81% of children and adolescents have wheat allergy
Gradually increase the amount of ‘boiled noodles’ consumed at home
Expert consultation is required for asthma, blood test inadequacy, etc.
A study has been published for the first time in Korea showing that wheat allergies caused by eating bread, noodles, or snacks can be safely overcome with ‘oral immunotherapy’ that gradually increases the intake of boiled noodles.
Wheat allergy is an allergic reaction to the protein component contained in wheat, which causes rashes, itching, and breathing difficulties. In severe cases, shock (anaphylaxis) may occur, which can be life-threatening.
A joint research team consisting of Professor Ji-Hyeon Kim of the Department of Pediatrics and Adolescents at Samsung Seoul Hospital, Professors Min-Ji Kim and Ji-Won Kim of the Department of Pediatrics and Adolescents at Sejong Chungnam National University Hospital, and Professor Min-Young Jeong of the Department of Pediatrics and Adolescents at Kosin University Gospel Hospital announced on the 26th the results of a study showing that even if you have a wheat allergy, it can be effectively and safely alleviated through well-prepared oral immunotherapy.
The research team administered oral immunotherapy to 50 children and adolescents aged 3 to 17 who were diagnosed with wheat allergy between October 2015 and July 2022, and selected the remaining 22 as a control group to observe the degree of alleviation of wheat allergic reactions.
Oral immunotherapy involves carefully examining the degree of allergic reaction to wheat protein intake through a boiled cotton challenge test, and determining the initial intake amount based on the amount of cotton intake that caused the allergic reaction. The cotton is thoroughly boiled in boiling water for 5 minutes, and the patient is instructed to thoroughly measure the amount eaten using a scale that can measure accurately to two decimal places.
After that, the amount of noodles cooked in the same way was carefully increased every 3 to 7 days until it reached 3 g (90 mg based on wheat protein). The intake was increased by 5% daily or 25% weekly compared to the previous intake until the final target intake of 80 g of boiled noodles (2,400 mg of wheat protein) was reached. When the target wheat protein intake of 2,400 mg was exceeded, it was considered to have entered the maintenance phase, and wheat-containing food was consistently fed at least once a week for at least 12 months.
During this process, the research team educated the guardians on the precautions for anaphylaxis, symptom management, and epinephrine injection methods necessary for emergency response to ensure the safety of the participants, and had them keep a symptom diary so that they could consult with medical staff if necessary.
As a result, it was reported that 41 out of 50 children and adolescents (82%) who received oral immunotherapy had their allergic symptoms disappear. This was achieved after only 9 months (median) of oral immunotherapy. In contrast, only 1 out of 22 children (4.5%) in the control group had their allergic symptoms disappear naturally.
Comparison of blood tests performed at the start of oral immunotherapy and after achieving both increased intake showed that the participants’ immune-related values improved. With continued wheat intake, immunoglobulin (IgG4) levels increased, suggesting that antibodies to wheat were produced, which alleviated allergic reactions. Eosinophil counts also decreased, confirming that the immune system had adapted.
In the control group, on the other hand, the level related to allergic reactions (IgE) increased, and there was no change in other indicators.
Allergic reactions following oral immunotherapy were stably managed. The number of allergic reactions reported per person was approximately two, with skin symptoms such as itching being the most common.
The participants’ lives changed significantly after oral immunotherapy. After the phase of increasing the intake of boiled noodles and the stabilization and maintenance phase, most of the participants (44 people, 88%) were able to consume wheat in any form or type without any restrictions on the amount.
In the control group, approximately 90% (20 people) still restricted their wheat intake and were concerned about possible allergic reactions if they unknowingly consumed it.
The research team emphasized that while it is “encouraging,” “it should not be started arbitrarily without consulting a medical professional.” This is because this study also confirmed that oral immunotherapy is more likely to fail and can cause serious side effects in patients when asthma is present or immunological tests are inadequate.
In particular, it was reported that 15 out of 50 participants (30%) experienced anaphylaxis, indicating that education and early response by medical staff based on professional experience are very important.
Professor Kim Ji-hyun, who led the study, said, “Food allergies are a problem that lowers the quality of life of patients and their families for a long time. It is not simply about not being able to eat their favorite foods, but also about suffering from anxiety about when and how an emergency might occur.”
He said, “If you can overcome wheat allergy in a comfortable way at home through sufficient consultation with medical staff and professional education, you can at least be free from the fear of allergic reactions and look forward to the day when you can enjoy a variety of foods to your heart’s content.”
This study was conducted with the support of the National Research Foundation of Korea and the Ministry of Science and ICT. The results of the study were published in the recent issue of the ‘ASIAN PACIFIC JOURNAL OF ALLERGY AND IMMUNOLOGY (IF=5)’.
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2024-08-26 02:33:29