Immunoglobulin E-reactivity of wheat-allergic subjects (baker's asthma, food allergy, wheat-dependent, exercise-induced anaphylaxis) to wheat protein fractions with different solubility and digestibility

Baker's asthma, food allergy to wheat, and wheat‐dependent, exercise‐induced anaphylaxis (WDEIA) are different clinical forms of wheat allergy. We investigated the correlation of solubility and digestion stability of wheat allergens with the IgE‐reactivity patterns of different patient groups. Three wheat protein fractions were extracted according to their solubility: salt‐soluble albumins and globulins, ethanol‐soluble gliadins, and glutenins soluble only after treatment with detergents and reducing reagents. Sera from subjects with history of each variant of wheat allergy were characterized by CAP FEIA and immunoblotting. There was a high degree of heterogeneity of recognized allergens between the different subject groups as well as within these groups. However, subjects with WDEIA showed similar immunoglobulin E (IgE)‐reactivity patterns to gliadins and especially to a 65 kDa protein. Subjects with baker's asthma as well as the food‐allergic subjects had the most intense IgE‐reactivity to the albumin/globulin fraction. The latter group additionally showed IgE‐reactivity to the other fractions. Divergent results of immunoblotting and CAP‐FEIA demonstrated that the detection of wheat‐specific IgE highly depends on the applied method, thus the diagnostic tool must be carefully chosen. Most wheat allergens were rapidly digested as analyzed by determination of IgE‐reactivity on immunoblots to wheat extracts after simulation of gastric and duodenal digestion. However, ethanol‐soluble gliadins were stable to gastric enzymes and exhibit low solubility in gastric and duodenal fluids. Therefore, they are likely to be important in food allergy to wheat.