Children with wheat anaphylaxis and with low wheat specific IgE have a different IgE immunoblot pattern than those with high wheat specific IgE
Issued Date
2025-12-01
Resource Type
ISSN
0125877X
eISSN
22288694
Scopus ID
2-s2.0-105029237912
Pubmed ID
36773279
Journal Title
Asian Pacific Journal of Allergy and Immunology
Volume
43
Issue
4
Start Page
811
End Page
818
Rights Holder(s)
SCOPUS
Bibliographic Citation
Asian Pacific Journal of Allergy and Immunology Vol.43 No.4 (2025) , 811-818
Suggested Citation
Rutrakool N., Piboonpocanun S., Wangthan U., Srisuwatchari W., Thongngarm T., Jirapongsananuruk O., Visitsunthorn N., Vichyanond P., Pacharn P. Children with wheat anaphylaxis and with low wheat specific IgE have a different IgE immunoblot pattern than those with high wheat specific IgE. Asian Pacific Journal of Allergy and Immunology Vol.43 No.4 (2025) , 811-818. 818. doi:10.12932/ap-140622-1387 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/114989
Title
Children with wheat anaphylaxis and with low wheat specific IgE have a different IgE immunoblot pattern than those with high wheat specific IgE
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: Children with wheat anaphylaxis can present with a wide range of wheat-specific IgE (sIgE). Objective: To identify differences in clinical features and predominant wheat allergens sensitized by these patients. Methods: Children with history of wheat anaphylaxis were recruited. Skin prick test (SPT) to wheat, sIgE to wheat, omega-5 gliadin (ω5G), lipid transfer protein (LTP) were investigated. Profiles of IgE-bound wheat allergens were studied to identify predominant wheat allergens. Results: Twenty-nine children (17 males) aged 1-18 years were enrolled. Sixteen patients (55.2%) had wheat-sIgE > 100 kUA/L (WA<inf>hi</inf>) and 13 patients (44.8%) had wheat-sIgE < 34 kUA/L (WA<inf>lo</inf>). The median of peak wheat-sIgE in WA<inf>hi</inf> and WA<inf>lo</inf> were 340.5 kUA/L (IQR 184.3, 564.5) and 12.2 kUA/L (IQR 1.4, 41.3), respectively. Oral food challenge test (OFC) was carried out in 12 of 13 patients in the WA<inf>lo</inf> group, all of which had positive results. Eight of these 12 patients developed anaphylaxis during OFC despite having wheat-sIgE less than 10 kUA/L. There were no differences in clinical characteristics and atopic history between WA<inf>hi</inf> vs. WA<inf>lo</inf> . Medium to low molecular weight gliadin (< 40 kDa) and glutenin (< 60 kDa) were commonly recognized by patients with WA<inf>hi</inf>. IgE immunoblot pattern among the WA<inf>lo</inf> group was more widely dispersed than those with WA<inf>hi</inf>. Conclusion: Wheat anaphylaxis can occur in patients with low wheat-sIgE. Predominant wheat allergens recognized by patients with WA<inf>lo</inf> were different than those with WA<inf>hi</inf> . Such difference could be responsible for anaphylaxis at even low levels of wheat-sIgE.