Neyer A, Dölle-Bierke S, Höfer V, Grünhagen J, Beyer K, Worm M
Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergy, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Clin Exp Allergy. 2025 Apr;55(4):319-329. doi: 10.1111/cea.70017. Epub 2025 Feb 19.
Wheat is a well-known elicitor of food allergy, but epidemiological data are limited. The aim of this study was to investigate the prevalence of wheat allergy in an unselected population of adults and adolescents and to characterise the clinical features of this cohort, as well as those of patients who experienced wheat-induced anaphylaxis.
A population-based cross-sectional study was conducted. Fifteen thousand individuals aged 12-80 years were randomly selected, and a standardised questionnaire was applied. If symptoms after wheat consumption were reported, telephone interviews were conducted. In the case of suspected type 1 wheat allergy, a skin prick test, specific immunoglobulin E (sIgE) and oral food challenge (OFC) were performed. The prevalence of self-reported wheat sensitivity and wheat allergy was determined after data extrapolation. For the assessment of severe wheat allergy-associated symptoms, a cohort from the European Anaphylaxis Registry was analysed.
The questionnaire was answered by 1770 individuals, of whom 13.1% reported symptoms due to the consumption of foods containing wheat. Following telephone interviews (n = 105) and clinical diagnostics (n = 22), type 1 sensitisation to wheat was confirmed in 8 individuals, and 2 subjects were finally diagnosed with an IgE-mediated wheat allergy. After extrapolation, the prevalence of confirmed wheat allergy in the German population reached 0.25% [95% CI 0.08-0.9]. Self-reported wheat sensitivity was predominantly seen in females (71%), with local gastrointestinal and non-specific symptoms. This contrasted with wheat-induced anaphylaxis, where less than half occurred in females, and symptoms were mainly skin, cardiovascular or respiratory.
In a population with widespread wheat consumption, self-reported wheat sensitivity was common in adults and adolescents, but confirmed wheat allergy was rare. The distinct symptom profiles allow physicians to easily differentiate these entities. Dissemination of our findings may help to improve knowledge of the low prevalence of wheat allergy and may support the reduction of unnecessary dietary restrictions.
小麦是一种广为人知的食物过敏诱发因素，但流行病学数据有限。本研究的目的是调查未经过筛选的成人和青少年人群中小麦过敏的患病率，并描述该队列以及发生小麦诱发过敏反应的患者的临床特征。
开展了一项基于人群的横断面研究。随机选取了15000名年龄在12至80岁之间的个体，并应用了标准化问卷。如果报告了食用小麦后的症状，则进行电话访谈。对于疑似1型小麦过敏的情况，进行皮肤点刺试验、特异性免疫球蛋白E（sIgE）检测和口服食物激发试验（OFC）。在数据外推后确定自我报告的小麦敏感性和小麦过敏的患病率。为了评估与严重小麦过敏相关的症状，对欧洲过敏反应登记处的一个队列进行了分析。
1770人回答了问卷，其中13.1%报告了食用含小麦食物后的症状。经过电话访谈（n = 105）和临床诊断（n = 22），8人被确诊为对小麦有1型致敏，最终2名受试者被诊断为IgE介导的小麦过敏。外推后，德国人群中确诊的小麦过敏患病率达到0.25%[95%置信区间0.08 - 0.9]。自我报告的小麦敏感性主要见于女性（71%），伴有局部胃肠道和非特异性症状。这与小麦诱发的过敏反应形成对比，其中女性发生的不到一半，症状主要是皮肤、心血管或呼吸道症状。
在广泛食用小麦的人群中，成人和青少年中自我报告的小麦敏感性很常见，但确诊的小麦过敏很少见。不同的症状特征使医生能够轻松区分这些情况。传播我们的研究结果可能有助于提高对小麦过敏低患病率的认识，并可能有助于减少不必要的饮食限制。
