ArticleClinical and translational allergy2019
Cofactors of wheat-dependent exercise-induced anaphylaxis do not increase highly individual gliadin absorption in healthy volunteers.
Article in Clinical and translational allergy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 45 citations in OpenAlex.
- Demonstration of Gliadin Penetration into the Epidermis by Tape Stripping as Prerequisite for Percutaneous Sensitisation in Wheat Allergy.International journal of molecular sciences · 2026Article
- Wheat-Dependent Exercise-Induced Anaphylaxis Patients on a Wheat-Free Diet Exhibit a Gut Microbiota Composition More Similar to Healthy Individuals.Journal of asthma and allergy · 2026Article
- Risk factors/cofactors for heightened anaphylaxis severity in Japanese adults: A 10-year single-center retrospective cohort study.The World Allergy Organization journal · 2025Article
- Getting in Shape: Updates in Exercise Anaphylaxis.Current allergy and asthma reports · 2024Review
- Preparation and Immunochemical Characterization of a Water-Soluble Gluten Peptide Fraction for Improving the Diagnosis of Celiac Disease.Nutrients · 2024Article
- Timing of initial symptom onset during milk and wheat challenges: A retrospective study.Immunity, inflammation and disease · 2024Article
- When allergies have no name: is idiopathic anaphylaxis driven by co-factors?Frontiers in allergy · 2024Review
- Food-Dependent Exercise-Induced Anaphylaxis: A Distinct Form of Food Allergy-An Updated Review of Diagnostic Approaches and Treatments.Foods (Basel, Switzerland) · 2023Review
- Clinical profiles of patients with wheat-induced anaphylaxis at various ages of onset.The World Allergy Organization journal · 2023Article
- Idiopathic Anaphylaxis? Analysis of Data from the Anaphylaxis Registry for West Pomerania Province, Poland.International journal of environmental research and public health · 2022Article
- New Mechanistic Advances in FcεRI-Mast Cell-Mediated Allergic Signaling.Clinical reviews in allergy & immunology · 2022Review
- Clinical features and outcomes of patients with wheat-dependent exercise-induced anaphylaxis: a retrospective study.Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology · 2022Article
- Basophil Activation to Gluten and Non-Gluten Proteins in Wheat-Dependent Exercise-Induced Anaphylaxis.Frontiers in allergy · 2022Article
- Food allergies and food-induced anaphylaxis: role of cofactors.Clinical and experimental pediatrics · 2021Article
- Relationships of gut microbiota, short-chain fatty acids, inflammation, and the gut barrier in Parkinson's disease.Molecular neurodegeneration · 2021Article
- Comorbidities and Cofactors of Anaphylaxis in Patients with Moderate to Severe Anaphylaxis. Analysis of Data from the Anaphylaxis Registry for West Pomerania Province, Poland.International journal of environmental research and public health · 2021Article
- Highlights and recent developments in allergic diseases in EAACI journals (2019).Clinical and translational allergy · 2020Review
- Comparative Characterization of Gluten and Hydrolyzed Wheat Proteins.Biomolecules · 2020Article
- Characterization and Relative Quantitation of Wheat, Rye, and Barley Gluten Protein Types by Liquid Chromatography-Tandem Mass Spectrometry.Frontiers in plant science · 2019Article
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Authors and funding
10 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn wheat-dependent exercise-induced anaphylaxis (WDEIA), cofactors such as exercise, acetylsalicylic acid (ASA), alcohol or unfavorable climatic conditions are required to elicit a reaction to wheat products. The mechanism of action of these cofactors is unknown, but an increase of gliadin absorption has been speculated. Our objectives were to study gliadin absorption with and without cofactors and to correlate plasma gliadin levels with factors influencing protein absorption in healthy volunteers.
methodsTwelve healthy probands (six males, six females; aged 20-56 years) ingested 32 g of gluten without any cofactor or in combination with cofactors aerobic and anaerobic exercise, ASA, alcohol and pantoprazole. Gliadin serum levels were measured up to 120 min afterwards and the intestinal barrier function protein zonulin in stool was collected before and after the procedure; both were measured by ELISA. Stool microbiota profile was obtained by 16S gene sequencing.
resultsWithin 15 min after gluten intake, gliadin concentrations in blood serum increased from baseline in all subjects reaching highly variable peak levels after 15-90 min. Addition of cofactors did not lead to substantially higher gliadin levels, although variability of levels was higher with differences between individuals (p < 0.001) and increased levels at later time points. Zonulin levels in stool were associated neither with addition of cofactors nor with peak gliadin concentrations. There were no differences in gut microbiota between the different interventions, although the composition of microbiota (p < 0.001) and the redundancy discriminant analysis (p < 0.007) differed in probands with low versus high stool zonulin levels.
conclusionThe adsorption of gliadin in the gut in healthy volunteers is less dependent on cofactors than has been hypothesized. Patients with WDEIA may have a predisposition needed for the additional effect of cofactors, e.g., hyperresponsive or damaged intestinal epithelium. Alternatively, other mechanisms, such as cofactor-induced blood flow redistribution, increased activity of tissue transglutaminase, or increases in plasma osmolality and acidosis inducing basophil and mast cell histamine release may play the major role in WDEIA.
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