Wheat dependent exercise induced anaphylaxis possibly sensitized by the hydrolyzed wheat proteins in a facial cleansing soap
Department of Dermatology, School of Medicine, University of Occupational and Environmental Health, Japan.Journal of UOEH 03/2012; 34(1):85-9.
There are increasing cases of wheat dependent exercise-induced anaphylaxis (WDEIA) with transcutaneous or transmucosal sensitization. Hydrolyzed wheat included in a certain brand of soap was identified as a cause of sensitization. The useful clues to detect this disorder consist of the patient's past usage of a soap containing hydrolyzed wheat, the appearance of cutaneous or mucosal symptoms after the intake of wheat or washing with this soap, and a high level of specific IgE for wheat gluten. Because hydrolyzed wheat is used as an additive in a wide variety of cosmetics, we should pay careful attention to the ingredients of cosmetics when observing WDEIA.
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ABSTRACT: Background Recent studies have highlighted the importance of extra-intestinal routes of sensitization to food-related allergens as the cause of epidemics of food allergy. Instances of Japanese women developing food allergy to wheat after exposure to hydrolyzed wheat protein (HWP) present in facial soap have been reported. However, the epidemiologic impact of these ingredients as a cause of food allergy has not been well studied.Methods To clarify the epidemiological relationship between food allergy to wheat and contact exposure to HWP, a case-control study of Japanese women aged 20-54 yrs. with self-reported wheat allergy (cases, n=157) and age-matched control subjects without wheat allergy (controls, n=449) was performed using a large-scale web-based research panel. Subjects answered a web-based questionnaire regarding the use of skin and hair care products, as well as other possible risk factors.ResultsCurrent use of an HWP-containing facial soap (Cha no Shizuku R, Yuka, Japan) was significantly associated with an increased risk of wheat allergy (adjusted odds ratio, 2.6; 95% confidence interval, 1.2-5.7; frequencies of current use in cases and controls; 11 and 6%, respectively). Use of Cha no Shizuku was more common in subjects with more recent-onset wheat allergy, implying that this soap may have contributed to the recent epidemic of wheat allergy.Conclusions An epidemiological relationship between wheat allergy and contact exposure to HWP has been documented. This study implicates a possible role of contact exposure to food-derived protein hydrolysates as a risk factor for the development of food allergy manifesting itself as anaphylaxis.This article is protected by copyright. All rights reserved.
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