Food-dependent exercise-induced anaphylaxis -importance of omega-5 gliadin and HMW-glutenin as causative antigens for wheat-dependent exercise-induced anaphylaxis-

Allergol Int. 2009 Dec;58(4):493-8. doi: 10.2332/allergolint.09-RAI-0125. Epub 2009 Oct 25.


Food-dependent exercise-induced anaphylaxis (FDEIA) is a special form of food allergy where a food-intake alone does not induce any symptoms. However, allergic symptoms are elicited when triggering factors such as exercise or aspirin-intake are added after ingestion of the causative food. The most frequent causative foodstuff in Japan is wheat. The triggering factors, both exercise and aspirin-intake, facilitate allergen absorption from the gastrointestinal tract, resulting in allergic symptoms in the patients with wheat-dependent exercise-induced anaphylaxis (WDEIA). Analysis using purified wheat proteins revealed that approximately 80% of the patients with WDEIA have IgE reacting to omega-5 gliadin and the remaining of the patients to high molecular weight glutenin (HMW-glutenin). Simultaneous measurement of specific IgE to omega-5 gliadin and HMW-glutenin was found to be highly useful in diagnosing WDEIA compared with the routine diagnostic system for wheat.

Publication types

  • Review

MeSH terms

  • Allergens / immunology
  • Anaphylaxis / complications
  • Anaphylaxis / diagnosis
  • Anaphylaxis / immunology*
  • Antigens, Plant / immunology
  • Asthma, Exercise-Induced / complications
  • Asthma, Exercise-Induced / diagnosis
  • Asthma, Exercise-Induced / immunology*
  • Food / adverse effects
  • Gastrointestinal Tract / metabolism
  • Gliadin / immunology
  • Glutens / immunology
  • Humans
  • Immunoglobulin E / metabolism
  • Immunologic Tests
  • Wheat Hypersensitivity / complications
  • Wheat Hypersensitivity / diagnosis
  • Wheat Hypersensitivity / immunology*


  • Allergens
  • Antigens, Plant
  • omega-5 gliadin, wheat
  • Immunoglobulin E
  • Glutens
  • Gliadin
  • glutenin