<b><i>Introduction:</i></b> Screening for ω-5 gliadin specific IgE antibody (sIgE) has high diagnostic utility in cases of suspected wheat-dependent exercise-induced anaphylaxis (WDEIA); however, negative cases may require confirmatory tests, such as the oral challenge test. Thus, newly identified allergens that can be used for the serological diagnosis of WDEIA are needed. This study aimed to identify additional sIgE biomarkers of WDEIA. <b><i>Methods:</i></b> Forty-two patients with WDEIA (5 negative/37 positive for ω-5 gliadin sIgE) were enrolled. For comparison, 8 patients with immediate-type wheat allergy without WDEIA and 20 healthy controls without wheat allergy were also enrolled. Extracted wheat proteins were separated by 2D-PAGE. Proteins that reacted with serum IgE antibody in 2D Western blotting (2D-WB) were identified using mass spectrometry. Recombinant proteins were synthesized in <i>Escherichia coli</i>, and the antigenicity was tested using ELISA and the basophil activation test. <b><i>Results:</i></b> In 2D-WB, nine proteins reacted with the serum IgE antibody from at least 60% of patients with WDEIA (<i>n</i> ≥ 25/42). ELISA revealed that alpha/beta gliadin MM1 exhibited the highest positive immunoreactivity in 23 of 26 patients who were positive for ω-5 gliadin sIgE (88%) and in 5 of 5 patients who were negative for ω-5 gliadin sIgE (100%). Alpha/beta gliadin MM1 exhibited significantly higher basophil activation in 14 patients with WDEIA when compared to 5 individuals without a wheat allergy. <b><i>Conclusions:</i></b> Alpha/beta gliadin MM1 sIgE exhibited the highest seropositivity, even among patients who were negative for ω-5 gliadin sIgE. The inclusion of alpha/beta gliadin MM1 in allergen-sIgE tests may improve the sensitivity for diagnosing WDEIA.

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Summary Patients with immune thrombocytopenic purpura (ITP) often receive corticosteroids as a first‐line treatment strategy. The ability to predict the therapeutic response to corticosteroids before initiating treatment would reduce the risk of adverse events, but biomarkers of this parameter have not yet been established. Here, in a single‐centre, retrospective, cohort study of 127 ITP patients who received corticosteroids as first‐line treatment, we compared several characteristics and test results between those patients with a favourable response to corticosteroids (responder cohort, n = 68) and those with a poor response to corticosteroids (non‐responder cohort, n = 59) to identify potential biomarkers that were predictive of corticosteroid response. We extracted six factors as indicative of poor response to corticosteroid therapy for ITP: old age (≥81 years) (odds ratio [OR], 2.44; p = 0.02); low platelet count (<9 × 109/L) (OR, 2.25; p = 0.02); high level of platelet‐associated IgG (≥445 ng/107cells) (OR, 3.95; p < 0.01), high platelet distribution width (≥ 14.0 g/dL) (OR, 2.00; p = 0.03), high lymphocyte‐to‐monocyte ratio (≥ 3.52) (OR, 1.40, p = 0.04), and low megakaryocyte count in bone marrow (< 85.5/μl) (OR, 1.72; p = 0.04). Thus, our present data support the fact that these six factors are useful biomarkers for predicting corticosteroid response in patients with ITP.

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