Published online: July 6, 2018
Little is known on how every day activities influence the severity of the allergic reaction or the threshold (how little intake can elicit an allergic reaction) in patients with food allergies when they inadvertently ingest the offending food. Exercise, aspirin and alcohol are factors that may reduce the threshold of a reaction or increase reaction severity, but the impact of these augmentation factors has not been extensively studied.
In an article recently published in The Journal of Allergy and Clinical Immunology: In Practice, Christensen et al. challenged patients diagnosed with wheat allergy at rest and with the augmentation factors described above. The objective was to evaluate and compare the impact of these co-factors in anaphylaxis, a severe allergic reaction.
The authors found that physical exercise after wheat intake markedly decreased the threshold by 63% compared to a food challenge with wheat at rest. The impact of aspirin was even more pronounced at 83%. Intake of alcohol only reduced threshold in some patients. An even lower threshold was observed when exercise and aspirin were combined. Concomitant with the reduction in threshold, the patients also experienced more severe allergic reactions. The authors emphasized the importance of considering these augmentation factors when assessing patients who experience anaphylaxis.
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.
Wheat-dependent, co-factor augmented anaphylaxis; a prospective study of exercise, aspirin and alcohol efficacy as co-factors
By Morten J. Christensen, Esben Eller, Charlotte G. Mortz, Knut Brockow, Carsten Bindslev-Jensen