Evaluation of IgE Sensitization Profiles in a Pediatric Population with Wheat Allergy.

Introduction: IgE-mediated reactions to wheat can occur after ingestion, inhalation, contact or exercise. Among wheat allergens, Tri a14 and Tri a19 not only cause food allergy, but also baker's asthma (Tri a4) and exercise-induced anaphylaxis (Tri a19). Despite the prevalence of adverse reactions, few studies have been conducted in children. Aim: To evaluate the pattern of sensitization to wheat allergenic components in a group of pediatric patients with sIgE to wheat referring to the Pediatric Allergy Unit of University of Bologna. Materials and Methods: Patients were assessed by skin prick-test and serum specific IgE against pollens, wheat, gluten and the molecular allergens rTri a19 and rTri a14. The diagnosis was confirmed with open food challenges. Results: The diagnosis of wheat allergy was confirmed in 7 patients (64%), of whom 2 (29%) suffered also from grass pollen allergy. The levels of specific IgE (geometric mean) to wheat and gluten were 5 times higher in allergic patients compared to tolerant ones. The comparison between the patterns of sensitization showed a higher prevalence of sensitization against gluten (100% vs. 75% in tolerant patients) and the molecular components rTri a14 (71% vs. 25%) and rTri a19 (71% vs. 0%) in the wheat-allergic group. Positive predictive value for rTria a19 was higher than rTri a14 (100% vs. 83%). Conclusion: Patients with wheat allergy have different profiles of sensitization than the tolerant ones; in particular rTri a19 showed a higher positive predictive value than rTri a14. These findings need to be confirmed in a larger population.