Non-celiac gluten/wheat sensitivity (NCG/WS) is a syndrome characterized by intestinal and extra-intestinal sym-ptoms elicited by gluten/wheat ingestion in the persons, who are not affected by celiac disease and wheat allergy. Due to the lack of established biomarkers, the diagnosis of NCG/WS is based on the clinical picture, and it is necessary to validate it in well-defined double-blind, placebo-controlled challenge (The Salerno Experts´ Criteria). In the article is discussed a current knowledge of NCG/WS in terms of pathogenesis, diagnosis and treatment. Key words: gluten - gluten-related disorders - non-celiac gluten/wheat sensitivity - wheat.
- Klíčová slova
- gluten - gluten-related disorders - non-celiac gluten/wheat sensitivity - wheat,
- MeSH
- alergie na pšenici * diagnóza farmakoterapie MeSH
- bezlepková dieta MeSH
- celiakie * diagnóza dietoterapie MeSH
- dvojitá slepá metoda MeSH
- gluteny MeSH
- lidé MeSH
- pšenice MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- gluteny MeSH
Non-celiac gluten sensitivity has recently been recognized by the scientific community as a part of gluten-related disorders, and is defined as a condition with gastrointestinal and/or extra-intestinal symptoms triggered by gluten ingestion in the absence of celiac disease and wheat allergy. Currently, there is no specific serological marker and non-celiac gluten sensitivity remains a diagnosis of exclusion: testing for celiac disease and wheat allergy must be negative, symptoms must improve with a gluten-free diet, and diagnosis must be confirmed by the gluten challenge. In this article, we discuss current knowledge of pathophysiology, clinical and epidemilogical spectrum, diagnosis, and treatment of NCGS.
- Klíčová slova
- celiac disease - FODMAPs - gluten-free diet - gluten-related disorders - irritable bowel syndrome - non-celiac gluten sensitivity - wheat allergy.,
- MeSH
- alergie na pšenici diagnóza terapie MeSH
- bezlepková dieta MeSH
- celiakie diagnóza terapie MeSH
- gluteny * MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- gluteny * MeSH
UNLABELLED: Few studies concerning the importance of wheat allergy affecting the course ofatopic eczema in adolescents and adult patients exist. AIM: The evaluation if wheat allergy can deteriorate the course of atopic eczema. Follow-up of patients with confirmed food allergy to wheat. METHOD: Altogether 179 persons suffering from atopic eczema were included in the study: 51 men and 128 women entered the study with an average age of 26.2 (s.d. 9.5 years) Dermatological and allergological examinations were performed, including skin prick tests, atopy patch tests, and specific serum IgE for wheat, open exposure test and double-blind, placebo-controlled food challenge test with wheat flour. RESULTS: Wheat allergy affecting the coures of atopic eczema was confirmed in eight patients (4.5%) out of 179 patients enrolled in this study by double-blind, placebo controlled food challenge test. The course of atopic eczema showed a positive trend in patients with confirmed food allergy at 3, 6, 9, 12 month follow-up (statistical evaluation with paired t-test) after the elimination of wheat flour. CONCLUSION: Wheat allergy may play an important role in the worsening of atopic eczema (acting as a triggering exacerbating factor) only in a minority of adolescents and adult patients (4.5% in our study). The diagnostic methods (skin prick test, specific IgE, atopy patch test, history) cannot be used as separated tests for the determination of food allergy to wheat in patients with atopic eczema.Open exposure tests and double-blind, placebo-controlled food challenge should be used for the confirmation of wheat allergy affecting the course of atopic eczema.
- MeSH
- alergie na pšenici komplikace diagnóza MeSH
- atopická dermatitida etiologie patologie MeSH
- dospělí MeSH
- imunoglobulin E krev MeSH
- kožní testy MeSH
- lidé MeSH
- mladiství MeSH
- náplasťové testy MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- imunoglobulin E MeSH
BACKGROUND: The incidence of food allergy to wheat is increasing. Its diagnosis depends on the purity of major allergens and their inclusion in tests. Isolation and characterization of wheat allergens are therefore of utmost importance. OBJECTIVE: To purify and identify wheat flour allergens most frequently recognized by patients' IgE antibodies and to study their allergenicity. METHODS: Water/salt-soluble extracts from wheat flour were prepared and separated using a combination of ultrafiltration, isoelectric focusing and liquid chromatography. Purified proteins were analysed by immunoblotting using pooled sera from patients with atopic dermatitis who possessed IgE specific to wheat. Wheat proteins found to bind IgE were subsequently identified by matrix-assisted laser desorption/ionisation-time of flight mass spectrometry. The frequency and intensity of IgE binding of isolated proteins were tested using individual sera from patients and controls. RESULTS: We developed a procedure that allows isolation of wheat allergens from natural sources. Twenty-seven potential wheat allergens have been successfully identified; of these, the following seven are newly reported in food allergy: endogenous α-amylase/subtilisin inhibitor, trypsin/α-amylase inhibitor (AAI) CMX1/CMX3, thaumatin-like protein (TLP), xylanase inhibitor protein-1, β-glucosidase, class II chitinase and 26 kDa endochitinase. TLP and wheatwin were shown to activate patients' basophils to a similar extent as two well-known allergens, lipid transfer protein (Tri a 14) and AAI 0.19 (Tri a 28.0101). CONCLUSION AND CLINICAL RELEVANCE: Our new approach enables the isolation of water/salt-soluble wheat allergens in their native form in amounts sufficient both for biological testing (in vivo and in vitro) and for physicochemical characterization. Such studies will lead to a more detailed knowledge of allergenicity of wheat proteins and to improved accuracy of diagnostic tests.
- MeSH
- alergeny chemie imunologie izolace a purifikace MeSH
- alergie na pšenici diagnóza imunologie MeSH
- atopická dermatitida diagnóza imunologie MeSH
- bazofily imunologie MeSH
- dítě MeSH
- dospělí MeSH
- imunoglobulin E krev MeSH
- isoelektrická fokusace MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mouka analýza MeSH
- potravinová alergie diagnóza imunologie MeSH
- předškolní dítě MeSH
- pšenice chemie imunologie MeSH
- rostlinné proteiny chemie imunologie izolace a purifikace MeSH
- spektrometrie hmotnostní - ionizace laserem za účasti matrice MeSH
- ultrafiltrace MeSH
- vysokoúčinná kapalinová chromatografie MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- hodnotící studie MeSH
- práce podpořená grantem MeSH
- Názvy látek
- alergeny MeSH
- imunoglobulin E MeSH
- rostlinné proteiny MeSH
Wheat belongs to six major food allergens inducing IgE-mediated hypersensitivity reaction manifesting as cutaneous, gastrointestinal, and respiratory symptoms. Although cereals are a staple food item in most diets, only a few wheat proteins causing hypersensitivity have been identified. To characterize wheat allergens, salt-soluble wheat extracts were separated by 1-DE and 2-DE and IgE-binding proteins were detected by immunoblotting using sera of patients with allergy to ingested wheat. Proteins, frequently recognized by IgE on 2-DE were analyzed by MALDI-TOF and QTOF and their spectrum was completed by 1-DE and LCQ(DECA) nLC-MS/MS IT technique. Using all three techniques we identified 19 potential wheat allergens such as alpha-amylase inhibitors, beta-amylase, profilin, serpin, beta-D-glucan exohydrolase, and 27K protein. Employing newly developed ELISA, levels of IgE Abs against Sulamit wheat extract and alpha-amylase inhibitors type 1 and 3 were quantified and shown to be significantly elevated in sera of allergic patients compared to those of healthy controls. The level of IgE Abs against alpha-amylase inhibitor type 3 was lower, slightly above the cut-off value in the majority of patients' sera. Our findings contribute to the identification of wheat allergens aimed to increase the specificity of serum IgE and cell activation diagnostic assays.
- MeSH
- 2D gelová elektroforéza MeSH
- alergeny imunologie MeSH
- alergie na pšenici diagnóza imunologie MeSH
- alfa-amylasy antagonisté a inhibitory MeSH
- dítě MeSH
- dospělí MeSH
- elektroforéza v polyakrylamidovém gelu MeSH
- ELISA MeSH
- imunoblotting MeSH
- imunoglobulin E krev MeSH
- inhibitory enzymů imunologie metabolismus MeSH
- lidé MeSH
- mladiství MeSH
- peptidové fragmenty analýza metabolismus MeSH
- proteom analýza MeSH
- průtoková cytometrie MeSH
- pšenice škodlivé účinky imunologie metabolismus MeSH
- rostlinné proteiny imunologie metabolismus MeSH
- spektrometrie hmotnostní - ionizace laserem za účasti matrice MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- alergeny MeSH
- alfa-amylasy MeSH
- imunoglobulin E MeSH
- inhibitory enzymů MeSH
- peptidové fragmenty MeSH
- proteom MeSH
- rostlinné proteiny MeSH
