Wheat allergy: A double-blind, placebo-controlled study in adults

Joseph Scibilia, Elide A. Pastorello, Giuliana Zisa, Anna Ottolenghi, Carsten Bindslev-Jensen, Valerio Pravettoni, Elena Scovena, Anna Robino, Claudio Ortolani

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Wheat is believed to be an uncommon cause of food allergy in adults; the number of studies that address IgE mediated wheat allergy in adults is all too few. Objective: Determine how many subjects with a history of wheat allergy have real allergy by double-blind, placebo-controlled food challenge; identify the symptoms manifested during the challenge; determine the lowest provocation dose; determine the performance characteristics of wheat skin prick test and specific IgE; identify subjects with real wheat allergy for potential immunoblotting studies. Methods: Patients underwent skin test with commercial wheat extract; specific wheat IgE was determined. Subjects were challenged with 25 g wheat. Subjects who were positive to raw wheat challenge underwent cooked wheat challenge. Results: Thirty-seven double-blind placebo-controlled wheat challenges were performed on 27 patients. A total of 13 of 27 (48%) patients had a positive result. Eleven subjects with positive raw wheat challenge underwent cooked wheat challenge: 10 were positive. The provocation dose range was 0.1 to 25 g. Twenty-seven percent of the subjects allergic to wheat had a provocation dose that was ≤1.6 g. Conclusion: Wheat causes real food allergy in adults. More than a quarter of the patients allergic to wheat reacted to less than 1.6 g wheat. Specific IgE was more sensitive than skin test for wheat; however, specificity and predictive values were low for both tests. Thus, these tests should not be used to validate diagnosis of wheat allergy.

Original languageEnglish
Pages (from-to)433-439
Number of pages7
JournalJournal of Allergy and Clinical Immunology
Volume117
Issue number2
DOIs
Publication statusPublished - Feb 2006

Keywords

  • Anaphylaxis
  • Double-blind
  • Exercise-induced
  • Food allergy
  • Hypersensitivity
  • Performance characteristics
  • Placebo-controlled food challenge
  • Provocation dose
  • Symptoms
  • Wheat allergy

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy

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