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Wheat allergy: a double-blind, placebo-controlled study in adults.
J Allergy Clin Immunol. 2006 Feb; 117(2):433-9.JA

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 < or =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.

Authors+Show Affiliations

Unit of Allergology and Clinical Immunology, Azienda Ospedaliera Niguarda Hospital, Milan, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Controlled Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16461145

Citation

Scibilia, Joseph, et al. "Wheat Allergy: a Double-blind, Placebo-controlled Study in Adults." The Journal of Allergy and Clinical Immunology, vol. 117, no. 2, 2006, pp. 433-9.
Scibilia J, Pastorello EA, Zisa G, et al. Wheat allergy: a double-blind, placebo-controlled study in adults. J Allergy Clin Immunol. 2006;117(2):433-9.
Scibilia, J., Pastorello, E. A., Zisa, G., Ottolenghi, A., Bindslev-Jensen, C., Pravettoni, V., Scovena, E., Robino, A., & Ortolani, C. (2006). Wheat allergy: a double-blind, placebo-controlled study in adults. The Journal of Allergy and Clinical Immunology, 117(2), 433-9.
Scibilia J, et al. Wheat Allergy: a Double-blind, Placebo-controlled Study in Adults. J Allergy Clin Immunol. 2006;117(2):433-9. PubMed PMID: 16461145.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Wheat allergy: a double-blind, placebo-controlled study in adults. AU - Scibilia,Joseph, AU - Pastorello,Elide A, AU - Zisa,Giuliana, AU - Ottolenghi,Anna, AU - Bindslev-Jensen,Carsten, AU - Pravettoni,Valerio, AU - Scovena,Elena, AU - Robino,Anna, AU - Ortolani,Claudio, PY - 2005/07/04/received PY - 2005/10/12/revised PY - 2005/10/12/accepted PY - 2006/2/8/pubmed PY - 2006/3/24/medline PY - 2006/2/8/entrez SP - 433 EP - 9 JF - The Journal of allergy and clinical immunology JO - J. Allergy Clin. Immunol. VL - 117 IS - 2 N2 - 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 < or =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. SN - 0091-6749 UR - https://www.unboundmedicine.com/medline/citation/16461145/Wheat_allergy:_a_double_blind_placebo_controlled_study_in_adults_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091-6749(05)02269-4 DB - PRIME DP - Unbound Medicine ER -