Sensitization to α-gal and omega-5-gliadin in patients with chronic urticaria: clinical implications and need for...

Chronic urticaria (CU) is defined as the presence of recurring hives and/or angioedema lasting more than 6 weeks. The precise impact of food allergies, particularly to galactose-α-1,3-galactose (α-gal) and omega-5-gliadin (O5G), on the development of CU is not well established.

The study examines the frequency of sensitisation to these allergens and their clinical significance in individuals with CU.

We recruited 100 adults newly diagnosed with CU to evaluate the presence of specific immunoglobulin E antibodies and allergies to α-gal and O5G. The patients were categorised into three groups based on their specific IgE levels: those sensitised to α-gal, those sensitised to O5G, and those not sensitised to either. Demographic, clinical, and laboratory variables were compared across the groups.

The findings indicated that 5% of the cohort was sensitised to α-gal, and 4% showed sensitivity to O5G, while only 4% of patients had a convincing history of food allergy (two to red meat and two to wheat). The sensitised groups exhibited the greatest levels of total IgE, and had a higher proportion of males. The α-gal group showed higher levels of specific IgE to Ascaris lumbricoides than the group without sensitisation. The groups had similar features in all other assessed aspects.

Our CU cohort's sensitivity and convincing food allergy to α-gal and O5G were comparatively modest. While routine screening may not be essential, focused testing of individuals with severe or uncommon symptoms might enhance the accuracy of diagnosis and treatment.