Treatment difficulties in wheat oral immunotherapy and the predictive value of wheat-specific IgE
1
Issued Date
2025-12-01
Resource Type
ISSN
0125877X
eISSN
22288694
Scopus ID
2-s2.0-105029438917
Pubmed ID
38183640
Journal Title
Asian Pacific Journal of Allergy and Immunology
Volume
43
Issue
4
Start Page
873
End Page
880
Rights Holder(s)
SCOPUS
Bibliographic Citation
Asian Pacific Journal of Allergy and Immunology Vol.43 No.4 (2025) , 873-880
Suggested Citation
Pacharn P., Witeetanavanich S., Srisuwatchari W., Rutrakool N., Wongteerayanee C., Tanticharoenwiwat P., Senavonge A., Kanchanapoomi K., Jirapongsananuruk O., Visitsunthorn N., Vichyanond P. Treatment difficulties in wheat oral immunotherapy and the predictive value of wheat-specific IgE. Asian Pacific Journal of Allergy and Immunology Vol.43 No.4 (2025) , 873-880. 880. doi:10.12932/ap-010923-1682 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/115019
Title
Treatment difficulties in wheat oral immunotherapy and the predictive value of wheat-specific IgE
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Abstract
Background: Factors associated with wheat oral immunotherapy (OIT) difficulties in patients with IgE-mediated wheat allergy have not been well studied. Objective: We aimed to assess factors associated with difficulties in wheat OIT. Methods: We retrospectively collected data from children under 18 years of age with history of IgE-mediated wheat allergy who underwent wheat OIT. The initial specific IgE (sIgE) of wheat and omega-5-gliadin, wheat skin prick test (SPT) sizes, eliciting doses, and adverse reactions during the OIT were evaluated. Results: A total of 81 children were enrolled, with a mean age of 7.0 ± 2.7 years at the initiation of wheat OIT. The median follow-up duration was 2 years (IQR 1.2–3.0 years). Difficulties in wheat OIT included patients who experienced frequent reactions (at least grade 2 or exercise-induced reactions) or deviated from the up-dosing protocol, which we defined as ‘Complicated cases.’ Twenty-six patients (32.1%) were complicated cases. Initial wheat-sIgEs were significantly higher in complicated cases than in noncomplicated cases (median of 192.3 kUA/L (IQR 30.4–590.0) vs 6.9 kUA/L (IQR 1.9–100.0) (p = 0.001)). Initial omega-5-gliadin-sIgEs in the complicated group were also significantly higher, with a median of 15.0 kUA/L (IQR 6.3–69.8) vs 1.6 kUA/L (IQR 0.2–11.4) (p < 0.001). The risk factors for complicated cases include higher omega-5-gliadin-sIgEs and anaphylaxis during the oral food challenge test (aOR 1.035 and 5.684, respectively). Conclusion: The initial wheat and omega-5-gliadin-sIgEs were significant risk factors for complicated OIT patients and could be used to monitor these patients carefully during the OIT period.