Concept

Wheat allergy

Summary
Wheat allergy is an allergy to wheat which typically presents itself as a food allergy, but can also be a contact allergy resulting from occupational exposure. Like all allergies, wheat allergy involves immunoglobulin E and mast cell response. Typically the allergy is limited to the seed storage proteins of wheat. Some reactions are restricted to wheat proteins, while others can react across many varieties of seeds and other plant tissues. Wheat allergy is rare. Prevalence in adults was found to be 0.21% in a 2012 study in Japan. Wheat allergy may be a misnomer since there are many allergenic components in wheat, for example serine protease inhibitors, glutelins and prolamins and different responses are often attributed to different proteins. Twenty-seven potential wheat allergens have been successfully identified. The most severe response is exercise/aspirin-induced anaphylaxis attributed to one omega gliadin that is a relative of the protein that causes celiac disease. Other more common symptoms include nausea, urticaria, and atopy. Gluten sensitivity and Coeliac disease are two different diseases even if the management could be similar. Management of wheat allergy consists of complete withdrawal of any food containing wheat and other gluten-containing cereals (gluten-free diet). There are four major classes of seed storage proteins: albumins, globulins, prolamins and glutelins. Within wheat, prolamins are called gliadins and glutelins are called glutenins. These two protein groups form the classic glutens. While gluten is also the causative agent of celiac disease (CD), celiac disease can be contrasted to gluten allergy by the involvement of different immune cells and antibody types (See Comparative pathophysiology of gluten sensitivities), and because the list of allergens extend beyond the classic gluten category of proteins. Gluten sensitivity Prolamins and the closely related glutelins, a recent study in Japan found that glutenins are a more frequent allergen, however gliadins are associated with the most severe disease.
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