Wheat allergy, also known as wheat hypersensitivity is most commonly a food allergy, but can also be a respiratory or contact allergy resulting from occupational exposure. Like all allergies wheat allergy involves IgE and mast cell response.
Typically the allergy is limited to the seed storage proteins of wheat, some reactions are restricted to wheat proteins, while others can react across many varieties of seeds and other plant tissues. Wheat allergy may be a misnomer since there are many allergenic components in wheat, for example serine proteinase inhibitors, glutelins and prolamins and different responses are often attributed to different proteins. The most severe response is exercise/aspirin induced anaphylaxis attributed to one omega gliadin that is a relative of the protein that causes coeliac disease. Other more common symptoms include nausea, urticaria, atopy.
Types of allergens
There are four major classes of seed storage proteins: albumins, globulins, prolamins and glutelins. Within wheat prolamins are called gliadins and glutelins are called glutenins. These two protein groups form the classic glutens. While gluten is a causative agent of Coeliac disease (CD), coeliac disease can be contrasted to gluten allergy by the involvement of different immune cells and antibody types (See Comparative pathophysiology of gluten sensitivities), and because the list of allergens extend beyond the classic gluten category of proteins.
Hyposensitization (or allergy desensitization) is a form of immunotherapy in which the patient is vaccinated with progressively larger doses of an allergen to which they have been diagnosed as being sensitive. Hyposensitization can either reduce the severity of symptoms or eliminate hypersensitivity altogether.
Immunotherapy or desensitization therapy for allergies must not be confused with homeopathic treatments. Immunotherapy administered through cutaneous injections or sublingually has substantial empirical support. Numerous research articles and several meta-analytic studies support its clinical effectiveness. Conversely, homeopathy (or Rinkel immunotherapy) is not generally endorsed by the medical profession as it lacks substantial empirical support. In addition, the perceived similarity between how the two treatments “work” is entirely superficial. Homeopathic treatment claims to gain efficacy as concentration decreases; desensitization therapy aims to increase the patient’s tolerance to allergens, and thus increases the dosage used in order to be more effective, though this must be done slowly.
An elimination diet is a method of identifying foods that an individual cannot consume without adverse effects. Adverse effects may be due to food allergy, food intolerance, other physiological mechanisms[citation needed], or a combination of these. When the mechanism is unknown, but a food is suspected, the mechanism may be described as a food sensitivity or a food hypersensitivity. Elimination diets typically involve entirely removing a suspected food from the diet for a period of time from two weeks to two months, and seeing whether symptoms resolve during that time.
Common reasons for undertaking an elimination diet include suspected food allergies and suspected food intolerances. An elimination diet might remove one or more common foods, such as eggs or milk, or it might remove one or more minor or non-nutritive substances, such as artificial food colorings.
An elimination diet relies on trial and error to identify specific allergies and intolerances. Typically, if symptoms resolve after the removal of a food from the diet, then the food is reintroduced to see whether the symptoms reappear. This challenge-dechallenge-rechallenge approach is particularly useful in cases with intermittent or vague symptoms.
The elimination diet is a diagnostic tool or method used to determine whether patients symptoms are food related. The term is sometimes used incorrectly to describe a diet which eliminates certain foods for a patient; this type of diet is more correctly called a treatment diet.
When an allergen such as pollen or dust is inhaled by a person with a sensitized immune system, it triggers antibody production. These antibodies mostly bind to mast cells, which contain histamine. When the mast cells are stimulated by pollen and dust, histamine (and other chemicals) are released. This causes itching, swelling, and mucus production. Symptoms vary in severity from person to person. Very sensitive individuals can experience hives or other rashes. Particulate matter in polluted air and chemicals such as chlorine and detergents, which can normally be tolerated, can greatly aggravate the condition.