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

J Allergy Clin Immunol. 2006 Feb;117(2):433-9. doi: 10.1016/j.jaci.2005.10.014.


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.

Publication types

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

MeSH terms

  • Adolescent
  • Adult
  • Allergens / administration & dosage
  • Allergens / adverse effects*
  • Allergens / immunology
  • Denmark
  • Double-Blind Method
  • Female
  • Humans
  • Immunoglobulin E / blood
  • Italy
  • Male
  • Middle Aged
  • Placebos
  • Predictive Value of Tests
  • Skin Tests
  • Triticum / adverse effects*
  • Triticum / immunology
  • Wheat Hypersensitivity / diagnosis*
  • Wheat Hypersensitivity / physiopathology*


  • Allergens
  • Placebos
  • Immunoglobulin E