Should wheat, barley, rye, and/or gluten be avoided in a 6-food elimination diet?

Abstract

Eosinophilic esophagitis (EoE), a food antigen-mediated disease, is effectively treated with the dietary elimination of 6 foods commonly associated with food allergies (milk, wheat, egg, soy, tree nuts/peanuts, and fish/shellfish). Because wheat shares homologous proteins (including gluten) with barley and rye and can also be processed with these grains, some clinicians have suggested that barley and rye might also trigger EoE as a result of cross-reaction and/or cross-contamination with wheat. In this article, we discuss the theoretical risks of cross-reactivity and cross-contamination among wheat, barley, and rye proteins (including gluten); assess common practices at EoE treatment centers; and provide recommendations for dietary treatment and future studies of EoE.

• Authors: Kara L Kliewer, Carina Venter, Alison M Cassin, J Pablo Abonia, Seema S Aceves, Peter A Bonis, Evan S Dellon, Gary W Falk, Glenn T Furuta, Nirmala Gonsalves, Sandeep K Gupta, Ikuo Hirano, Amir Kagalwalla, John Leung, Vincent A Mukkada, Jonathan M Spergel, Marc E Rothenberg
• Journal: The Journal of allergy and clinical immunology (J Allergy Clin Immunol) Vol. 137 Issue 4 Pg. 1011-1014 (Apr 2016) ISSN: 1097-6825 [Electronic] United States
• PMID: 26725190 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Chemical References

• Allergens
• Glutens

Topics

• Allergens (immunology)
• Cross Reactions
• Eosinophilic Esophagitis (diet therapy, etiology, immunology)
• Food Hypersensitivity (complications, diet therapy, immunology)
• Glutens (immunology)
• Hordeum (immunology)
• Humans
• Secale (immunology)
• Triticum (immunology)