Wheat allergy in children - new tools for diagnostics.

Area of Science:

• Food allergy diagnostics
• Immunology
• Pediatric allergy

Background:

• Wheat allergy diagnosis in children is challenging.
• Limited data exists on reliable wheat allergens for predicting clinical reactivity.

Purpose of the Study:

• To assess the role of specific wheat allergenic components in diagnosing wheat allergy.
• To identify key allergens for predicting clinical reactivity.

Main Methods:

• 108 children with suspected wheat allergy underwent oral wheat challenges.
• Skin prick tests and serum IgE antibody microarray assays were used to assess responsiveness to 12 wheat allergenic components.

Main Results:

• 30% of children had immediate reactions, 27% delayed, and 47% no reactions to wheat.
• Positive IgE responses to multiple allergens (≥5) significantly improved diagnostic accuracy (LR+ 5.10).
• Dimeric alpha-amylase inhibitors (AAI 0.19, LR+ 6.12), gliadins (LR+ 3.57-4.53), and HMW glutenin subunits (LR+ 4.37) were most effective in differentiating immediate reactors.

Conclusions:

• Wheat allergy diagnosis remains complex, even with component-resolved methods.
• Dimeric AAI 0.19 and gliadins are identified as relevant allergens in clinically reactive patients.
• Measuring IgE responses to multiple wheat components can enhance diagnostic accuracy.