Update of immunoglobulin E-mediated wheat allergy

Wheat allergy is one of the common causes of food allergies in children. The prevalence varies by age and country, and is known to be 0.04%-0.97% globally and 0.2%-1.3% in Korea. Wheat allergy usually appears with skin symptoms within 2 hours after ingestion, and in severe cases, it causes systemic symptoms and anaphylaxis. Wheat-dependent exercise-induced anaphylaxis, a serious wheat allergy, may occur after wheat consumption along with cofactors, such as exercise, alcohol, aspirin and/or nonsteroidal anti-inflammatory drugs. Wheat allergy is confirmed by oral food challenge. However, the challenging test is difficult to perform, although it is a confirmative diagnostic method. With the development of component resolved diagnostics, omega-5 gliadin specific immunoglobulin E (sIgE) along with wheat sIgE are useful for diagnosis of it. Wheat allergy should be differentiated from oral mite anaphylaxis or crossreactivity to grass pollen allergy. It is recommended to avoid foods containing wheat, however, recently, efforts are being made to improve quality of life with oral immunotherapy. (Allergy Asthma Respir Dis 2024;12:9-16)