Grass-Allergic Children Frequently Show Asymptomatic Low-Level IgE Co-Sensitization and Cross-Reactivity to Wheat

Int Arch Allergy Immunol. 2018;177(2):135-144. doi: 10.1159/000489610. Epub 2018 Jun 12.

Abstract

Background: Specific immunoglobulin E (IgE) sensitization to wheat is more common than a doctor's confirmed wheat allergy and is also frequently observed in grass pollen-allergic patients (pollinosis patients). Thus, the objective of this study was to investigate the level and feature of serological IgE cross-reactivity between grass pollen and wheat in a cohort of pollinosis subjects with no diagnosis of wheat allergy.

Methods: Seventy-two children, aged 5-17 years, with a doctor's diagnosis of pollinosis, IgE towards grass pollen, and currently eating wheat were recruited. Serum samples were analyzed for IgE against wheat, timothy grass/wheat-specific allergen components, Pru p 3, and cross-reactive carbohydrate determinants (CCD) and specific IgE-binding inhibition experiments were performed.

Results: Sixty percent of the grass pollen subjects were sensitized to wheat with a median of 0.5 kUA/L. Wheat-sensitized subjects were more often sensitized to the two allergens, Phl p 12 and CCD, known to be cross-reactive between grass and wheat. Sensitizations to seven wheat-specific allergens derived from the gluten fraction were, with the exception of one individual, only found in wheat-sensitized subjects. These subjects also more often reported current and past history of allergy to staple foods (milk, egg, wheat, soy, and fish).

Conclusion: Wheat sensitization caused by cross-reactivity but also by sensitization to wheat-specific allergens was common in the grass-allergic children and also associated with allergy to staple foods other than wheat. The results indicate the presence of a subgroup of pollinosis patients with simultaneous sensitization to wheat and food allergy not only caused by cross-reactions.

Keywords: Allergy; Children; Cross-reactivity; Grass; Immunoglobulin E; Inhibition; Wheat.

MeSH terms

  • Adolescent
  • Allergens / immunology*
  • Child
  • Child, Preschool
  • Cross Reactions*
  • Female
  • Humans
  • Hypersensitivity / complications*
  • Immunoglobulin E / blood*
  • Immunoglobulin E / immunology
  • Male
  • Phleum / immunology
  • Poaceae / immunology*
  • Triticum / immunology*
  • Wheat Hypersensitivity / complications*

Substances

  • Allergens
  • Immunoglobulin E