Walnut Allergy Research Articles

Age and Geographical Location Determine the Molecular Pattern of Walnut Allergy in Madrid, Spain.

Age and Geographical Location Determine the Molecular Pattern of Walnut Allergy in Madrid, Spain.

Jug r 1 sensitization in 0- to 35-month-old children with egg, milk, or wheat sensitization.

The incidence of tree nut allergies in children is increasing, with walnut allergy being the most common in the United States and Japan. Allergic reactions, including anaphylaxis, frequently occur at the first intake of tree nuts, suggesting prior sensitization. Our aim was to identify which children should be considered for workup for preexisting sensitization. Juglans regia (Jug r) 1-specific IgE screening for 0- to 35-month-old children who had a positive specific IgE result for egg white, milk, or wheat and had never ingested walnuts was conducted at a food allergy referral hospital between November 2018 and December 2022. Clinical data regarding age; sex; allergic disease complications; and egg, milk, or wheat allergy were examined retrospectively. The rate of Jug r 1-specific IgE positivity (level> 0.34 kUA/L) of 205 children (125 of whom were boys) was 9.8%, with a median Jug r 1-specific IgE level of 12.5 kUA/L in patients with a positive test result. Eczema was observed in 119 patients (58%). The rate of Jug r 1-specific IgE positivity was significantly higher in the eczema-positive group (15.1% [18 of 119]) than in the eczema-negative group (2.3% [2 of 86]) (P= .002). In the eczema-positive group, the rates of Jug r 1-specific IgE positivity per sensitized antigen were 13.7% for egg, 17.0% for milk, and 17.1% for wheat. The rate of Jug r 1-specific IgE positivity was significantly higher in the group with severe eczema (26.6% [17 of 64]) than in the group with nonsevere eczema (1.8% [1 of 55]) (P< .001). Even in children younger than 3 years, 15% of children with eczema and egg, milk, or wheat sensitization were sensitized to Jug r 1.

Clinical and prognostic evaluation of legumes and tree nuts allergy in children

PurposeAllergy to legumes and tree nuts (TNs) is one of the most important causes of fatal and near-fatal food-induced allergic reactions. However, our knowledge of the clinical features of legumes and TNs allergies in children is limited. In this study, we aim to identify clinical characteristics, development of tolerance, risk factors of legumes and TNs allergies in children. MethodsThis retrospective study was designed at two cities at the west part of Turkey. Fifty-seven children with legumes and TNs diagnosed at Clinic of Pediatric Allergy of Balikesir University and Dr Behcet Uz Children Hospital for 2014–2018 years were examined. Current age, gender, age of onset of the legumes and/or TN allergy, the type of the allergic reactions, family history of atopy, results of skin prick test (SPT), and/or oral challenge test and presence of concomitant food allergies, tolerance development and cross reactions were recorded. ResultsIn total, 83 allergies related with legumes and TNs were determined in 57 patients. Mean age of patients was 18.75±13 months and 40.4% were girl. Fifty-two of these reactions were related with legumes (62.6%) and 29.9% of patients had reaction with more than one. Peanut allergy was most common in legumes allergy (53.8%) and walnut allergy was most common in TNs allergy (54.8%). Urticaria was most common type of allergic reaction (56.6%), 28.9% of reactions were anaphylaxis. No statistically significant difference was found between legumes and TNs in terms of the frequency of development of anaphylaxis (P=0.062). Concomitant food allergy was present 80.7% of patients. Patients with legume allergy had significantly high hazelnut and walnut allergy (P=0.04, P<0.001, respectively). Significantly, high peanut and lentil allergy were detected in patients with TNs allergy (P=0.01, P=0.026, respectively). There was co-sensitization and co-allergy between legumes and TNs in children as expected. Tolerance development was shown in 12.2% of patients. ConclusionsIn addition to other food allergies, legumes/TNs allergies are also observed to occur with increasing frequency in children. Co-sensitization and co-allergy between legumes and TNs are frequent. Tolerance development for legumes/TNs allergies is expectedly low.

Sensitivity of prick test with walnut commercial extracts and of prick by prick with raw walnut compared with open food challenge in walnut allergy.

Background and aim:Diagnosis of walnut allergy includes the evaluation of IgE sensitization by skin prick tests (SPT) with standardized commercial extracts. When assuming the loss of relevant allergens due to extract preparation and storage, it is possible to perform SPT with fresh foods, i.e., prick by prick (PbP). To our knowledge, there is no published comparison between SPT with commercial extracts and PbP with fresh food about their sensitivity to the diagnosis of walnut allergy. Therefore, we describe our experience.Methods:We observed seven children (mean age ± SD 6.8 years ± 5.2, range 2 - 15 years; male 85%) with an history of immediate adverse reaction following walnut ingestion. All but one the patients underwent SPT with at least two out of three walnut commercial extracts (Lofarma, Milan, Italy; ALK-Abellò, Milan, Italy; Allergopharma, Rome, Italy). It has also been performed PbP with raw walnut. IgE-mediated walnut allergy was diagnosed based on suggestive history, positivity of PbP and failed open food challenge with walnut.Results:The SPT with Lofarma extract was never positive (sensitivity = 0%), that performed with ALK extract was positive in 2/5 cases (sensitivity 40%) and that of Allergopharma extract was positive in 1/5 cases (sensitivity 20%). PbP was positive in 7/7 cases (sensitivity 100%).Conclusions:In the specific case of walnut allergy in pediatric age, the execution of SPT alone with commercial extract may not be sufficient and clarifying in the diagnostic iter. We suggest to always associate the execution of PbP test. (www.actabiomedica.it)

Allergy to walnuts and hazelnuts in atopic dermatitis patients and analysis of sensitization to molecular components

ABSTRACTAimTo evaluate the occurrence of food allergy to walnuts and hazelnuts in atopic dermatitis patients.MethodsThe examination of specific IgE to molecular components with Multiplex ISAC testing was performed. The diagnosis of food allergy was confirmed in patients suffering from food reactions to walnuts/hazelnuts together with positive results of specific IgE to molecular components.Results and conclusion: Altogether 100 atopic dermatitis patients were examined – 48 men, 52 women, the average age 40.9 years. Hazelnuts allergy was confirmed in 25% of patients; these patients are majorly allergic to PR 10 protein, minorly to storage proteins. Walnut allergy was confirmed in 14% of patients; these patients are majorly allergic to storage proteins and to non-specific lipid transfer proteins. Sensitization to Bet v 1 homologues and profilins was associated with mild symptoms; nsLTPs and seed storage proteins were related to severe reactions.

Component resolved diagnosis of walnut allergy in young children: Jug r 1 as a major walnut allergen.

Walnuts (WN) are one of the main causes of tree nut allergies. However, the potential value of component resolved diagnosis (CRD) for WN allergy is controversial. We analyzed the clinical and immunological features of clinical WN allergy and the usefulness of CRD in young children. Forty-one participants with a history of ingesting WN who were assessed for serum-specific IgE to WN (WNsIgE) using CRD (ImmunoCAP ISAC 112) at the Department of Pediatrics in Ajou University Hospital were enrolled and their demographic profiles, clinical symptoms, and laboratory findings were evaluated. A total of 32 patients were diagnosed with clinical WN allergy, of which 31 had specific immunoglobulin E antibodies to Jug r 1 (Jug r1-sIgE). The Jug r 1-sIgE levels were higher in WN-allergic patients than in WN-tolerant patients and significantly higher in patients with anaphylaxis than in the WN-tolerant patients. Receiver-operating characteristic curves demonstrated that the Jug r 1-sIgE level was much better in discriminating between clinical WN allergy and WN tolerance in young children than the WN-sIgE level. Jug r 1 is the major component allergen in young children with clinical WN allergy. To measure Jug r 1-sIgE appears to be a promising approach for both diagnosis and predicting severity in young children with a history of suspected WN allergy.

A Prospective Validation of the NUT CRACKER Diagnostic Algorithm for Walnut and Pecan Allergy with Prediction of Severity

We previously devised an algorithm using skin prick tests (SPT), basophil activation tests (BAT), and co-allergy status to reduce the need for oral food challenges (OFCs) in 63 patients with suspected walnut/pecan allergies. To validate prospectively the NUT CRACKER (Nut Co-Reactivity-Acquiring Knowledge for Elimination Recommendations) diagnostic algorithm in a new cohort of patients (n= 120) and to study the utility of SPT and BAT in predicting walnut-pecan allergy severity in both groups (n=183). Patients (n= 183) aged 8 (6-11) years, median (interquartile range), with suspected tree nut allergy were studied. SPT used ground nut extract (10 mg/mL), and BAT assessed allergen-induced basophil CD63 expression. Allergy was determined based on a recent reaction or a positive OFC, and tolerance was defined by regular consumption or a negative OFC. Walnut BAT was significantly higher in walnut/pecan dual compared with single walnut allergy (P= .003) and predicted the need for epinephrine during positive walnut OFCs (P= .009). Results of walnut and pecan BAT correlated with the corresponding nut eliciting dose (P= .014 and P<.001, respectively). Receiver operating curves for walnut and pecan allergy in the prospective cohort yielded area under the curves ranging from 0.87 to 0.93 for SPT and BAT. Concordant with the original study, pecan-allergic patients were all co-allergic for walnut. The algorithm decreased the need for OFCs by 78.8 % with 6 of 240 (2.5%) falsely positives and no false negatives. The algorithm was validated prospectively and awaits broader testing across other populations. The use of BAT further associates with severity in walnut/pecan allergy.

Walnut Allergy Across Europe: Distribution of Allergen Sensitization Patterns and Prediction of Severity

Walnut allergy is common across the globe, but data on the involvement of individual walnut components are scarce. To identify geographical differences in walnut component sensitization across Europe, explore cosensitization and cross-reactivity, and assess associations of clinical and serological determinants with severity of walnut allergy. As part of the EuroPrevall outpatient surveys in 12 European cities, standardized clinical evaluation was conducted in 531 individuals reporting symptoms to walnut, with sensitization to all known walnut components assessed in 202 subjects. Multivariable Lasso regression was applied to investigate predictors for walnut allergy severity. Birch-pollen-related walnut sensitization (Jug r 5) dominated in Northern and Central Europe and lipid transfer protein sensitization (Jug r 3) in Southern Europe. Profilin sensitization (Jug r 7) was prominent throughout Europe. Sensitization to storage proteins (Jug r 1, 2, 4, and 6) was detected in up to 10% of subjects. The walnut components that showed strong correlations with pollen and other foods differed between centers. The combination of determinants best predicting walnut allergy severity were symptoms upon skin contact with walnut, atopic dermatitis (ever), family history of atopic disease, mugwort pollen allergy, sensitization to cat or dog, positive skin prick test result to walnut, and IgE to Jug r 1, 5, 7, or carbohydrate determinants (area under the curve= 0.81; 95% CI, 0.73-0.89). Walnut-allergic subjects across Europe show clear geographical differences in walnut component sensitization and cosensitization patterns. A predictive model combining results from component-based serology testing with results from extract-based testing and information on clinical background allows for good discrimination between mild to moderate and severe walnut allergy.

Black walnut tree syrup is not allergenic in individuals with a documented walnut allergy

Black walnut tree syrup is not allergenic in individuals with a documented walnut allergy

A Case of Anaphylaxis due to Sesame Seeds Suspected of Cross-reactivity with Peanut and Walnut Allergy

A Case of Anaphylaxis due to Sesame Seeds Suspected of Cross-reactivity with Peanut and Walnut Allergy

Clinical and Molecular Characterization of Walnut and Pecan Allergy (NUT CRACKER Study)

Diagnostic methods for distinguishing walnut-allergic patients from walnut-sensitized but walnut-tolerant individuals are limited. Furthermore, characteristics of single walnut versus dual walnut-pecan allergy are lacking. To provide clinical and molecular characteristics of walnut- and pecan-allergic patients. A prospective cohort study of 76 walnut-sensitized patients was performed. Walnut skin prick test and serum measurements of specific IgE to walnut and its components were performed. Patients were challenged to walnut and pecan unless they regularly consumed walnut and pecan. Of the 76 patients studied, 61 were diagnosed as walnut-allergic and 15 as walnut-tolerant. IgE levels greater than or equal to 0.35 kUA/L to Jug r 1 or 4 provided the best diagnostic method for identifying walnut-allergic patients (accuracy, 0.93). Of the 61 walnut-allergic patients, 49 were pecan-allergic whereas 12 were pecan-tolerant. None of the walnut-tolerant patients was allergic to pecan. Dual allergic patients had significantly lower walnut reaction dose (median, 100 mg vs 1230 mg; P < .001). IgE levels greater than or equal to 0.35 kUA/L to Jug r 4, low-molecular-weight vicilins, or high-molecular-weight vicilins best segregated dual walnut-pecan-allergic patients from single walnut-allergic patients. Inhibition studies demonstrated that walnut pretreatment completely blocked IgE binding to pecan, whereas in some patients, pecan incubation only partially blocked IgE binding to walnut. Walnut components are helpful in diagnosing walnut allergy and in identifying patients with pecan coallergy. Competitive ELISA indicates that pecan comprises a subset of the allergenic determinants of walnut.

Walnut oral immunotherapy for desensitisation of walnut and additional tree nut allergies (Nut CRACKER): a single-centre, prospective cohort study

The safety and efficacy of oral immunotherapy for tree nut allergy has not been demonstrated to date, and its effectiveness is complicated by the high prevalence of co-allergies to several nuts. This study aimed to investigate the use of walnut oral immunotherapy in the desensitisation of walnut and additional tree nuts in patients who are co-allergic to several nuts. In a single-centre, prospective cohort study (the Nut Co-Reactivity ACquiring Knowledge for Elimination Recommendations study) at the Institute of Allergy, Immunology, and Paediatric Pulmonology at the Yitzhak Shamir Medical Centre, we recruited patients aged 4 years or older who were allergic to walnut, with or without co-allergy to pecan, hazelnut, and cashew. The diagnosis of each food allergy was based on a positive skin prick test or specific serum IgE (≥0·35 kUA/L) to the corresponding nut together with a positive oral food challenge, unless an immediate (within 2 h of exposure) reaction in the past year had been documented. Patients with uncontrolled asthma or a medical contraindication to receive adrenaline were excluded. Patients were assigned to walnut oral immunotherapy or the control group (observation and strict dietary exclusion) on the basis of the order of presentation to the clinic. Oral immunotherapy began with a 4-day dose-escalation phase to establish the single highest tolerated dose, which was consumed daily at home for 24 days; subsequent monthly dose escalations were repeated until 4000 mg walnut protein was achieved. Patients who were desensitised to walnut continued to consume 1200 mg walnut protein daily for 6 months as maintenance. The primary outcome was walnut desensitisation (passing an oral food challenge with 4000 mg of walnut protein) at the end of the study, analysed by intention to treat. In patients who were co-allergic to pecan, hazelnut, and cashew, the proportion who achieved cross-desensitisation to these nuts in addition to walnut desensitisation was examined. 73 patients with a walnut allergy were enrolled between May 15, 2016, and Jan 14, 2018. 49 (89%) of 55 patients in the oral immunotherapy group were desensitised to walnut compared with none of 18 patients in the control group (odds ratio 9·2, 95% CI 4·3-19·5; p<0·0001). Following walnut desensitisation, all patients who were co-allergic to pecan (n=46) were also desensitised to pecan. Additionally, 18 (60%) of 30 patients who were co-allergic to hazelnut or cashew, and 14 (93%) of 15 patients who were co-allergic to hazelnut alone, were either fully desensitised or responded to treatment. 47 (85%) of 55 patients had an adverse reaction (mostly grade 1 or 2) during up-dosing in the clinic; eight patients required intramuscular epinephrine in response to a dose at home. Of 45 patients who had follow-up data for the maintenance phase, all maintained walnut desensitisation and one patient required epinephrine during this period. Walnut oral immunotherapy can induce desensitisation to walnut as well as cross-desensitisation to pecan and hazelnut in patients who have tree nut co-allergies, with a reasonable safety profile. A low daily dose of the allergen maintains desensitisation. None.

Deciphering the Walnut-Pecan Allergy Paradigm Using Component Resolved Diagnostics

Current diagnostic methods for diagnosing walnut and pecan allergy are limited. The utility of walnut components to improve walnut and pecan allergy diagnosis was examined. Fifty-one patients with suspected walnut or pecan allergy were evaluated. Allergy to each nut was diagnosed based on a positive skin prick test together with a history of recent reaction or a positive oral food challenge. Analysis of sIgE to pecan and to walnut and its components (Jug r 1, Jug r 3, Jug r 4, and vicilins (natural processing products of Jug r 2 and Jug r 6)) was performed. Of the 51 patients studied, 36 (70.6%) were walnut-allergic and 28 (54.9%) had pecan allergy. All pecan-allergic patients had walnut allergy. Positive sIgE (≥0.35 kUA/L) to walnut was highly sensitive (0.92) but not specific (0.47) for diagnosing walnut allergy. Jug r 1 maintained high sensitivity (0.81) with improved specificity (0.8) while Jug r 3, Jug r 4 and the vicilins were significantly less sensitive (0.14-0.61) with moderate specificity (0.67-0.8). Combined Jug r 1 and Jug r 4 was optimal for diagnosing walnut allergy in our population, achieving a sensitivity of 0.94 and a specificity of 0.73. For differentiating walnut only from walnut-pecan dual allergic patients, Jug r 1 demonstrated a poor specificity (0.25), while Jug r 4 and the vicilins were more specific (0.75). sIgE to Jug r 1 improves the diagnosis of walnut allergy, whereas Jug r 4 and the vicilins may help to distinguish pecan-allergic patients from those with walnut allergy alone.

Walnut Syrup is not Allergenic in Individuals with a Documented Walnut Allergy

Walnut Syrup is not Allergenic in Individuals with a Documented Walnut Allergy

Allergen Recognition Patterns in Walnut Allergy Are Age Dependent and Correlate with the Severity of Allergic Reactions

Walnut is an important elicitor of food allergy in children and adults with a high rate of severe reactions. Multicenter studies using a common clinical protocol and a comprehensive allergen are lacking. To investigate potential correlations between molecular sensitization patterns and clinical characteristics of walnut-allergic patients. A total of 91 walnut-allergic subjects and 24tolerant controls from Switzerland, Germany, and Spain were included. Walnut allergy was established by food challenge in all but anaphylactic subjects. Specific IgE (sIgE) to walnut extract, rJug r 1 (2S albumin), rJug r 3 (nonspecific lipid transfer protein 1), nJug r 4 (11S globulin), rJug r 5 (PR-10 protein), 2vicilin fractions, profiling, and cross-reactive carbohydrate determinant was determined by ImmunoCAP. A threshold of 0.10 kUA/L was used for positivity. Sensitivity of sIgE to walnut extract was 87% and increased to 96% for the sum of all walnut components. sIgE to walnut extract and all walnut components, except rJug r 5, was significantly higher in patients younger than 14 years at inclusion. Stratification by age at onset of walnut allergy led to similar results. All patients younger than 14 years had severe reactions, whereas 38% of patients 14 years or older were mild reactors. Severe reactors (n= 70) had higher sIgE levels than did mild reactors (n= 21) to walnut extract (P < .0001), rJug r 1 (P<.0001), nJug r 4 (P= .0003), and both vicilin fractions (P<.0001), but not to Jug r 3 and Jug r 5. Sensitization to walnut storage proteins is acquired in childhood and correlates with severe reactions. sIgE levels to storage proteins Jug r 1 and Jug r 4 and vicilin fractions, but not to nonspecific lipid transfer protein and PR-10 proteins, correlate with systemic reactions to walnut.

Clinical utility of Jug r 1-specific IgE in diagnosis of walnut allergy

Clinical utility of Jug r 1-specific IgE in diagnosis of walnut allergy

Retrospective definition of reaction risk in Italian children with peanut, hazelnut and walnut allergy through component-resolved diagnosis

BackgroundSerum IgE evaluation of peanut, hazelnut and walnut allergens through the use of component-resolved diagnosis (CRD) can be more accurate than IgE against whole food to associate with severe or mild reactions. ObjectivesThe aim of the study was to retrospectively define the level of reaction risk in children with peanut, hazelnut and walnut sensitization through the use of CRD. Methods34 patients [n=22 males, 65%; median age eight years, interquartile range (IQR) 5.0–11.0 years] with a reported history of reactions to peanut and/or hazelnut and/or walnut had their serum analyzed for specific IgE (s-IgE) by ImmunoCAP® and ISAC® microarray technique. ResultsIn children with previous reactions to peanut, the positivity of Arah1 and Arah2 s-IgE was associated with a history of anaphylaxis to such food, while the positivity of Arah8 s-IgE were associated with mild reactions. Regarding hazelnut, the presence of positive Cora9 and, particularly, Cora14 s-IgE was associated with a history of anaphylaxis, while positive Cora1.0401 s-IgE were associated with mild reactions. Concerning walnut, the presence of positive Jug r 1, Jug r 2, Jug r 3 s-IgE was associated with a history of anaphylaxis to such food. ImmmunoCAP® proved to be more useful in retrospectively defining the risk of hazelnut anaphylaxis, because of the possibility of measuring Cor a14 s-IgE. ConclusionsOur data show that the use of CRD in patients with allergy to peanut, hazelnut and walnut could allow for greater accuracy in retrospectively defining the risk of anaphylactic reaction to such foods.

A subset of walnut allergic adults is sensitized to walnut 11S globulin Jug r 4.

The role of sensitization to commercially available allergens of English walnut (Juglans regia) Jug r 1, 2 and 3 in walnut allergy has been previously investigated in walnut allergic adults and was unable to explain all cases of walnut allergy. Identify recognized walnut allergens, other than the ones previously investigated (Jug r 1-3), in walnut allergic adults and determine the sensitization frequency and diagnostic value. Three different in-house walnut extracts were prepared and analysed on SDS-PAGE blots to identify allergenic walnut proteins. Immunoblots and immunoprecipitation, followed by LC-MS analysis, were performed to screen for, and confirm, IgE binding to walnut allergens in selected walnut allergic adults. In a cohort of 55 walnut challenged adults, including 33 allergic and 22 tolerant, sensitization to native and recombinant walnut allergen Jug r 4 was assessed using immunoblotting and immuno-line blot (EUROLINE), respectively. Screening of sera of 8 walnut allergic adults identified Jug r 4 as an allergen in our population. In the total cohort of 55 subjects, 5 were positive for Jug r 4 on immunoblot and 10 on EUROLINE. All but one EUROLINE positive subject had a positive food challenge (sensitivity 27%, specificity 95%, PPV 90%, NPV 47%). All 5 subjects positive on immunoblot were also positive on EUROLINE. LC-MS analysis showed a lack of Jug r 4 in the ImmunoCAP extract. Co-sensitization to other 11S albumins (eg hazelnut Cor a 9) was common in Jug r 4 sensitized subjects, potentially due to cross-reactivity. Walnut 11S globulin Jug r 4 is a relevant minor allergen, recognized by 27% of walnut allergic adults. It has a high positive predictive value of 90% for walnut allergy. Specific IgE against Jug r 4 occurred mostly with concomitant sensitization to other walnut components, mainly Jug r 1.

A mouse model of walnut allergy mimics key features of the human disease

A mouse model of walnut allergy mimics key features of the human disease

Immunoglobulin E-binding Proteins of Cooked Walnuts in Korean Children.

PurposeThe immunological characteristics of young Korean children with walnut (WN) allergy and the influence of different cooking methods on WN proteins have not been evaluated to date. This study aimed to evaluate the major WN allergens identified among Korean children, together with changes in WN antigenicity caused by common cooking methods.MethodsWe enrolled children under the age of 13 years with WN serum-specific immunoglobulin (Ig) E concentrations. The protein fractions of dry-fried and boiled WN extracts were compared with those of raw WNs using sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), 2-dimentional gel electrophoresis (2DE) and a proteomic analysis using electrospray ionization (liquid chromatography-mass spectrometry [LC-MS]). An immunoblotting analysis was conducted to examine IgE reactivity toward raw WNs using serum samples from 6 children with a clinical WN allergy. To determine the processed WN proteins with IgE-binding capacity, a 2D-immunoblotting analysis was performed using the pooled sera of 20 WN-sensitized children.ResultsProtein bands from raw WNs were identified at 9, 16, 28, 52, 58, and 64 kDa via SDS-PAGE. The 9- and 16-kDa protein bands were enhanced by boiling, whereas the 52- and 64-kDa bands were considerably diminished. On LC-MS analysis, of the 66 IgE-binding proteins present in raw WNs, 57 were found in dry-fried WNs, but only 4 in boiled WNs. The sera of 5 out of 6 participants reacted with the 52-kDa protein bands and those of 4 out of 6 participants reacted with the 16- and 28-kDa protein bands, respectively. Meanwhile, a 2D-immunoblotting result confirmed the presence of different binding patterns among children who consumed cooked WNs.ConclusionsThe protein profile of boiled WNs is substantially different from that of raw WNs. However, 4 proteins including prolamins remained stable after dry-frying or boiling. Further studies are needed to evaluate the clinical relevance of these findings.