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

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 kU_A/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.

Male sex is strongly associated with IgE-sensitization to airborne but not food allergens: results up to age 24 years from the BAMSE birth cohort

“…Part of the association between IgE-sensitization to shrimp and peanut among males is probably explained by serological IgE cross-reactivity with house dust mites and birch, respectively 33,34 . Similarly, some of the sex differences regarding wheat sensitization at age 24 years found in our study could likely be explained by serological IgE cross-reactivity with timothy 35 . The discrepancy regarding the associations between sex and IgEsensitization to foods and airborne allergens we found is intriguing and can probably not be explained by general differences in allergen exposure, although we know that the intake of some dietary components, such as antioxidants, may differ between males and females 36 .…”

A robust method for the estimation and visualization of IgE cross-reactivity likelihood between allergens belonging to the same protein family

“…Tests including multiplex platforms provide a great body of information concerning IgE binding to individual allergens. Understanding the cross-reactivity of individual allergenic proteins may help in explaining the results of allergy testing [257, 267]. Therefore, we are convinced that the A-RISC index can be used in the interpretation of results originating from component resolved allergy diagnostics.…”

Recent Advances in Clinical Allergy and Immunology

“…Interestingly, wheat sensitization was caused by both cross-reactivity and cosensitization to wheat-specific allergens, and was associated with allergy to staple foods other than wheat [18]. …”