[Gluten] Wheat allergy

Wheat-dependent, exercise-induced anaphylaxis FDEIA
is known as a distinct form of allergic reaction induced over several hours by the ingestion of a causative food and subsequent physical exercise. Wheat is the most widely reported among a number of foods associated with FDEIA. Patients with wheat-dependent, exercise-induced anaphylaxis (WDEIA) display a wide range of clinical symptoms from local or generalized urticaria
to dyspnea, hypotension, collapse, and shock.
However, the suspicion and diagnosis of FDEIA is difficult because the amount of wheat ingested as well as the degree of exercise needed to provoke symptoms vary greatly. Apart from exercise, various factors, such as aspirin, can also be triggers. There are occasions when more than two triggers, such as exercise and cold stimulation, are needed to provoke the symptoms in WDEIA.

Allergens involved in wheat allergy

Wheat proteins are categorized into four fractions on the basis of their solubility in a series of solvents: water(albumins), dilute salt solutions (globulins), aqueous alcohol (gliadins), and dilute alkali or acid (glutelins).
There is a clear overlap between the spectra of proteins responsible for diverse clinical conditions of wheat food allergy. However, regarding the allergens involved in wheat food allergy, allergic responses to the ingestion of wheat can be divided into two clinical types. WDEIA is mainly associated with gluten, particularly v-5 gliadins and high-molecular-weight (HMW) glutenin subunits. Other responses that include classic food allergy and atopic dermatitis relate to a wide range of water/salt-soluble and insoluble wheat proteins.