolerability, and safety of related clinical trials will then be discussed.
小麦是全球主食的组成部分,是儿童常见的食物过敏原。小麦过敏(WA)的症状从皮疹到呼吸急促不等,严重影响生活质量。在初步临床怀疑后,个体可能会接受常规使用的过敏测试,如小麦过敏原特异性皮肤点刺试验(SPT)、特定免疫球蛋白E(sIgE)水平的血液检测或口服食物激发试验。WA的传统管理方法是避免食用小麦,但由于小麦在各种食品中普遍存在,意外食用可能不可避免。本文旨在概述WA的免疫途径,随后介绍其新兴的诊断方法,即可溶性酒精SPT提取物、组分分辨诊断和嗜碱性粒细胞活化试验(BAT)。然后将讨论小麦过敏原特异性口服免疫疗法(OIT)的潜在机制以及相关临床试验的疗效、耐受性和安全性总结。