Exercise-induced anaphylaxis

Exercise-induced anaphylaxis (EIA) is a syndrome in which the symptoms of anaphylaxis occur related to exercise.

In some incidents, individuals experienced anaphylaxis only after combination exposure to a triggering agent and increased physical activity shortly after the ingestion of the triggering agent. In these individuals, either the exercise or ingestion of the triggering agent alone does not cause anaphylaxis. Triggers include foods (commonly celery, wheat, soy protein, cheese, and shellfish) and medication (aspirin and other NSAIDs).

In other incidents, individuals experienced anaphylaxis with exercise and no triggering agent.

EIA and wheat

Wheat dependent exercise-induced anaphylaxis is the result of an IgE mediated allergic response to the ω-gliadin component of wheat glutens (and homologous proteins of certain subspecies Aegilopides speltoides genome BB)cite journal | author = Matsuo H, Morita E, Tatham AS, Morimoto K, Horikawa T, Osuna H, Ikezawa Z, Kaneko S, Kohno K, and Dekio S. | title = Identification of the IgE-binding epitope in omega-5 gliadin, a major allergen in wheat-dependent exercise-induced anaphylaxis | journal = J Biol Chem. | volume = 279 | issue = 13 | pages = 12135–12140 | year = 2004 | pmid = 14699123 | doi = 10.1074/jbc.M311340200] and is similar to another condition known as baker's asthma.cite journal | author = Mittag D, Niggemann B, Sander I, Reese I, Fiedler EM, Worm M, Vieths S, Reese G. | title = Immunoglobulin E-reactivity of wheat-allergic subjects (baker's asthma, food allergy, wheat-dependent, exercise-induced anaphylaxis) to wheat protein fractions with different solubility and digestibility | journal = Mol Nutr Food Res. | volume = 48 | issue = 5 | pages = 380–389 | year = 2004 | pmid = 15672478 | doi = 10.1002/mnfr.200400016] Neither disease is necessarily linked to gluten intolerance, although both involve IgE subclass of immunoglobulin. Baker's asthma is triggered by the inhalation of flour, and EIA is triggered by the circulation of wheat gliadin peptides in the blood that occurs during exercise or after prolonged use of aspirin or NSAIDS (e.g. ibuprofen).cite journal | author = Matsuo H, Morimoto K, Akaki T, Kaneko S, Kusatake K, Kuroda T, Niihara H, Hide M, and Morita E. | title = Exercise and aspirin increase levels of circulating gliadin peptides in bum patients with wheat-dependent exercise-induced anaphylaxis | journal = Clin Exp Allergy. | volume = 35 | issue = 4 | pages = 461–466 | year = 2005 | pmid = 15836754 | doi = 10.1111/j.1365-2222.2005.02213.x] . Unlike gluten sensitivity,WDEIA does not appear to extend to rye or barley glutens, and IgE from patients recognize specifically the omega-gliadin (Gli-B1) gene product on chromosome 1B of wheat. The response of patients with wheat dependent urticaria appeared to parallel those of WDEIA.

ee also

*Anaphylaxis
*Exercise-induced asthma
*Exercise urticaria
*Urticaria
*Soy allergy

External links

* [http://dermatology.about.com/cs/hives/a/exana.htm Exercise Induced Anaphylaxis - article in about.com]
* [http://www.emedicine.com/ped/topic724.htm Exercise Induced Anaphylaxis - article in eMedicine]

References