Remission rate of patients with wheat allergy sensitized to hydrolyzed wheat protein in facial soap.

Hydrolyzed wheat protein (HWP) is made from gluten by acid or enzymemodification and used formany cosmetics around theworld. Recently, reports emerged about 2169 patients with wheat allergy sensitized to HWP in facial soap (HWP-wheat allergy) and consequently represented in an important social problem in Japan.1e3 Most patients had used the same soap bar named “Cha-no-ShizukuTM” containing HWP. HWPused in “Cha-no-ShizukuTM”wasGlupearl19S.Although itwasalsocontained inseveralother typesof soap bars, all of themhad alreadybeen recalled.Most of the patients sensitized to HWPwere female and their peak agewas in the 40s.3 Several severe cases led toanaphylaxis. 56%and16%of thepatientsdeveloped symptoms after exercise or oral intake of NSAIDs, respectively. Although serumwheatand gluten-specific IgE are negative and u-5 gliadin-specific IgE is positive in CAP-FEIA (CAP-fluoro enzyme immune assay) in most patients with conventional wheatdependent exercise-induced anaphylaxis (WDEIA),4 wheatand gluten-specific IgE are positive and u-5 gliadin-specific IgE is negative in many patients with HWP-wheat allergy, even in the WDEIA subtype.3,5 Moreover, patients with HWP-wheat allergy exhibit positive skin prick tests and basophil histamine release tests (HRT) against HWP, Glupearl 19S. Those positive reactions against HWP are specific to patients with HWP-wheat allergy.5 Wepreviously reporteda remissioncaseofHWP-wheatallergyafter cessation of HWP-containing soap6 and also reported that hypersensitivities againstwheat componentsweremostly reduced in those patients.5 However, substantial numbers of patients still avoid food containingwheat, and the remission rate and/or change of hypersensitivityagainstHWPofoverall patientshavenot yetbeendetermined. Here, we investigated clinical remission rate of HWP-wheat allergy and negative conversion rate of ex vivo HRT against HWP. We retrospectively studied 110 patients who were diagnosed with HWP-wheat allergy, visited Hiroshima University Hospital from January 2010 to December 2013, and who were followed until September 2014. Patients were diagnosed according to the criteria for immediate wheat allergy to the hydrolyzed wheat (Glupearl 19S) contained in “Cha-no-Shizuku” soap and some other products by the Special Committee for the Safety of Protein Hydrolysate in Cosmetics (Supplementary Table 1).7 The remission rate of HWPwheat allergy and the negative conversion rate of HRT against HWPwere analyzed by KaplaneMeier methods, and related factors were analyzed by the log-rank test. We defined “Remission” as condition free of symptoms for more than 3 months without any