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Wheat starch and IgE mediated wheat allergy

Question:

1/25/2024
Any good studies on wheat allergic patient and wheat starch. The later is being used more in the food industry.

Answer:

Studies addressing the relevance of wheat starch regarding wheat allergy are sparse. I did a Pub Med search and was able to find a few manuscripts that addressed this issue.

Wheat starch consists of amylose and amylopectin organized into alternating semicrystalline and amorphous layers in granules that vary in size and are embedded in the endosperm protein matrix. (1) Based on radioimmune assays, wheat starch has been shown to contain up to 1.9 x 10-2% wheat gliadin (2). Wheat starch may be insufficiently purified of wheat proteins and therefore could provoke IgE mediated hypersensitivity reaction wheat allergic patients. (3)

I reached out to Dr. David Fleischer, an expert in this area and he offered his thoughts as follows. Since wheat starch can contain protein, it is best to avoid. I wanted to confirm and did so with Carina Venter, our world-renowned research dietitian. She said the following: Wheat starch can actually be rendered gluten-free in the US, and in that case, it may be tolerated. In the EU there are many gluten free wheat starch. To my knowledge, wheat starch always contains wheat protein of some sort but can be gluten free.

In summary, wheat starch does contain wheat protein and therefore should be avoided by patients with IgE mediated sensitivity to wheat protein. On the other hand, wheat starch can be gluten free and tolerated by patients with celiac disease.

1) van Rooyen J, Simsek S, Oyeyinka SA, Manley M. Wheat starch structure-function relationship in breadmaking: A review. Compr Rev Food Sci Food Saf. 2023 May;22(3):2292-2309. doi: 10.1111/1541-4337.13147. Epub 2023 Apr 3. PMID: 37010110.
2) Ciclitira PJ, Ellis HJ, Evans DJ, Lennox ES. A radioimmunoassay for wheat gliadin to assess the suitability of gluten free foods for patients with coeliac disease. Clin Exp Immunol. 1985 Mar;59(3):703-8. PMID: 3987095; PMCID: PMC1576931.
3) Czaja-Bulsa G, Bulsa M. What Do We Know Now about IgE-Mediated Wheat Allergy in Children? Nutrients. 2017 Jan 4;9(1):35. doi: 10.3390/nu9010035. PMID: 28054973; PMCID: PMC5295079.

Special thanks to David Fleischer, MD and Carina Venter, PhD, RD for their contributions.

Jeffrey G Demain, MD, FAAAAI