{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:18:52Z","timestamp":1789172332492,"version":"build-2803163510"},"reference-count":28,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,7,18]],"date-time":"2023-07-18T00:00:00Z","timestamp":1689638400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Deutsche Derma Gesell"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Wheat\u2010dependent exercise\u2010induced anaphylaxis (WDEIA) is an IgE\u2010mediated food allergy with allergic symptoms ranging from intermittent urticaria to severe anaphylaxis that occurs when wheat ingestion is combined with augmenting cofactors such as exercise, non\u2010steroidal anti\u2010inflammatory drugs, or alcohol. In most cases, patients are identified by sensitization to \u03c95\u2010gliadins in the gluten fraction of wheat. \u03c95\u2010gliadin\u2010negative subtypes of WDEIA are often difficult to diagnose and may be caused by Tri a 14 (wheat lipid transfer protein), after percutaneous sensitization with hydrolyzed wheat proteins, or, in rare cases, by cross\u2010reactivity to grass pollen. Diagnosis is established based on the patients\u2019 history in combination with serum IgE profile, skin testing, basophil activation tests, and challenge tests with cofactors. Individual dietary counselling remains the central pillar in the management of WDEIA patients. A completely wheat\u2010free diet is a possible option. However, this appears to promote tolerance less than continued regular consumption of gluten\u2010containing cereals in the absence of cofactors. All patients should have an emergency set for self\u2010treatment including an adrenaline autoinjector and receive adequate instruction. More data are needed on sublingual immunotherapy for WDEIA, a potentially promising therapeutic prospect. This article provides an overview of current knowledge on the diagnosis and management of WDEIA including an optimized challenge protocol using wheat gluten and cofactors.<\/jats:p>","DOI":"10.1111\/ddg.15162","type":"journal-article","created":{"date-parts":[[2023,7,18]],"date-time":"2023-07-18T12:26:23Z","timestamp":1689683183000},"page":"1131-1135","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Wheat\u2010dependent exercise\u2010induced anaphylaxis: subtypes, diagnosis, and management"],"prefix":"10.1111","volume":"21","author":[{"given":"Valentina","family":"Faihs","sequence":"first","affiliation":[{"name":"Department of Dermatology and Allergy Biederstein School of Medicine Technical University of Munich  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Kugler","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy Biederstein School of Medicine Technical University of Munich  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viktoria","family":"Schmalhofer","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy Biederstein School of Medicine Technical University of Munich  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina Anne","family":"Scherf","sequence":"additional","affiliation":[{"name":"Department of Bioactive and Functional Food Chemistry Institute of Applied Biosciences Karlsruhe Institute of Technology (KIT)  Karlsruhe Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Lexhaller","sequence":"additional","affiliation":[{"name":"Department of Bioactive and Functional Food Chemistry Institute of Applied Biosciences Karlsruhe Institute of Technology (KIT)  Karlsruhe Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte G","family":"Mortz","sequence":"additional","affiliation":[{"name":"Odense Research Center for Anaphylaxis (ORCA) Department of Dermatology and Allergy Centre Odense University Hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten","family":"Bindslev\u2010Jensen","sequence":"additional","affiliation":[{"name":"Odense Research Center for Anaphylaxis (ORCA) Department of Dermatology and Allergy Centre Odense University Hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tilo","family":"Biedermann","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy Biederstein School of Medicine Technical University of Munich  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Knut","family":"Brockow","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy Biederstein School of Medicine Technical University of Munich  Munich Germany"},{"name":"Odense Research Center for Anaphylaxis (ORCA) Department of Dermatology and Allergy Centre Odense University Hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/cea.12640"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2021.03.037"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.2147\/JAA.S81550"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.13091"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.4168\/aair.2014.6.4.370"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2018.02.013"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2018.06.018"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.2332\/allergolint.12-OA-0495"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.2005.02213.x"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/cea.14265"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13601-019-0260-0"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.2332\/allergolint.09-RAI-0125"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2017.12.023"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.5414\/ALX02335"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.12020"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2007.01504.x"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/clt2.12050"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1159\/000301577"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1159\/000520936"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.2332\/allergolint.12-RAI-0494"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/cod.14144"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.alit.2020.09.005"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2014.08.024"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.15032"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1159\/000091165"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2222.2001.01023.x"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13601-019-0265-8"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.15053"}],"container-title":["JDDG: Journal der Deutschen Dermatologischen Gesellschaft"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ddg.15162","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T01:39:32Z","timestamp":1697506772000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ddg.15162"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,18]]},"references-count":28,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["10.1111\/ddg.15162"],"URL":"https:\/\/doi.org\/10.1111\/ddg.15162","archive":["Portico"],"relation":{},"ISSN":["1610-0379","1610-0387"],"issn-type":[{"value":"1610-0379","type":"print"},{"value":"1610-0387","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,18]]},"assertion":[{"value":"2022-10-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}