Introduction and Objectives

Wheat and cereal grains have a broad range of cross-reactivity, but the clinical relevance of this cross-reactivity is uncertain. This study aimed to evaluate clinical and in vitro cross-reactivity with barley, oat, and Job’s tears among wheat-allergic patients.

Materials and Methods

Patients aged 5 to 15 years with IgE-mediated wheat allergy were enrolled. Skin prick test (SPT) and specific IgE (sIgE) to wheat, barley, and oat, and SPT to Job’s tears were performed. Oral food challenge (OFC) was conducted if the SPT was ≤5 mm in size and there was no history of anaphylaxis to each grain. Profiles of sIgE bound allergens of wheat, barley, and oat, and inhibition ELISA of IgE binding to barley and oat with wheat were performed.

Results

Ten patients with a median age of 8 years were enrolled. Nine of those patients had a history of wheat anaphylaxis. The median SPT size and sIgE level to wheat was 7.3 mm and 146.5 kU_A/l, respectively. The cross-reactivity rate for barley, oat, and Job’s tears was 60.0%, 33.3%, and 20.0%, respectively. Significantly larger SPT size and higher sIgE level were observed in patients with positive cross-reactivity to barley and oat when compared to patients without cross-reactivity. Barley and oat extracts inhibited 59% and 16% of sIgE bound to wheat gliadins and glutenins, respectively.

Conclusion

The cross-reactivity rate was quite low for oat and Job’s tears compared to that of barley; therefore, avoidance of all cereal grains may be unnecessary in patients with severe wheat allergy.

中文翻译：

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谷物在 IgE 介导的小麦过敏儿童中的临床和体外交叉反应。

简介和目标

小麦和谷物具有广泛的交叉反应性，但这种交叉反应性的临床相关性尚不确定。本研究旨在评估小麦过敏患者与大麦、燕麦和工作泪液的临床和体外交叉反应。

材料和方法

招募了 5 至 15 岁患有 IgE 介导的小麦过敏症的​​患者。对小麦、大麦和燕麦进行皮肤点刺试验 (SPT) 和特异性 IgE (sIgE)，对约伯的眼泪进行 SPT。如果 SPT 大小≤ 5 mm 且对每粒谷物没有过敏反应史，则进行口服食物激发试验 (OFC)。进行了小麦、大麦和燕麦的 sIgE 结合过敏原的概况，以及对小麦、大麦和燕麦的 IgE 结合的抑制 ELISA。

结果

招募了 10 名中位年龄为 8 岁的患者。其中 9 名患者有小麦过敏史。小麦的中值 SPT 大小和 sIgE 水平分别为 7.3 mm 和 146.5 kU _A /l。大麦、燕麦和乔布氏眼泪的交叉反应率分别为 60.0%、33.3% 和 20.0%。与没有交叉反应的患者相比，在对大麦和燕麦有阳性交叉反应的患者中观察到显着更大的 SPT 大小和更高的 sIgE 水平。大麦和燕麦提取物分别抑制了 59% 和 16% 的 sIgE 与小麦醇溶蛋白和谷蛋白结合。

结论

与大麦相比，燕麦和约伯的眼泪的交叉反应率相当低；因此，对于严重小麦过敏的患者，避免所有谷物可能是不必要的。