PMID- 37315737
OWN - NLM
STAT- MEDLINE
DCOM- 20231005
LR  - 20231010
IS  - 1534-4436 (Electronic)
IS  - 1081-1206 (Linking)
VI  - 131
IP  - 4
DP  - 2023 Oct
TI  - Challenge-confirmed diagnosis restores quality of life in cofactor-dependent 
      wheat allergy.
PG  - 494-500.e1
LID - S1081-1206(23)00415-5 [pii]
LID - 10.1016/j.anai.2023.06.008 [doi]
AB  - BACKGROUND: Food allergies including cofactor-dependent allergies such as 
      cofactor-dependent wheat allergy (CDWA) decrease the quality of life (QOL) of 
      patients. OBJECTIVE: To define the health-related QOL and fears in patients with 
      CDWA and to evaluate the impact of diagnosis confirmation by oral challenge test 
      (OCT). METHODS: Patients with CDWA diagnosed by clinical history, sensitization, 
      and OCT were invited to participate. Clinical characteristics, patients' fears, 
      self-perceived overall QOL, the Food Allergy Quality of Life Questionnaire-Adult 
      Form score, and the risks and benefits of OCT were evaluated after the final 
      diagnosis. RESULTS: A total of 22 adults with CDWA (13 male, 9 female; mean age 
      53.5 years; median 5 years until diagnosis) were included. Specific 
      immunoglobulin E (IgE) levels for gluten proteins were inversely correlated with 
      the reaction threshold (P < .05). Higher reaction severity in the patients' 
      histories correlated with increased basal serum tryptase levels (P = .003) and 
      gluten and gliadin specific IgE (P < .05), but not to QOL. After the first 
      allergic reaction, patients reported a drop in QOL (P < .001). 
      Challenge-confirmed diagnosis and medical consultation could restore the 
      patients' QOL (P < .05) and reduce their fear of further reactions (P < .01). No 
      severe reactions occurred during OCT, which was rated as not stressful and highly 
      beneficial. Compared with patients with CDWA diagnosed without OCT in the 
      literature, health-related QOL was less impaired (mean Food Allergy Quality of 
      Life Questionnaire-Adult Form score 3.8), especially regarding the emotional 
      impact (P < .001 vs existing literature). CONCLUSION: Until final diagnosis, 
      patients with CDWA have a severe physical and psychological burden. OCT is a safe 
      method to confirm the diagnosis, restore the patients' severely affected QOL, and 
      reduce their fear of further reactions.
CI  - Copyright (c) 2023 American College of Allergy, Asthma & Immunology. Published by 
      Elsevier Inc. All rights reserved.
FAU - Faihs, Valentina
AU  - Faihs V
AD  - Department of Dermatology and Allergy Biederstein, School of Medicine, Technical 
      University of Munich, Munich, Germany.
FAU - Kugler, Claudia
AU  - Kugler C
AD  - Department of Dermatology and Allergy Biederstein, School of Medicine, Technical 
      University of Munich, Munich, Germany.
FAU - Bent, Rebekka K
AU  - Bent RK
AD  - Department of Dermatology and Allergy Biederstein, School of Medicine, Technical 
      University of Munich, Munich, Germany.
FAU - Biedermann, Tilo
AU  - Biedermann T
AD  - Department of Dermatology and Allergy Biederstein, School of Medicine, Technical 
      University of Munich, Munich, Germany.
FAU - Brockow, Knut
AU  - Brockow K
AD  - Department of Dermatology and Allergy Biederstein, School of Medicine, Technical 
      University of Munich, Munich, Germany. Electronic address: knut.brockow@tum.de.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20230612
PL  - United States
TA  - Ann Allergy Asthma Immunol
JT  - Annals of allergy, asthma & immunology : official publication of the American 
      College of Allergy, Asthma, & Immunology
JID - 9503580
RN  - 0 (Allergens)
RN  - 8002-80-0 (Glutens)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Adult
MH  - Humans
MH  - Male
MH  - Female
MH  - Middle Aged
MH  - *Wheat Hypersensitivity/diagnosis
MH  - Quality of Life/psychology
MH  - Allergens
MH  - *Food Hypersensitivity
MH  - Glutens
MH  - Immunoglobulin E
EDAT- 2023/06/15 01:08
MHDA- 2023/10/05 06:43
CRDT- 2023/06/14 19:15
PHST- 2023/05/05 00:00 [received]
PHST- 2023/05/25 00:00 [revised]
PHST- 2023/06/05 00:00 [accepted]
PHST- 2023/10/05 06:43 [medline]
PHST- 2023/06/15 01:08 [pubmed]
PHST- 2023/06/14 19:15 [entrez]
AID - S1081-1206(23)00415-5 [pii]
AID - 10.1016/j.anai.2023.06.008 [doi]
PST - ppublish
SO  - Ann Allergy Asthma Immunol. 2023 Oct;131(4):494-500.e1. doi: 
      10.1016/j.anai.2023.06.008. Epub 2023 Jun 12.