Allergy Sensitization Research Articles

Childhood food allergy and food allergen sensitisation are associated with adult airways disease: A birth cohort study.

Childhood food allergy (FA) and food allergen sensitization (FAS) are associated with allergic airway disease(s) [AAD] (asthma and rhinitis) in childhood. However, the associations between childhood FA/FAS and AAD in adulthood are not well described. We investigated the longitudinal relationship between childhood FA/FAS to common food allergens and AAD at 18 and 26years, in the Isle of Wight birth cohort. Study subjects (N=1456) were followed up at fixed time points from ages 1-26years for FA/FAS status. AAD were evaluated from 4years onwards. The associations between FA/FAS and AAD were assessed with univariate analyses and then multivariable logistic regression, adjusting for clinically relevant co-variates. Food allergy at 4years was significantly associated with asthma at 18years [adjusted odds ratio (aOR): 2.75, 95% CI: 1.53-4.92, p=.001] and 26years (aOR: 2.62, 95% CI: 1.32-5.20, p=.006). Conversely, childhood FA was not associated with adulthood rhinitis whatsoever. While FAS at ages 4 and 10 were associated with both AAD, the associations between FAS and rhinitis were less robust relative to asthma. Childhood FA increased the odds of asthma during adulthood by nearly threefold. Additionally, childhood FAS was also associated with increased odds of asthma in adulthood. Conversely, FAS but not FA in childhood was associated with rhinitis in adulthood. We suggest that children with FA/FAS should be followed up to facilitate early detection and intervention of subsequent AAD, particularly asthma.

Comprehensive proteome analysis of bread deciphering the allergenic potential of bread wheat, spelt and rye

Background/ObjectivesCereal products like flour and bread are known to trigger diseases such as wheat allergy, celiac disease and non-celiac wheat sensitivity (NCWS). Some of these diseases are caused by allergenic proteins, the expression of which might vary depending on the grain type and manufacturing processes. Therefore, we examined the protein composition and abundance of potentially allergenic proteins in flours from bread wheat, spelt and rye, and corresponding breads. Materials and methodsUsing Nano-LC-ESI-MS/MS and label free quantification (LFQ) we analyzed the proteome of six different bread flours (wholegrain and superfine flours from rye, spelt and bread wheat) and 14 bread types (yeast and sourdough fermented breads from all flours and wheat breads plus/minus bread improver). Potentially allergenic proteins in flours and breads were functionally categorized using the Pfam database and relatively quantified by LFQ. ResultsWe could show that almost equal numbers of proteins can be identified in rye- and spelt samples compared to wheat samples using the Uniprot bread wheat protein database, indicating high sequence conservation between cereals. In total, 4424 proteins were identified in the 20 flour and bread samples. The average number of identified proteins in flour (2719 ± 243) was slightly higher than in bread (2283 ± 232; P < 0.001). In wheat- and spelt wholegrain flour higher protein numbers (wheat: 2891 ± 90; spelt: 2743 ± 140) were identified on average than in superfine flour (wheat: 2562 ± 79; P = 0.009; spelt: 2431 ± 140; P = 0.004). Neither the absolute number nor the abundance distribution of potentially allergenic proteins were dependent on the flour type or the fermentation process, but known allergenic proteins like gliadins showed higher relative abundance in spelt- and wheat samples, compared to rye samples. ConclusionWe provide comprehensive proteome data for six flour types and related breads showing that the grain species have greater influence on proteome composition than milling and fermentation processes. Our data indicate that allergenic proteins are not selectively degraded during bread production and are more abundant in bread wheat and spelt compared to rye. SignificanceOur proteomics study revealed that bread contains a number of potentially and proven allergenic proteins. Most likely allergenicity is not dependent on milling or conventional fermentation processes, but on the grain type. Relative abundance of allergenic proteins was higher in spelt- and wheat samples than in rye samples. Considering rye bread as better suited to atopic individuals predisposed to react to cereal allergens, clinical trials are warranted to verify this assumption.

Thermal processing of insect allergens and IgE cross-recognition in Italian patients allergic to shrimp, house dust mite and mealworm

Edible insects are considered as a promising and sustainable alternative protein source for humans, although risk assessments, with particular reference to the allergic potential of insect proteins, are required. Considering that insects are likely to be consumed after processing, it is crucial to assess how processing can influence allergenicity. In our study, we investigated how boiling and frying affect the IgE cross-recognition of proteins from five edible insects (mealworm, buffalo worm, silkworm, cricket and grasshopper). We considered three groups of Italian patients allergic to shrimps and to house dust mites, who had never consumed insects before and two subjects with occupational allergy and food sensitization to mealworm. Our data suggest that thermal processing may change the solubility of proteins, thereby resulting in a protein shift from water-soluble fractions to water-insoluble fractions. Immunoblot and LC-MS/MS analyses have shown that tropomyosin may play an important role as a cross-allergen for house dust mite and shrimp allergic patients, while larval cuticle protein seems to play a major role in the cross-reactivity of patients primarily sensitized to mealworm.On the basis of our results, the effects of processing appear to be protein-, species- and treatment-specific. Therefore, house dust mite, shrimp and mealworm allergic patients should consume insects with caution, even after thermal processing.

Awareness of Celiac Disease among the General Public in Saudi Arabia

Background: Celiac disease (CD) is an immune-mediated systemic disorder triggered by dietary gluten and is considered one of the most common lifelong food-related disorders worldwide. The knowledge of CD among the general public in Saudi Arabia remains limited. Therefore, we aimed to assess the awareness and knowledge of CD among the general public in Saudi Arabia. Methods: A cross-sectional online survey including members of the general public was conducted in Saudi Arabia. The survey included questions assessing the public’s awareness about CD, gluten sensitivity, and peanut allergy, as well as celiac disease-related knowledge. Results: From a total of 1230 responses received, 76.7% (95% confidence interval [CI], 74.0%–79.4%) were females, 42.0% (95% CI, 37.7–46.3) were aged between 31–45 years, and 64.3% (95% CI, 61.0%–67.6%) had Bachelor’s degree. Less than half of the participants had heard of CD (48.4%; 95% CI, 44.4%–52.4%), but the majority had heard of peanut allergy (80.1%; 95% CI, 77.6%–82.6%) and gluten sensitivity (72.4%; 95% CI, 69.5%–75.3%). The prevalence of CD was estimated incorrectly by more than 80% of participants. Other questions on participants’ knowledge associated with CD were answered “Do not know” by the majority. Females demonstrated a greater awareness of CD, peanut allergy, and gluten sensitivity, and had a higher percentage of correct responses to questions related to CD than males. Conclusion: This study highlights the need to increase the awareness and knowledge of CD, especially in the recognition of its symptoms. Educational efforts toward increasing the awareness of the general public about CD could help optimize its diagnosis and management.

The Relationship Between Lower Respiratory Tract Microbiome and Allergic Respiratory Tract Diseases in Children

Similar to those in the upper respiratory tract, there are microbes present in the healthy human lower respiratory tract (LRT), including the lungs and bronchus. To evaluate the relationship between LRT microbiome and allergic respiratory diseases in children, we enrolled 68 children who underwent bronchoscopy from January 2018 to December 2018 in the affiliated hospital of the Capital Institute of Pediatrics. Using the total IgE (TIgE) values, children were divided into two groups: allergy sensitivity (AS) group and non-allergy sensitivity (NAS) group. Nucleic acid was extracted from samples of bronchoalveolar lavage fluid (BALF) from the two groups of children taken during bronchoscopy treatment and the 16S rDNA gene was sequenced and analyzed. The results showed that Haemophilus, Moraxella, Streptococcus, Prevotella, Neisseria, and Rothia were detected in all patients. There was a statistically significant difference in the composition and distribution of microbiota between the AS and NAS groups (p < 0.01). Analysis of the correlation of clinical indices and microbiome showed that TIgE was positively correlated with Bacteroidetes and negatively correlated with Streptococcus. Absolute lymphocyte count showed a relationship with Streptococcus, and the absolute neutrophil count or percentage of neutrophils showed a relationship with Cardiobacterium. The LRT microbiome functioned similarly to the intestinal microbiome. That is, the decrease in microbial diversity and the change in composition could lead to an increase in allergic symptoms. The microbiome of the LRT in children, especially that of Bacteriodetes and Streptococcus, showed a correlation with respiratory allergic diseases.

Cockroach exposure and its allergy sensitization in asthma patients.

Asthma is a heterogeneous disease with distinct phenotypes. Serum tIgE, SSIgE and SPT are the methods of evaluating allergen sensitization. The present study evaluates the exposure and sensitization to cockroach (Periplaneta americana) antigens in asthma patients in a metropolitan city of India. The study enrolled 200 consecutive bronchial asthma patients, diagnosed as per GINA guidelines. As per history of exposure to cockroaches, the patients are divided in two groups as exposed and non-exposed asthmatic. All the enrolled subjects underwent SPT against common aeroallergens including cockroach, spirometry and estimation of tIgE level and SSIgE against cockroach. Out of 200 asthma patients, a total of 114 (57%) asthmatic were found SPT positive against one of the common aeroallergens, of which 68 (34%) showed SPT sensitivity against cockroach. A total of 103 (51.5%) patients were found exposed to cockroaches. In the cockroach exposed group, the mean serum tIgE was found significantly higher than the non-exposed group (569.31±224.64 vs 479.29±237 IU/ml; p=0.007). The mean SSIgE against cockroach in exposed groups was found not significant than non-expose group (4.87±11.19 vs 4.11±8.39 KUA/L; p=0.589). The mean tIgE was also not significant in atopic compared to non-atopic asthmatic (553.25±218.12 IU/ml vs 489.1±251.16 IU/ml; p=0.056). The mean SSIgE against cockroach was 5.66±10.45 KUA/L for atopic and 2.96±8.98 KUA/L for non-atopic (p=0.054). The airway obstruction was almost the same in both groups. Asthmatic patients who were exposed to cockroach and atopic had high tIgE, SSIgE levels and SPT positivity against cockroach antigen compared to non-exposed patients.

Celiac disease, wheat allergy, and nonceliac sensitivity to gluten: topical issues of the pathogenesis and diagnosis of gluten-associated diseases

Historically, wheat and other gluten-containing grains have been an essential part of the diet of many people worldwide. However, the widespread use of gluten-containing products has led to an increased incidence of adverse reactions associated with their consumption, such as celiac disease and wheat allergy, as well as nonceliac gluten sensitivity, which has become common in recent years.&#x0D; Gluten-associated diseases have similar clinical manifestations (abdominal pain, bloating, diarrhea, nausea, and vomiting). The pathogenetic mechanisms underlying celiac disease and wheat allergy are quite well understood; in both cases, an immune response occurs when wheat proteins are consumed, both with effective treatment. Nonceliac gluten sensitivity is the subject of discussion; however, the processes underlying this disease are not fully understood; thus, its diagnosis and treatment have no unified approach. To date, nonceliac gluten sensitivity is a diagnosis of exclusion, which is established in the absence of markers of celiac disease or wheat allergy and improved following a gluten-free diet.&#x0D; A gluten-free diet is the most effective treatment for gluten-related diseases. However, like any other strict dietary restriction, gluten avoidance can result in reduced intakes of important nutrients, such as dietary fiber, protein, and micronutrients. In recent years, an increasing trend is found in the general population without confirmed gluten-related disorders that gluten-free product consumption or gluten-free diet adherence since gluten avoidance can improve well-being or gluten can be toxic for all human beings&#x0D; According to current guidelines, only patients diagnosed with celiac disease or wheat allergy are advised to follow a strict gluten-free diet.&#x0D; Herein, the modern conception of the immunopathology of gluten-related diseases and an overview of new potential therapies are presented.

Pollen-food allergy syndrome and component sensitization in adolescents: A Japanese population-based study.

Allergic rhino-conjunctivitis with pollen allergy has been prevalent worldwide and Pollen-food allergy syndrome (PFAS) refers to individuals with pollen allergy who develop oral allergy syndrome (OAS) on consuming fruits and vegetables. The prevalence of PFAS varies by region and that in Japanese adolescents remains to be elucidated. In this cross-sectional study, we examined the epidemiological characteristics of PFAS in a general population of Japanese adolescents according to pollen allergy, OAS, and IgE component sensitization. Participants comprised adolescents, at age 13 years, from a prospective birth cohort study in Japan. We administered questionnaires to collect information from parents regarding pollen allergy, PFAS and OAS at each child's age 13 years. ImmunoCAP ISAC was used to assess IgE component sensitization. Among 506 participants with a complete questionnaire and ISAC measurement results, 56.5% had a history of hay fever, 16.0% had a history of OAS, 51.0% had pollen allergy, and 11.7% had a history of PFAS; additionally, 72.7% were sensitized to one or more tree, grass, and/or weed allergens. The most common sensitization (95.7%) among adolescents with pollen allergy was to Japanese cedar (Cry j 1). The most common causal foods were kiwi and pineapple (both 39.0%). Knowledge levels about PFAS were poor among affected adolescents. We found a high prevalence of PFAS among adolescents in Japan. Although it affects approximately 1/10 adolescents in the general population, public awareness regarding PFAS is poor. Interventional strategies are needed to increase knowledge and to prevent PFAS in the general population.

Fructo-oligosaccharides, hydrolyzed soy protein and yeast (Saccharomyces sp.) extract as potential cryoprotectans in gluten-free frozen dough and bread quality.

People with celiac disease, wheat allergy, and non-celiac gluten sensitivity required bakery products without gluten. However, gluten-free bread has a high rate of starch retrogradation during shelf life, resulting in loss of softness in the bread crumbs. The inclusion of frozen doughs for gluten-free bread can provide a feasible solution to increase product supply with high technological and sensory quality, providing fresh bread with uniform characteristics. The biggest challenge in the frozen dough for gluten-free bread is related to the high amount of water added to the dough (70-120 % - flour basis) because the ice crystals formed during the freezing step can cause damage to yeast. The use of cryoprotectants in the dough is an alternative for preserving yeast during freezing and cold chain maintenance. This study aimed to evaluate the behavior of fructo-oligosaccharide, hydrolyzed soy protein, and yeast extract as a cryoprotectant in the gluten-free frozen dough and the evaluation of bread quality. Through the Response Surface Methodology, using a Simplex-Centroid Mixture Design, the cryoprotectants were evaluated up to a concentration of 5 % (flour basis) with freezing of the dough for 7 days at -18 °C. The results showed that with the use of cryoprotectants, there was an increase in volume increase of the doughs, in the specific volume of the bread, and the softness of the crumb. The use of 69 % fructo-oligosaccharide and 31 % hydrolyzed soy protein, without the yeast extract, was considered as the optimal formulation for the tested cryoprotectants, with a probability of 79.60 % of success obtained by the desirability function. These levels promoted a better biopreservation of yeast fermentation power and resulting in an improved crumb softness and specific volume at 46 and 40 %, respectively, compared to the standard sample.

Childhood asthma: Novel endotyping by cytokines, validated through sensitization profiles and clinical characteristics.

Specific allergy sensitization pattern, using "component-resolved diagnosis" (CRD), is a central component of allergy and asthma in childhood. Besides this, allergic asthma has been characterized by a Th2-shifted endotype with elevation of classical Th2 cytokines. Recently, other endotypes with distinct mechanisms focusing on cytokine regulation evolved, yet those pathways are still not well understood. (a) To define reproducible immunological endotypes using cytokine expression in an asthma cohort and (b) to characterize their sensitization profile and clinical phenotype. Supernatants from PBMCs of 234 children (median age 10years) of an asthma cohort were analysed for cytokine expressions. The children were split into a training (n=49) and validation (n=185) group. The training group was used to identify immunological endotypes by clustering cytokine expressions, which were then assessed regarding clinical characteristics and specific IgE of recombinant allergen components. Next, our findings were validated in the validation group. We identified novel endotypes based on primarily unstimulated cytokine expression. One endotype showed an IFN-γ/Interleukin (IL)-17/IL-5 predominance, a different sensitization pattern (high in birch/apple; p<.01), and inferior lung function (p<.01). A second endotype grouped young children with food allergy and reduced lung function. Our findings were reproducible in the validation group. We identified two novel clinical asthma endotypes via cytokine expression pattern with distinct sensitization patterns. These novel findings are critical for clinical guidance and open avenues for identifying underlying mechanisms and more patient-specific therapies.

Characterization of 150 Wheat Cultivars by LC-MS-Based Label-Free Quantitative Proteomics Unravels Possibilities to Design Wheat Better for Baking Quality and Human Health.

Wheat (Triticum aestivum ssp. aestivum) contributes to 20% of the human protein supply, delivers essential amino acids and is of fundamental importance for bread and pasta quality. Wheat proteins are also involved in adverse human reactions like celiac disease (CD), wheat allergy (WA) and non-celiac wheat sensitivity (NCWS). Using liquid chromatography-mass spectrometry (LC-MS)-based label-free quantitative (LFQ) proteomics of aqueous flour extracts, we determined 756 proteins across 150 wheat cultivars grown in three environments. However, only 303 proteins were stably expressed across all environments in at least one cultivar and only 89 proteins thereof across all 150 cultivars. This underlines the large influence of environmental conditions on the expression of many proteins. Wheat cultivars varied largely in their protein profile, shown by high coefficients of variation across different cultivars. Heritability (h2) ranged from 0–1, with 114 proteins having h² > 0.6, including important proteins for baking quality and human health. The expression of these 114 proteins should be amenable to targeted manipulation across the wheat supply chain by varietal choice and breeding for designing healthier wheat with better quality. Further technical development is urgently required to assign functions to identifiable proteins labeled yet uncharacterized in databases and speeding up detection methods to routinely use proteomics in wheat supply chains.

Allergy-Related Symptoms Are Poorly Predicted by IgE and Skin Prick Testing in Early Life

Introduction: In childhood, the so-called allergic march involves progression from IgE sensitization to allergy-related symptoms. Both IgE sensitization and relevant clinical symptoms are required for the diagnosis of allergy, but concordance between test results and clinical symptoms varies greatly, creating challenges for the diagnostics and for the prediction of outcomes. We assessed the prevalence of IgE sensitization and allergy symptoms, concordance between 2 IgE sensitization testing methods, and predictive value of these tests in relation to clinical symptoms in young Finnish children. Methods: The current study included 2 series of children: a birth cohort, in which the participants were followed prospectively from birth up to 3 years, and a young children cohort observed from 3 to 5 years of age. They were regularly monitored for sensitization by measuring serum allergen-specific IgEs (sIgEs) and performing skin prick tests (SPTs). The emergence of atopic dermatitis, wheezing, and symptoms associated with food allergies was recorded. Results: Over the first 5 years of life, the prevalence of sIgE sensitization was 46%, while it was 36% for positive SPTs. Disease prevalence was 26% for atopic dermatitis, 25% for wheezing, and 19% for symptoms associated with food allergies. Concordance between sIgE and SPT results was good for aeroallergens, but poor for dietary allergens. The association between clinical symptoms and sensitization was stronger at 5 years than at 3 years of age. The proportion of children with concordant combinations of allergy symptoms and sensitization markers in contrast to those with discordant combinations increased from 3 to 5 years. Conclusion: In early childhood, testing for IgE sensitization predicts allergy-related symptoms in an age-dependent manner, but not particularly well. Tests predict symptoms caused by aeroallergens clearly better than those caused by dietary allergens. The clinical relevance of sensitization testing in early life is therefore limited in the prediction of true allergy.

The Gluten Gene: Unlocking the Understanding of Gluten Sensitivity and Intolerance.

Wheat flour is one of the most important food ingredients containing several essential nutrients including proteins. Gluten is one of the major protein components of wheat consisted of glutenin (encoded on chromosome 1) and gliadin (encoded on chromosome 1 and 6) and there are around hundred genes encoding it in wheat. Gluten proteins have the ability of eliciting the pathogenic immune responses and hypersensitivity reactions in susceptible individuals called “gluten-related disorders (GRDs)”, which include celiac disease (CD), wheat allergy (WA), and non-celiac gluten sensitivity (NCGS). Currently removing gluten from the diet is the only effective treatment for mentioned GRDs and studies for the appropriate and alternative therapeutic approaches are ongoing. Accordingly, several genetic studies have focused on breeding wheat with low immunological properties through gene editing methods. The present review considers genetic characteristics of gluten protein components, focusing on their role in the incidence of gluten-related diseases, and genetic modifications conducted to produce wheat with less immunological properties.

Cockroach Allergy, Allergen Based Immuno Diagnostic and Specific Immunotherapy: Present Status and Future Trends

Cockroach allergy sensitivity is increasing alarmingly. As in the modern world people choose to stay indoors which increased the inhalation of fine dust emerging from cockroach scales present in air causing the allergy symptoms in sensitive people. The scheme of flats in apartments with long lengthier toilet ducted lines are the sources for cockroach habitat. City apartment buildings are specifically responsible for increased cockroach allergy problem. Cockroach allergen causing allergy has been proclaimed around the world and the most typical cockroaches associated with allergy are the German cockroach Blattella germanica and the American cockroach Periplaneta americana. The secretion and remains of the whole insect are the origin of environmental cockroach allergen. Diagnosis is by specific IgE test followed by Skin Prick Test SPT. Long term management of allergy disorders apart from pharmacotherapy is done by preventive measures and Allergen Specific Immunotherapy ASI in the form of either Subcutaneous Immunotherapy SCIT or by Sublingual Immunotherapy SLIT to reduce the allergy symptoms and enhance Quality of Life as against observed by Pharmacotherapy. In this article present status and future trends on cockroach allergy allergen diagnosis and specific immunotherapy have been reviewed.

The Role of Allergen Sensitivity on Pityriasis Alba

Objective: Pityriasis alba is mostly seen in individuals with a history of atopy, although it may occur in non-atopic individuals. Despite many hypothesis, no certain etiologic factor for pitryriasis alba has been determined. We aimed to investigate the roles of environmental factors, inhalant and food allergy sensitization in its etiopathogenesis. Methods: We noted patients’ and controls’ age, gender, education level of parents, xerosis, hand soap type, bathing frequency, bath water temperature, wind condition in the location, using sun screen cream, sun exposure time, results of inhalant allergen and food allergen testing. Inhalant allergy test was carried out through a skin prick test for children older than two years, and a food allergy test was carried out through prick to prick test for children of all ages. Results: The findings showed that there were significant relationships between pityriasis alba and xerosis, inhalant allergen sensitization (p&lt;0.0001, p=0.009, respectively). Conclusion: We conclude that xerosis and inhalant allergen sensitization are associated with pityriasis alba. Therefore, we think that clinicians should suggest moisturizers to patients with pityriasis alba and make their inhalant allergy tests in clinical follow-up of patients.

Глютен-ассоциированная патология: в фокусе пациенты с синдромом раздраженного кишечника

Wheat is an essential part of the diet of many people around the world. Despite the many beneficial aspects of eating wheat products, they can be associated with the development of a variety of diseases. The spectrum of gluten-associated pathologies includes celiac disease, wheat allergy, and non-celiac gluten sensitivity (NCGS). The clinical symptoms of gluten-associated pathology are similar to those of irritable bowel syndrome (IBS). Diagnosis of celiac disease and wheat allergy is now straightforward. NCGS remains a diagnosis of exclusion due to the lack of specific biomarkers and standardized research methods. Many patients with IBS consider themselves gluten-sensitive and their symptoms are relieved by a gluten-free diet. Most likely it is NCGS that occurs in a heterogeneous group of patients with IBS. However it remains controversial whether the development of symptoms in this case is associated with gluten itself or with other components of wheat, such as non-gluten proteins and FODMAPs.

A Consensus Approach to the Primary Prevention of Food Allergy Through Nutrition: Guidance from the American Academy of Allergy, Asthma, and Immunology; American College of Allergy, Asthma, and Immunology; and the Canadian Society for Allergy and Clinical Immunology

Recently published data from high-impact randomized controlled trials indicate the strong potential of strategies to prevent the development of food allergy in high-risk individuals, but guidance in the United States at present is limited to a policy for only the prevention of peanut allergy, despite other data being available and several other countries advocating early egg and peanut introduction. Eczema is considered the highest risk factor for developing IgE-mediated food allergy, but children without risk factors still develop food allergy. To prevent peanut and/or egg allergy, both peanut and egg should be introduced around 6 months of life, but not before 4 months. Screening before introduction is not required, but may be preferred by some families. Other allergens should be introduced around this time as well. Upon introducing complementary foods, infants should be fed a diverse diet, because this may help foster prevention of food allergy. There is no protective benefit from the use of hydrolyzed formula in the first year of life against food allergy or food sensitization. Maternal exclusion of common allergens during pregnancy and/or lactation as a means to prevent food allergy is not recommended. Although exclusive breast-feeding is universally recommended for all mothers, there is no specific association between exclusive breast-feeding and the primary prevention of any specific food allergy.

The Two Faces of Wheat.

Wheat-based foods have been staple foods since about 10,000 years and constitute a major source of energy, dietary fiber, and micronutrients for the world population. The role of wheat in our diet, however, has recently been scrutinized by pseudoscientific books and media reports promoting the overall impression that wheat consumption makes people sick, stupid, fat, and addicted. Consequently, numerous consumers in Western countries have started to question their dietary habits related to wheat consumption and voluntarily decided to adopt a wheat-free diet without a medical diagnosis of any wheat-related disorder (WRD), such as celiac disease, wheat allergy, or non-celiac gluten sensitivity. The aim of this review is to achieve an objective judgment of the positive aspects of wheat consumption as well as adverse effects for individuals suffering from WRDs. The first part presents wheat constituents and their positive nutritional value, in particular, the consumption of products from whole-grain flours. The second part is focused on WRDs that affect predisposed individuals and can be treated with a gluten-free or -reduced diet. Based on all available scientific knowledge, wheat consumption is safe and healthy for the vast majority of people. There is no scientific evidence to support that the general population would benefit from a wheat-free diet.

Allergen detection and analysis in Eastern Taiwan area.

Objective:Environmental factors, eating habits, and different ages might affect the profiles of allergy sensitization. The purpose of this study was to survey the different profiles of allergen sensitization in different ages in eastern Taiwan.Materials and Methods:We analyzed the allergic patients who had allergen sensitization examinations by the Phadiatop (atopy screen; IBT Laboratories, Lenexa, KS, USA) and the Pharmacia CAP System method at Haulien Tzu Chi Hospital from January 2010 to December 2015. Results were compared in different ages.Results:A total of 15,455 patients were analyzed. The food and aeroallergen screen sensitization rate of children was significantly higher than that of adults (44.0% vs. 9.9% and 61.9% vs. 52.2% P < 0.05). Children had statistically significantly higher cow milk allergen-specific sensitization rate than that of adults (32.9% vs. 5.8% P < 0.05). The higher sensitization of shrimp occurred in adults than children. (33.6% vs. 24.8% P < 0.05).Conclusion:Our data demonstrate that children have higher cow milk allergy sensitization and adults have higher sensitization of shrimp.

The gluten challenge is still the best option for children with a difficult diagnosis like non-coeliac gluten sensitivity.

Gluten-related diseases, such as coeliac disease, wheat allergy and non-coeliac gluten sensitivity, are increasingly being diagnosed in children. Non-coeliac gluten sensitivity is an unclear and controversial entity, unlike the other two conditions. The recommended diagnosis is a double-blind, placebo-controlled gluten provocation test. Similarly, the test may be performed on children with suspected gluten-related diseases in very specific circumstances and under medical supervision. One example is patients who have started a gluten-free diet without undergoing a duodenal biopsy.