Epidemiology of wheat allergy
The reported prevalence of adverse reactions to wheat and gluten has escalated in recent years, as demonstrated by the rise in sales and distribution of wheat free food products across the world.
There is a lack of information about the true prevalence of food challenge proven wheat allergy. The few published studies utilising this method, estimate a wheat allergy prevalence of 0.1 – 0.6% in Europe [1-5]. The prevalence of wheat intolerance is unknown, primarily because of the difficulty of studying this due to the lack of clear definitions and the delayed and often subjectivity of the reactions.
Wheat – a complex grainWheat is a complex food containing cross-reacting proteins to both other cereals and pollens. Wheat and cereals are composed of four classes of proteins; the water/salt soluble albumins and globulins and the water/salt insoluble gliadins and glutenins, which together are known as prolamins/gluten. Of these, there are two major proteins considered to lead to adverse reactions, the lipid transfer protein (LTP) and the omega-5 gliadins (both considered to be prolamins or seed storage proteins) . It is important to take these factors into account when performing tests to confirm a wheat allergy: Wheat is a grass and the profilins in wheat are likely to cross-react with grass; not indicating the likelihood of reaction to consumption of wheat [7-9]. Wheat also contains a number of proteins that may cross-react with rye and barley and allergies to these should therefore be ruled out before diagnosing a wheat allergy.
- Osterballe, M., Hansen, T. K., Mortz, C. G., Host, A. and Bindslev-Jensen, C. (2005) 'The prevalence of food hypersensitivity in an unselected population of children and adults', Pediatr Allergy Immunol, 16(7), 567-73.
- Zuberbier, T., Edenharter, G., Worm, M., Ehlers, I., Reimann, S., Hantke, T., Roehr, C. C., Bergmann, K. E. and Niggemann, B. (2004) 'Prevalence of adverse reactions to food in Germany - a population study', Allergy, 59(3), 338-45.
- Venter, C., Pereira, B., Grundy, J., Clayton, C. B., Arshad, S. H. and Dean, T. (2006) 'Prevalence of sensitization reported and objectively assessed food hypersensitivity amongst six-year-old children: a population-based study', Pediatr Allergy Immunol, 17(5), 356-63.
- Venter, C., Pereira, B., Voigt, K., Grundy, J., Clayton, C. B., Higgins, B., Arshad, S. H. and Dean, T. (2008) 'Prevalence and cumulative incidence of food hypersensitivity in the first 3 years of life', Allergy, 63(3), 354-9.
- Ronchetti, R., Jesenak, M., Trubacova, D., Pohanka, V. and Villa, M. P. (2008) 'Epidemiology of atopy patch tests with food and inhalant allergens in an unselected population of children', Pediatr Allergy Immunol, 19(7), 599-604.
- Nam YH, Hwang EK, Jin HJ, Lee JM, Shin YS, Ye YM, Palacin A, Salcedo G, Lee SY, Park HS. Comparison of specific IgE antibodies to wheat component allergens in two phenotypes of wheat allergy. J Korean Med Sci. 2013 Nov;28(11):1697-9.
- Donovan GR, Baldo BA. Crossreactivity of IgE antibodies from sera of subjects allergic to both ryegrass pollen and wheat endosperm proteins: evidence for common allergenic determinants. Clin Exp Allergy 1990;20:501–509.
- Jones SM, Magnolfi CF, Cooke SK, Sampson HA. Immunologic cross-reactivity among cereal grains and grasses in children with food hypersensitivity. JAllergy Clin Immunol 1995;96:341–351.
- Sander I, Raulf-Heimsoth M, Duser M, Flagge A, Czuppon AB, Baur X. Differentiation between cosensitization and cross-reactivity in wheat flour and grass pollen-sensitized subjects. IntArch Allergy Immunol 1997;112:378–385.