Asthma induced by inhalation of flour in adults with food allergy to wheat

Abstract

For the first time, it has been shown that specific bronchial reactivity to wheat proteins can be detected in patients with different disorders associated with food allergy to wheat. The presence of asthma induced by inhaled flour is not strictly related to occupational exposure and it may also occur in subjects not displaying asthma among symptoms induced by wheat ingestion.

Respiratory Morbidity Induced by Occupational Inhalation Exposure to High Concentrations of Wheat Flour Dust

“…Consistent with other studies [3,26,27,28], respiratory symptoms were found to be significantly more prevalent among exposed subjects (Table 2). Similarly, occupational exposure to flour dust has been reported to lead to reduction of ventilatory capacities [12,13,14,15,16,17]. In accordance with these findings, we have shown that exposure to flour dust resulted in significant reductions in some parameters of pulmonary function such as VC, FVC, FEV 1 , FEV 1 /FVC ratio and PEF.…”

“…They also have a higher degree of nonspecific bronchial responsiveness than control workers [9,10] and exhibit greater variability of lung function during the work week [9]. Studies of occupational exposure to flour dust with pulmonary function tests have shown significant decreases in lung function parameters such as forced vital capacity (FVC), forced expiratory volume in the first second (FEV 1 ), peak expiratory flow (PEF) and maximum voluntary ventilation [12,13,14,15,16,17]. Currently, more than 14 million tonnes of wheat are produced and used, annually, in Iran [18].…”

Anaphylaxis to Wheat Flour-Derived Foodstuffs and the Lipid Transfer Protein Syndrome: A Potential Role of Wheat Lipid Transfer Protein Tri a 14

“…However, different European clinical groups have reported a substantial number of adult subjects with allergy to wheat flour-derived products, including those showing wheat-dependent exercise-induced anaphylaxis, in the last years [3,4,5,6,26]. …”

“…Consequently, the high consumption of wheat-derived foodstuffs has led to its association with food allergies in children [2], and recently, also in adult patients [2,3,4,5,6]. A wide array of wheat flour proteins, both salt-soluble proteins and prolamins, and particularly members of the α-amylase/trypsin inhibitor family and ω5-gliadin (in wheat-dependent exercise-induced anaphylaxis), have been linked to food wheat allergy [3,5,7,8,9].…”

Does Sensitization to Foods in Adults Occur Always in the Gut?

“…Along with the obvious example of baker’s asthma, which never develops into frank food allergy due to the heat-sensitivity of the relevant allergenic protein(s) (in effect, cases of frank food allergy after ingesting meals contaminated by uncooked wheat flour are reported [72]), there are several other examples of airborne sensitization to grains followed by food allergy. Similarly to sunflower seed, millet may cause severe food allergy in bird keepers, following sensitization by inhalation [73].…”