J Allergy Clin Immunol
Department of Dermatology, Hospital for Skin and Allergic Diseases, University of Helsinki, Helsinki, Finland.
Published: June 2003
Background: Patients with wheat-dependent, exercise-induced anaphylaxis (WDEIA) experience recurrent anaphylactic reactions when exercising after ingestion of wheat products. We have identified omega-5 gliadin (Tri a 19) as a major allergen in WDEIA, but the role of exercise in eliciting the symptoms remains obscure.
Objective: The aim was to examine whether tissue transglutaminase (tTG)-mediated cross-linking could be involved in modulating the IgE-binding ability and in vivo reactivity of digested omega-5 gliadin peptides in WDEIA.
Methods: Purified omega-5 gliadin was digested with pepsin or with pepsin and trypsin and treated with tTG. The binding of IgE antibodies in pooled sera from 10 patients with WDEIA was studied by means of immunoblotting before and after tTG treatment of the digested peptides. The peptides derived from pepsin digestion were separated by means of gel-filtration chromatography, and IgE reactivity of 4 different peptide fractions was studied by immunoblotting before and after tTG treatment. The fraction showing the greatest degree of cross-linking by tTG was further studied by means of IgE ELISA, ELISA inhibition, and skin prick testing.
Results: The IgE-binding ability of omega-5 gliadin was retained after pepsin and pepsin-trypsin digestion. tTG treatment of the whole peptic digest formed large peptide complexes, with molecular weights ranging from 40 to greater than 200 kd. These cross-linked aggregates bound IgE antibodies in immunoblotting more intensely than untreated, pepsin-digested, or pepsin-trypsin-digested omega-5 gliadin. A gel-filtration fraction of the whole peptic digest corresponding to the highest peak of the chromatogram and showing the greatest degree of tTG-mediated cross-linking showed an increase in serum IgE reactivity in ELISA after tTG treatment, as well as a shift of reactivity to cross-linked complexes. In the 20 patients with WDEIA, the mean skin prick test wheal elicited by this tTG-treated peptic fraction was 77% larger (P <.001) than that elicited by the untreated peptic fraction and 56% larger (P <.01) than that elicited by intact omega-5 gliadin.
Conclusions: Omega-5 gliadin-derived peptides are cross-linked by tTG, which causes a marked increase in IgE binding both in vitro and in vivo. Activation of tTG during exercise in the intestinal mucosa of patients with WDEIA could lead to the formation of large allergen complexes capable of eliciting anaphylactic reactions.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1067/mai.2003.1498 | DOI Listing |
Yonsei Med J
January 2025
Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.
Screening tests for specific immunoglobulin E (sIgE) to food allergens, such as the multiple allergen simultaneous test (MAST), are widely used in patients with suspected food allergies in South Korea. We evaluated whether MAST could effectively screen wheat-dependent exercise-induced anaphylaxis (WDEIA) and α-gal syndrome (AGS). We retrospectively reviewed patients with WDEIA and AGS diagnosed with unequivocal history and positive sIgE results for omega-5 gliadin and α-gal using ImmunoCAP, respectively.
View Article and Find Full Text PDFPostepy Dermatol Alergol
October 2024
Special Hospital for Pulmonary Diseases, Zagreb, Croatia.
Introduction: 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.
Aim: The study examines the frequency of sensitisation to these allergens and their clinical significance in individuals with CU.
Zhonghua Yu Fang Yi Xue Za Zhi
November 2024
Department of Clinical Laboratory of the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou510120, China.
Front Allergy
October 2024
Allergy and Immunology Division, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.
Idiopathic anaphylaxis (IA) is a severe allergic reaction without identifiable external triggers, presenting significant challenges in diagnosis and management. However, growing evidence suggests that many cases classified as idiopathic may actually be driven by cofactors such as exercise, hormonal fluctuations, medications, or hidden allergens. This mini-review explores the evolving understanding of IA, highlighting the role of these cofactors in triggering or amplifying anaphylactic reactions.
View Article and Find Full Text PDFFront Allergy
September 2024
Department of Allergy, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China.
Exercise-induced anaphylaxis (EIA) is a rare and potentially life-threatening disorder. In difficult to control and refractory cases of EIA, biologics such as omalizumab and dupilumab have shown promise, with documented successful outcomes. Here, we present a case of EIA with lipid transfer protein (LTP) sensitization successfully treated with omalizumab with long-term follow-up.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!
© LitMetric 2025. All rights reserved.