Food-dependent exercise-induced anaphylaxis due to cereal consumption (in particular wheat)

Abstract The aim of the present study was to investigate the main characteristics of exercise-induced anaphylaxis due to the consumption of wheat, rice, rye, oats, barley, corn and millet. For this purpose, the necessary sources were searched in PubMed, ResearchGate, Scopus, Web of Science and Google Scholar databases, data on the characteristics of allergenic cereals in exercise-induced anaphylaxis due to cereal consumption and the peculiarities of prevention of this disease were synthesised and summarised. It has been studied that anaphylaxis caused by physical activity due to cereal consumption belongs to the first type of allergic reactions. Sensitisation occurs by inhalation and contact. The most common allergen among cereals is wheat. Sensitisation can occur not directly through the consumption of cereals, but as a result of contamination of these cereals with living microorganisms (mites, bacteria). In some cases, sensitization occurs not to the cereal proteins themselves but to allergens from contaminants, mainly storage mites found in improperly stored grains. The reference to bacteria concerns rare situations where microbial contamination alters cereal proteins in ways that increase their immunogenicity. Cofactors are essential factors that aggravate allergic reactions. The most common cofactors are physical activity, medication and alcohol consumption. A number of methods are used to reduce the allergenicity of cereals: purification and isolation of allergenic proteins are performed by physical and chemical methods (ultrafiltration, chromatography, precipitation) and by heat treatment. However, such measures do not guarantee 100% safety, so it is necessary to explain to patients the expediency of exercising in groups or with friends who can provide immediate emergency assistance if necessary. The use of alternative cereals and recipe modification is recommended. Thus, allergies to rice, rye, millet, barley, oats, and corn are much less common than wheat, but all of these allergens can cause anaphylaxis, which can lead to death if not treated immediately.