- Original Article -
THE SENSITIVITY AND CLINICAL COURSE OF PATIENTS WITH WHEAT-DEPENDENT EXERCISE-INDUCED ANAPHYLAXIS SENSITIZED TO HYDROLYZED WHEAT PROTEIN IN FACIAL SOAPMakiko Hiragun1), Kaori Ishii1), Takaaki Hiragun1), Hajime Shindo1), Shoji Mihara1), Hiroaki Matsuo2) and Michihiro Hide1)
1)Division of Molecular Medical Science, Department of Dermatology, Graduate School of Biomedical Sciences, Hiroshima University
2)Division of Clinical Pharmacotherapeutics, Graduate School of Biomedical Sciences, Hiroshima University
Background: Recently an increasing number of patients with wheat-dependent exercise-induced anaphylaxis (WDEIA), developed during or after using hydrolyzed wheat protein (HWP)-containing soap (HWP-WDEIA), were reported in Japan.
Methods: To clarify the relation between WDEIA and HWP-containing soap and their prognosis, we investigated the patients who visited Hiroshima University Hospital and were diagnosed as WDEIA from January 2010 to June 2011. We took detailed clinical histories, performed skin prick tests, serum immunoassays for antigen-specific IgE and basophil histamine release test, and followed up their clinical courses after the diagnosis.
Results: Among 36 patients with WDEIA, 30 patients had used only one type of HWP-soap. The patients with HWP-WDEIA were mainly women and had developed facial symptoms and angioedema. They suffered from blood pressure reductions less frequently than patients with conventional WDEIA. The levels of glutens-specific IgE were higher than those of ω-5 gliadin in patients with HWP-WDEIA (p<0.05, One-way ANOVA). All patients with HWP-WDEIA were positive against HWP in histamine release test. Among the conventional wheat antigens, glutenins induced highest histamine release from basophils of patients with HWP-WDEIA. The sensitivities of patients against glutens and glutenins were reduced over months along with the discontinuance of HWP-soap.
Conclusions: The development of HWP-WDEIA is associated with the use of HWP-soap. The sensitivities to HWP that cross reacts with non-processed wheat may be reduced or possibly cured after the discontinuation of HWP-soap.
key words: clinical course, histamine release test, hydrolyzed wheat protein, IgE, wheat-dependent exercise-induced anaphylaxis
Received: August 26, 2011
Jpn. J. Allergol., 60 (12): 1630-1640, 2011
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