Japanese Journal of Allergology

Objective: To reveal the clinical utility of an IgE test specific to ω-5 gliadin in the diagnosis of immediate-type wheat allergy. Methods: We detected ω-5 gliadin-specific IgE in sera from all patients examined for wheat-specific IgE in our allergy clinic between January and October, 2008. The diagnostic value of the test was analyzed against the true diagnosis of wheat allergy based on oral wheat challenge or convincing clinical history. Subjects comprised 233 patients (median age, 3.6 years), 59 patients were diagnosed with wheat allergy, and 174 were judged to have no wheat allergy. Results: The prevalence of being diagnosed as wheat allergy was 68% in the patients with CAP score 2 to ω-5 gliadin IgE (n=31), and 87% in those with CAP score 3 (n=15). All of the 3 patients with CAP score 4 or more were wheat allergic. However, 24% of patients with wheat allergy showed negative results (<0.35U_A/ml). According to the data, we proposed the probability curve of ω-5 gliadin-specific IgE. Conclusions: IgE testing specific to ω-5 gliadin can offer a useful clinical marker for the diagnosis of immediate-type wheat allergy. But the data should always be evaluated with wheat-specific IgE titers, because of the low clinical sensitivity to detect the patients with wheat allergy.

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Background: Though the epidemiological relationship between obesity and asthma has been widely investigated, the mechanism is less known. Several studies have examined that weight loss improved lung function in adults. However, it has not been systematically studied in children. We investigated the effect of weight reduction on respiratory function in obese children with asthma. Methods: We selected 10 obese children aged 7-13 years with physician diagnosed asthma who was subjected the weight reduction program in Fukuoka National Hospital in 2003-2007. Obesity was defined by BMI>90 percentile of the same age population. Before and after the program, they performed the spirometry. And they were measured the height, the weight, the %Fat, and the Fat volume. Logistic linear analysis was conducted to determine the correlation between relative change in each obesity markers and relative change in each respiratory parameter. Results: Reduction of BMI, %Fat, and Fat volume correlated with relative changes in %FVC and %FEV1. Reduction of %Fat and Fat volume also correlated with relative changes in %PEF and %V_<50>. Conclusion: Reduction of BMI, %Fat, and Fat volume can improve respiratory function in obese children with asthma. Obesity may be contribute to aggravate the symptoms of asthma.

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