Should wheat, barley, rye, and/or gluten be avoided in a 6-food elimination diet? - 06/04/16
Doi : 10.1016/j.jaci.2015.10.040
Kara L. Kliewer, PhD, RD a, Carina Venter, PhD, RD a, Alison M. Cassin, MS, RD a, J. Pablo Abonia, MD a, ∗, Seema S. Aceves, MD, PhD b, ∗, Peter A. Bonis, MD c, ∗, Evan S. Dellon, MD, MPH d, ∗, Gary W. Falk, MD, MS e, ∗, Glenn T. Furuta, MD f, ∗, Nirmala Gonsalves, MD g, ∗, Sandeep K. Gupta, MD h, ∗, Ikuo Hirano, MD g, ∗, Amir Kagalwalla, MD i, ∗, John Leung, MD c, ∗, Vincent A. Mukkada, MD j, ∗, Jonathan M. Spergel, MD, PhD k, ∗, Marc E. Rothenberg, MD, PhD a, ⁎∗ 
a Division of Allergy and Immunology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
j Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
b Division of Allergy and Immunology, Department of Pediatrics and Medicine, University of California, San Diego and Rady Children's Hospital, San Diego, Calif
c Division of Gastroenterology, Tufts Medical Center, Boston, Mass
d Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, NC
e Division of Gastroenterology, Hospital of the University of Pennsylvania, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pa
f Section of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colo
g Division of Gastroenterology and Hepatology, Northwestern University Feinberg School of Medicine, Chicago, Ill
h Section of Pediatric Gastroenterology, Hepatology and Nutrition, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Ind
i Division of Gastroenterology, Hepatology and Nutrition, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill
k Division of Allergy and Immunology, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pa
∗Corresponding author: Marc E. Rothenberg, MD, PhD, Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, MLC 7028, 3333 Burnet Ave, Cincinnati, OH 45229.Division of Allergy and ImmunologyCincinnati Children's Hospital Medical CenterMLC 7028, 3333 Burnet AveCincinnatiOH45229
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.
Le texte complet de cet article est disponible en PDF.Key words : Eosinophilic esophagitis, 6-food elimination diet, wheat, cross-reactivity, gluten
Abbreviations used : CEGIR, EoE, 6FED
| Supported in part by U54 AI117804, which is part of the Rare Disease Clinical Research Network (RDCRN), an initiative of the Office of Rare Disease Research (ORDR), National Center for Advancing Translational Sciences (NCATS), and funded through collaboration between the NCATS, National Institute of Allergy and Infectious Diseases, and National Institute of Diabetes and Digestive and Kidney Diseases, which have collectively resulted in the Consortium of Eosinophilic Gastrointestinal Disease Researchers (CEGIR). |
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| Disclosure of potential conflict of interest: K. L. Kliewer has received a grant and travel support from the Consortium of Eosinophilic Gastrointestinal Disease Researchers (CEGIR; National Institutes of Health [NIH]). C. Venter has consultant arrangements with Danone, has received payment for lectures from Nestlé, and has received payment for development of education presentations from Mead Johnson. A. M. Cassin has consultant arrangements with and has received payment for lectures and development of educational presentations from Nutricia North America. J. P. Abonia has received a consulting fee or honorarium from the Kentucky Allergy Society and has received a grant from the NIH (U54 Grant [CEGIR], PCORI grant). S. S. Aceves has received grants from the NIH (U54 Consortium grant CEGIR, R01) and Raptor Pharmaceutical, is on the American Partnership for Eosinophilic Disorders Medical Advisory Board, has stock/stock options in Meritage Pharma, has received travel support from the NIH/National Institute of Diabetes and Digestive and Kidney Diseases. P. A. Bonis is Chief Medical Officer at UpToDate. E. S. Dellon has consultant arrangements with Aptalis, Novartis, Receptos, Regeneron, and Roche and has received research funding from Miraca, Meritage, Receptos, and Regeneron. G. W. Falk has received a grant and travel support from CEGIR, has consultant arrangements with Aptalis, and has received grants from Meritage, Receptos, and Regeneron. G. T. Furuta is a medical advisor to Campaign Urging Research for Eosinophilic Disease (CURED), has consultant arrangements with Genentech and UpToDate, has received grants from the NIH, has a patent for Esophageal String Test, and is cofounder of EnteroTrack. N. Gonsalves has received lecture fees from Nutricia and receives royalties from UpToDate. S. K. Gupta has consultant arrangements with Receptos and Abbott Nutrition. I. Hirano has consultant arrangements with Receptos, Regeneron, and Meritage; has received grants from the NIH and the American Society of Gastrointestinal Endoscopy; and has received royalties from UpToDate. A. Kagalwalla has received payment for lectures from Nutricia. V. A. Mukkada has received grants from the Rare Disease Clinical Research Network (U54 AI117804) and the Patient Centered Outcomes Research Institute. J. M. Spergel has received grants from the NIH, DBV Technology, Food Allergy Research and Education, Aimmune Therapeutics, and the Stanford Food Allergy Research Center; is on the Scientific Advisory Board for DBV Technology; has consultant arrangements with Danone; has received payment for lectures from MEI; and has stock/stock options in DBV Technology. M. E. Rothenberg has received a grant from the NIH; has received money paid to his institution from the CURED Foundation, the Buckeye Foundation, Food Allergy Research and Education, and the APFED Foundation; is a board member for the International Eosinophil Society; is on the medical advisory panel for the American Partnership for Eosinophilic Disorders; has consultant arrangements with Immune Pharmaceuticals, Receptos, Celsus Therapeutics, Genentech/Roche, and Novartis; has patents submitted and owned by CCHMC for which he is an inventor; has received royalties from Teva Pharmaceuticals; and has stock/stock options in Immune Pharmaceuticals, Receptos, Celsus Therapeutics, and NKT Therapeutics. J. Leung declares that he has no relevant conflicts of interest. |
© 2015
American Academy of Allergy, Asthma & Immunology. Publié par Elsevier Masson SAS. Tous droits réservés.
Vol 137 - N° 4
P. 1011-1014 - avril 2016 Retour au numéro
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