Giving children trace amounts of wheat may increase their tolerance

November 1, 2018

A study published in the Journal of Allergy and Clinical Immunology suggests that wheat oral immunotherapy may be therapeutic for those allergic to wheat. Researchers at the Elliot and Roslyn Jaffe Food Allergy Institute at the Icahn School of Medicine at Mount Sinai enrolled 46 wheat-allergic patients with a median age of 8.7 years to determine the efficacy and safety of oral immunotherapy for wheat. With oral immunotherapy, the patient is given an allergen in trace amounts that are gradually escalated in hopes of desensitizing the patient to the substance. Clinical trials conducted previously by Jaffe Food Allergy Institute researchers have yielded promising results, including a high rate (70%–80%) of subjects reaching desensitization with an acceptable safety profile for foods such as cow milk, egg, and peanut.

After 52 weeks of treatment, 52% of wheat-allergic children enrolled in the study were able to consume a cumulative dose of 4,443 mg of wheat protein, roughly the equivalent of one to two slices of bread, a hamburger bun, or a half-cup of cooked pasta, without encountering an adverse reaction.

Wheat allergic responses correlate to proteins present in the wheat. Therefore, to study the efficacy of oral immunotherapy, there needs to be a sufficient dose of protein. “Wheat contains relatively low amounts of protein compared to peanut or milk, making it a little more challenging to study,” said Anna Nowak-Wegrzyn, professor of pediatrics, Icahn School of Medicine at Mount Sinai, clinical researcher at the Jaffe Food Allergy Institute, and first author of the study. “As a result, our young patients had to consume large quantities of wheat flour in order to ingest escalating doses of protein.”

“Overall, we were very pleased with the efficacy and safety of wheat oral immunotherapy for highly allergic patients,” said Nowak-Wegrzyn. “As a next step, we look forward to further studies to establish the optimal maintenance dose and duration of oral immunotherapy for our young patients.”