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Wheat allergy: a double-blind, placebo-controlled study in adults
Joseph Scibilia1, Elide A Pastorello, Giuliana Zisa
1Unit of Allergology and Clinical Immunology, Azienda Ospedaliera Niguarda Hospital, Milan, Italy.
The Journal of Allergy and Clinical Immunology
|February 8, 2006
Summary
Wheat allergy is a real concern for adults, with nearly half of those tested showing a positive reaction. Many allergic individuals react to small amounts of wheat, indicating the need for accurate diagnostic methods.
Area of Science:
- Food allergy research
- Clinical immunology
- Gastroenterology
Background:
- Wheat allergy is considered uncommon in adults, with limited research on IgE-mediated reactions.
- Existing studies on adult wheat allergy are insufficient.
Purpose of the Study:
- To confirm wheat allergy in adults using double-blind, placebo-controlled food challenges (DBPCFC).
- To document allergic symptoms, determine lowest provocation doses, and evaluate diagnostic test performance.
- To identify subjects with confirmed wheat allergy for further immunological studies.
Main Methods:
- Adults with a history of wheat allergy underwent skin prick testing (SPT) and specific IgE testing.
- DBPCFC involved challenges with 25g of wheat, followed by cooked wheat challenges for positive raw wheat reactors.
- Provocation doses were recorded.
Main Results:
- Out of 27 patients, 13 (48%) showed a positive DBPCFC result for wheat allergy.
- Among those positive to raw wheat, 10 out of 11 also reacted to cooked wheat.
- The lowest provocation dose ranged from 0.1g to 25g, with 27% reacting to ≤1.6g of wheat.
Conclusions:
- Wheat is a confirmed cause of food allergy in adults.
- A significant portion of wheat-allergic adults react to small wheat quantities (<1.6g).
- While specific IgE showed higher sensitivity than SPT, both tests had low specificity and predictive values, deeming them unsuitable for definitive wheat allergy diagnosis.
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