Substance Info: (and synonyms)

Background Info:

Need to differentiate between Rye the foodstuff (Secale cereale), Cultivated Rye grass pollen (Secale cereale), Rye grass (Lolium perenne), and Wild Rye grass (Elymus tricoides).

See Cultivated Rye grass for information on the pollen components.

Two other species exist in the genus Secale. A distantly related genus, Elymus, contains species known as wild ryes that are used as cover and for forage; a wheat hybrid is known as giant rye.

Rye, a hardy, tufted annual grass 1-1.5m tall, was probably native to southwestern Asia but is now widely cultivated in the temperate regions of the world, often where conditions are unfavorable for wheat, where it is used mostly as a bread grain and as a livestock feed. It is still grown extensively in northern Europe and Asia. It apparently had co-evolved with Wheat and Barley for over 2,000 years until its value for food was recognised. But it has many other uses. Less than 50% of the rye grown in the U.S. is harvested for grain, with the remainder used as pasture, hay, silage or as a cover crop. About half of the amount harvested for grain is used for livestock feed or exported, and the remainder is used for alcoholic beverages, food, and seed.

The grain is used to make flour, the importance of which is second only to Wheat. Although rye flour does not develop true gluten, it has proteins which give it the capacity for making leavened bread (It lacks the proteins that make wheat suitable for leavening, and rye bread is denser and usually darker than wheat bread.) Rye is usually mixed with 25 to 50% wheat flour for bread making. Rye bread is especially popular in Northern Europe. Rye can also be used to make cakes, etc. The seed can be sprouted and added to salads. The roasted grains are a substitute for coffee.

Malt, a sweet substance produced by germinating the seed, is extracted from the roasted germinated seed and used as a sweetening agent and in making beer, etc. Canadian and United States whiskies are made mainly from rye.

The grains are used in folk remedies for cancers and tumors. They are reported to be laxative. The straw used as a fuel, thatching, paper-making, weaving hats, mats, etc.; as a packing material for nursery stock, bricks and tiles; for bedding, paper manufacture, archery targets, and mushroom compost.


Adverse Reactions:


[ 1 / 15 ]

There is considerable controversy whether maternal peanut ingestion during pregnancy might influence sensitization in later life. This study examined whether maternal peanut ingestion during pregnancy might increase sensitization in the offspring. A population-based longitudinal cohort study with 16 years follow-up was conducted (N=373). Maternal antenatal peanut consumption was documented at birth and peanut and rye sensitization were determined by measurement of serum-specific IgE at age 16. Peanut sensitization was common (14%). In the entire cohort (n=310), there was no association between antenatal peanut ingestion and peanut sensitization (P=0.17). However, there was a strong association between antenatal peanut ingestion and decreased risk of rye sensitization and peanut sensitization in those (n=201) without a family history (FH) of asthma (Rye OR 0.30, 95% CI 0.14-0.63, P=0.001 and Peanut OR 0.18, 95% CI 0.04-0.78, P=0.02). There was an increased risk of rye sensitization in those (n=108) with a FH of asthma and antenatal peanut ingestion (Rye OR 2.69, 95% CI 1.11-6.51 P=0.03). It was considered that these sensitizations were likely to be related to the presence of IgE antibodies to cross-reacting carbohydrate epitopes common to rye and peanut allergens. (Weber 2010 ref.25617 3)

Weber RW. On the cover - false ragweed. Ann Allergy Asthma Immunol 2010 Dec;105(6):A4

[ 2 / 15 ]

The aim of this study was to find out if barley starch syrup causes allergic reactions in patients with allergy to wheat, barley, rye or oats. Fifteen children with allergy to these cereals, confirmed by double-blind placebo-controlled food challenge (DBPCFC), were selected for the study. When exposed to cereals, seven of the children (47%) showed immediate type reactions, such as urticaria, rash or anaphylaxis. Eight of the children (53%) showed delayed type reactions, such as deterioration of atopic dermatitis or diarrhoea. The fifteen children with allergy to cereals were exposed to barley starch syrup in DBPCFC and none of them showed any objective signs of allergy. On skin-prick tests (SPT), five of the children (33.3%) showed a positive (>or= 3 mm) reaction to at least one of the cereals but none of them to barley starch syrup. This study confirmed with 98% confidence that at least 90% of the patients with verified allergy to cereals will not react with allergic symptoms to barley starch syrup. (Nermes 2009 ref.24046 5)

Nermes M, Karvonen H, Sarkkinen E, Isolauri E. Safety of barley starch syrup in patients with allergy to cereals. Br J Nutr 2009 Jan;101(2):165-8.

[ 3 / 15 ]

This study was performed to delineate the prevalence of, and evaluate possible risk factors for, adverse reactions to SPT in a prospective study of 5,908 patients aged Generalized allergic reactions
1. Boy, 5 m, eczema. Tested with 4 allergens, positive for cow’s milk and egg. After 10 min developed generalized urticaria, severe pruritus, swelling of the arm where the tests were performed, and excessive crying.
2. Boy, 6 m, eczema. Test with cow’s milk. After 10 min, generalized erythema, severe pruritus, itchy, red conjunctivae, vomiting.
3. Girl, 6 m, eczema. SPT with 5 allergens. Positive to egg, milk, wheat, rye, dog. Generalized urticaria, severe pruritus and reddening of eczema over the whole body.
4. Girl, 8 m, occasional urticaria when exposed to a casein hydrolysate formula on the skin, drop test negative. SPT with two allergens, both positive (Nutramigen and Profylac). After 10-15 min urticaria and pruritus.
5. Boy, 5.5 y, eczema, allergy to cow’s milk and egg. SPT to four allergens, positive to egg white and dog. After 10 min, sore throat, hoarseness, becomes pale, starts to cough and goes into cold sweat.
6. Boy, 10.5 y, with asthma and urticaria occasionally. SPT with 4 allergens, positive to almond and peanut. Complains of nasal congestion after 10 min.
7. Boy, 11 y, eczema, rhinitis, asthma. SPT with 9 allergens, positive tests to 7 (dog, cat, horse, birch, timothy, Cladosporium and Aspergillus). Nasal congestion and red, itchy and watery eyes.
(Norrman 2009 ref.23010 7)

Norrman G, Falth-Magnusson K. Adverse reactions to skin prick testing in children - Prevalence and possible risk factors. Pediatr Allergy Immunol 2009 Feb 4;

[ 4 / 15 ]

IgE-mediated cereal allergy and latent celiac disease.
A 4-year-old girl complained of episodes of abdominal pain, gastric fullness, flatulence, and vomiting immediately after intake of foods containing wheat and/or rye. She did not present any symptoms when she ate oatmeal and a brand of corn flakes made of wheat and corn. Symptoms started at 8 months of age. She did not present diarrhea, steatorrhea, weight loss, or failure to thrive. She did not have any relative with a history of celiac disease. Skin prick tests (mm) were positive for grass pollen (5), palm profilin (5), purified native Tri a 14 (wheat lipid transfer protein) (5), and gliadin (6). They were also positive to wheat (6), barley (4), rye (5), oats (4), rice (5), and corn (4). A prick-prick test for corn flakes was negative. Open oral food challenges were negative to corn flakes made of wheat and to soy shake, oatmeal, and rice. Single-blind placebo-controlled oral food challenge with wheat flour mixed with cooked rice induced nausea, abdominal pain, and vomiting 30 minutes after ingestion. Specific IgE were as follows: wheat gluten (14.6), oat (8.37), soy (0.93), rice (0.65), rye (15.3), barley (15.1), malt (24.5), corn (1.8), rBet v 2 (1.7), and Phi p 12 (1.4). Specific IgE to CM3/CM16 (cereal alpha-amylase inhibitors) was 5.30 kUA/L. Specific antitissue transglutaminase IgA (anti-tTG) and antigliadin autoantibodies (AGAs) were elevated in the patient's serum (anti-tTG, 629.5; AGAs, 8.1) and in her mother's serum (anti-tTG, 25.5; AGAs, 1.5). The HLA-DQ2 haplotype was detected in both the patient and her mother. An IgE-binding band of around 14 kDa, which may correspond to the cereal alpha-amylase inhibitors, was detected in all extracts. The allergens implicated in this case seem to correspond to amylase/trypsin inhibitor subunits, which were present in all 3-protein fractions of raw and cooked wheat, as well as LTP (Tri a 14). These allergens are the most commonly involved in wheat IgE-mediated food allergy in European patients [3]. In baker's asthma, the amylase/trypsin inhibitor family is also an important allergen together with thioredoxins, peroxidases, prolamins, and LTP (Tri a 14). (Torres 2008 ref.23094 8)

Torres JA, Sastre J, de las Heras M, Cuesta J, Lombardero M, Ledesma A. IgE-mediated cereal allergy and latent celiac disease. J Investig Allergol Clin Immunol 2008;18(5):412-4.

[ 5 / 15 ]

Eosinophilic esophagitis (EE) is often associated with concomitant atopic diseases. In children with EE in whom food allergens have been identified as causative factors, elemental and elimination diets result in an improvement or resolution of symptoms. Most adult EE patients are sensitized to aeroallergens, which cross-react with plant-derived food allergens, most commonly to grass pollen and cereals. The aims of this study were to investigate the clinical relevance of the sensitization to wheat and rye, and the efficacy of an allergen-specific elimination diet in adult EE patients. Six patients (five men, one woman) with permanently active EE sensitized to grass pollen and the cereals wheat and rye underwent a double-blind placebo-controlled food challenge and were kept on an elimination diet avoiding wheat and rye for 6 weeks. The challenge tests with wheat and rye did not provoke any EE symptoms in all patients. The elimination diet failed in reducing disease activity. Although one patient noticed an improvement of symptoms, endoscopic and histopathologic findings remained unchanged. (Simon 2006 ref.21649 7)

Simon D, Straumann A, Wenk A, Spichtin H, Simon HU, Braathen LR. Eosinophilic esophagitis in adults--no clinical relevance of wheat and rye sensitizations. Allergy 2006 Dec;61(12):1480-3.

[ 6 / 15 ]

Two sera were selected as representative of patients with either wheat-dependent exercise-induced anaphylaxis (WDEIA) or hypersensitivity to hydrolyzed wheat proteins (HHWP). Their IgE specificity was studied with wheat, barley and rye proteins. IgE from one patient with both contact urticaria and food allergy to gluten hydrolysates also cross reacted with gamma 3-hordein. Their pattern of reactivity with wheat, barley and rye proteins differed from that of a WDEIA patient tested in the same conditions. Those from the WDEIA patient showed expected reactions with omega-5 gliadin, gamma-35 and gamma-75 secalins, but also with wheat low-molecular-weight glutenin subunits (LMW-GS), and not with C hordeins. On the contrary, IgE from a HHWP patient reacted with C hordeins, various omega gliadins, and gamma-75 secalin, but very weakly with gamma-35 secalin and LMW-GS. Recombinant gamma-3 hordein inhibited strongly but not totally the WDEIA patient's IgE binding to prolamins. No such inhibition could be observed for the HHWP patient's IgE. Conclusions: At least part of the reactions of prolamins with the IgE from the WDEIA patient was due to antigenic homologies. The occurrence of cross-reacting carbohydrates was unlikely. These common IgE epitopes were not involved in the pathology of the HHWP patient. An IHHWP patient reacted like WDEIA patients with gamma 3-hordein, a barley prolamin cross-reacting with omega 5-gliadins. (Snégaroff 2006 ref.20292 3) See also: (Lauriere 2007 ref.20242 2)

Snégaroff J, Bouchez-Mahiout I, Pecquet C, Branlard G, Laurière M. Study of IgE antigenic relationships in hypersensitivity to hydrolyzed wheat proteins and wheat-dependent exercise-induced anaphylaxis. Int Arch Allergy Immunol 2006;139(3):201-8.

[ 7 / 15 ]

This study concludes that delaying initial exposure to cereal grains (wheat, barley, rye, oats) until after 6 months may increase the risk of developing wheat allergy. These results do not support delaying introduction of cereal grains for the protection of food allergy. A total of 1612 children were enrolled at birth and followed to the mean age of 4.7 years. Questionnaire data and dietary exposures were obtained at 3, 6, 9, 15, and 24 months and annually thereafter. The main outcome measure was parent report of wheat allergy. Children with celiac disease autoimmunity were excluded. Wheat-specific immunoglobulin E levels on children reported to have wheat allergy were obtained. Sixteen children (1%) reported wheat allergy. Children who were first exposed to cereals after 6 months of age had an increased risk of wheat allergy compared with children first exposed to cereals before 6 months of age (after controlling for confounders including a family history of allergic disorders and history of food allergy before 6 months of age). All 4 children with detectable wheat-specific immunoglobulin E were first exposed to cereal grains after 6 months. (Poole 2006 ref.14355 5)

Poole JA, Barriga K, Leung DY, Hoffman M, Eisenbarth GS, Rewers M, Norris JM. Timing of initial exposure to cereal grains and the risk of wheat allergy. Pediatrics 2006 Jun;117(6):2175-2182

[ 8 / 15 ]

Cereal-induced anaphylaxis in an adult after eating a baby cereal formula. A 34-year-old man, a carpenter, with previously diagnosed occupational asthma due to rye flour added to wood boards, developed severe anaphylaxis after testing a spoonful of baby cereal food - a non-gluten rice and corn formula). He developed respiratory and gastrointestinal symptoms, paleness and decreased level of consciousness. Skin prick test was positive for wheat, barley, rye flour, peanut and mustard. Serum specific IgE were found for all of these. A DBPCFC was positive for 0.1g of the cereal. A 37 kDa protein band was demonstrated in the baby food, flours and mustard. In addition, a defined 23 kDa band was found in the corn flour. (Asensio 2004 ref.9960 8)

Asensio T, Armentia A, Lombardero M, Callejo A, Martin G, Castrodeza J. Cereal-induced anaphylaxis in an adult after eating a baby cereal formula. Allergol Immunopathol (Madr) 2004;32(5):310-1

[ 9 / 15 ]

The aim of this study was to evaluate the allergenic reactivity of ingested and inhaled cereal allergens in different ages. 66 patients in three groups were studied. Group 1: 40 children aged 3 to 6 months who suffered from diarrhoea, vomiting, eczema or weight loss after the introduction of cereal formula in their diet and in which a possibility of coeliac disease was discarded. Group 2: 18 adults with food allergy due to cereals tested by prick tests, specific IgE and food challenge. Group 3: eight patients previously diagnosed as having baker's asthma. The authors found important sensitization to cereal in the 40 children. The most important allergens were wheat followed by barley and rye. Among the adults with cereal allergy, sensitization to other allergens was common, especially to Lolium perenne (rye grass) pollen. Immunoblotting showed similar allergenic detection in the three groups. (Armentia 2002 ref.6668 2)

Armentia A, Rodriguez R, Callejo A, Martin-Esteban M, Martin-Santos JM, Salcedo G, Pascual C, Sanchez-Monge R, Pardo M. Allergy after ingestion or inhalation of cereals involves similar allergens in different ages. Clin Exp Allergy 2002;32(8):1216-22

[ 10 / 15 ]

Life-threatening, recurrent anaphylaxis caused by allergy to gliadin and exercise. Wheat gliadin and the corresponding ethanol-soluble proteins of taxonomically closely related cereals (gliadin found in wheat, rye, barley and oats) were found to be the allergens in cereal-dependent exercise-induced anaphylaxis. (Varjonen 1997 ref.653 43)

Varjonen E, Vainio E, Kalimo K. Life-threatening, recurrent anaphylaxis caused by allergy to gliadin and exercise. Clin Exp Allergy 1997;27(2):162-6

[ 11 / 15 ]

In a study with challenges to the common cereals, 80% reacted to only one grain. (Jones 1995 ref.2465 0)

Jones SM, Magnolfi CF, Cooke SK, Sampson HA. Immunologic cross-reactivity among cereal grains and grasses in children with food hypersensitivity. J Allergy Clin Immunol 1995;96:341-51.

[ 12 / 15 ]

40 adult patients; 35 patients with atopic dermatitis, one with rhinitis and four with urticaria. 35 patients appeared positive in IgE immunoblotting with wheat and rye, 32 with barley and 33 with oats. (Varjonen 1994 ref.1330 3)

Varjonen E, Savolainen J, et al. IgE-binding components of wheat, rye, barley and oats recognized by immunoblotting analysis with sera from adult atopic dermatitis patients. Clin Exp Allergy 1994;24(5):481-9

[ 13 / 15 ]

Cereal-induced symptoms were dermatologic, gastrointestinal, or oropharyngeal, and their onset after provocation was immediate (eight cases), delayed (14 cases), or both immediate and delayed (one case). On oral provocation, 18 children exhibited a positive response to wheat, three to rye, one to barley, and one to oats. (Rasanen 1994 ref.1312 5)

Räsänen L, Lehto M, Turjanmaa K, Savolainen J, Reunala T. Allergy to ingested cereals in atopic children. Allergy 1994;49(10):871-6

[ 14 / 15 ]

Anaphylaxis with exercise. (Armentia 1990 ref.473 31)

Armentia A, Martin-Santos JM, Blanco M, Carretero L, Puyo M, Barber D. Exercise-induced anaphylactic reaction to grain flours. Ann Allergy 1990;65:149-151

[ 15 / 15 ]

See: Rye, for allergy to Rye seed/flour.
See: Cultivated Rye grass, for allergy to rye pollen from rye.
See also: Rye grass / Perennial rye grass
See also: Wild Rye grass

Editor Comment Editorial comment, common knowledge, or still to add - -

Non-Immune reactions

[ 1 ]

Recently, a large epidemiological investigation in a cohort of children at risk for IDDM found that exposure to cereals (rice, wheat, oats, barley, rye) that occurred early (< or = 3 months) as well as late (> or = 7 months) resulted in a significantly higher risk of the appearance of islet cell autoimmunity compared to the introduction between 4 and 6 months. (Guandalini 2007 ref.21598 5)

Guandalini S. The influence of gluten: weaning recommendations for healthy children and children at risk for celiac disease. Nestle Nutr Workshop Ser Pediatr Program 2007;60:139-51

[ 2 ]

Coeliac disease is a lifelong intolerance to the gluten found in wheat, barley and rye, and some patients are also sensitive to oats. The disease is genetically determined, with 10% of the first-degree relatives affected and 75% of monozygotic twins being concordant. Of the patients with coeliac disease 95% are human leucocyte antigen (HLA)-DQ2 or HLA-DQ8 positive. Characteristically, the jejunal mucosa becomes damaged by a T-cell-mediated autoimmune response that is thought to be initiated by a 33-mer peptide fragment in A2 gliadin, and patients with this disorder have raised levels of anti-endomysium and tissue transglutaminase antibodies in their blood. Coeliac disease is the major diagnosable food intolerance and, with the advent of a simple blood test for case finding, prevalence rates are thought to be approximately 1:100. Classically, the condition presented with malabsorption and failure to thrive in infancy, but this picture has now been overtaken by the much more common presentation in adults, usually with non-specific symptoms such as tiredness and anaemia, disturbance in bowel habit or following low-impact bone fractures. Small intestinal biopsy is necessary for diagnosis and shows a characteristically flat appearance with crypt hypoplasia and infiltration of the epithelium with lymphocytes. Compliance can be monitored by measuring antibodies in blood, which revert to negative after 6-9 months. Patients with minor symptoms, who are found incidentally to have coeliac disease, often ask whether it is necessary to adhere to the diet. Current advice is that dietary adherence is necessary to avoid the long-term complications, which are, principally, osteoporosis and small bowel lymphoma. (McGough 2005 ref.21599 2)

McGough N, Cummings JH. Coeliac disease: a diverse clinical syndrome caused by intolerance of wheat, barley and rye. Proc Nutr Soc 2005 Nov;64(4):434-50.

[ 3 ]

For 6 months a 42-year-old farmer suffered from increasing pain in both feet and calves. Angiography demonstrated progressive narrowing of all lower-leg arteries and there were no palpable pulses in the right foot and those in the left foot were markedly reduced. The patient had been exposed to ergotamine-containing milling dust in the preparation of rye flour. Inhalational intake of ergotamine was proven by a high plasma ergotamine level. Chronic ergotamine inhalation can cause ergotism affecting peripheral arteries. (Stange 1998 ref.7527 3)

Stange K, Pohlmeier H, Lubbesmeyer A, Gumbinger G, Schmitz W, Baumgart P. Vascular ergotism through inhalation of grain dust. [German] Dtsch Med Wochenschr 1998;123(51-52):1547-50

[ 4 ]

Coeliac disease (See Gluten)

Editor Comment Editorial comment, common knowledge, or still to add - -

Occupational reactions

[ 1 ]

Grain-induced asthma is a frequent occupational allergic disease mainly caused by inhalation of cereal flour or powder. The main professions affected are bakers, confectioners, pastry factory workers, millers, farmers, and cereal handlers. The major causative allergens of grain-related asthma are proteins derived from wheat, rye and barley flour, although baking additives, such as fungal alpha-amylase are also important. This review deals with the current diagnosis and treatment of grain-induced asthma, emphasizing the role of cereal allergens as molecular tools to enhance diagnosis and management of this disorder. Salt-soluble proteins (albumins plus globulins), particularly members of the alpha-amylase/trypsin inhibitor family, thioredoxins, peroxidase, lipid transfer protein and other soluble enzymes show the strongest IgE reactivities in wheat flour. In addition, prolamins (not extractable by salt solutions) have also been claimed as potential allergens. However, the large variability of IgE-binding patterns of cereal proteins among patients with grain-induced asthma, together with the great differences in the concentrations of potential allergens observed in commercial cereal extracts used for diagnosis, highlight the necessity to standardize and improve the diagnostic tools. The availability of purified allergens should be very helpful for a more refined diagnosis. (Quirce 2013 ref.29336 5)

Quirce S, az-Perales A. Diagnosis and Management of Grain-Induced Asthma. Allergy Asthma Immunol Res 2013 Nov;5(6):348-356

[ 2 ]

Flour is still one of the most common causes of occupational asthma worldwide. Thus far, little is known about the relevant allergens causing baker's asthma. Therefore the reliability of current diagnostic procedures is insufficient. Only few of the suspected causative wheat allergens have been hitherto characterized on the molecular level. The aim was to identify and characterize unknown wheat allergens related to baker's asthma to improve the reliability of diagnostic procedures.

IgE binding to wheat proteins with pooled sera from patients with baker's asthma was investigated. After identifying an alphabeta-gliadin, the frequency of sensitization was investigated by means of ELISA screening of 153 bakers' sera with the recombinant alphabeta-gliadin. Furthermore, the allergenicity of native total gliadin (alphabeta, gamma, omega) was analyzed by means of ImmunoCAP. 60-70% of bakery workers with rhinoconjunctivitis and asthma were found to have elevated specific IgE levels to wheat, rye, or both extracts.

One cDNA clone was identified as an alphabeta-gliadin. Serum IgE antibodies to the recombinant allergen were found in 12% of bakers with occupational asthma. Of the asthmatic bakers, 33% showed sensitization to native total gliadin; 4% of them had negative results on routine IgE testing with wheat extract. The study concludes that gliadins represent a newly discovered family of inhalable allergens in baker's asthma. This finding demonstrates that water-insoluble proteins might also represent causative allergens. (Bittner 2008 ref.20779 3)

Bittner C, Grassau B, Frenzel K, Baur X. Identification of wheat gliadins as an allergen family related to baker's asthma. J Allergy Clin Immunol 2008 Mar;121(3):744-9.

[ 3 ]

Rye flour has gained increased attention as a causative inhaled allergen in baker's asthma, a phenomenon attributed to its increased cultivation and use. Two cases of baker's asthma mainly caused by exposure to rye flour. Two bakery workers suffering from rhinoconjunctivitis and asthma symptoms at work were investigated. Specific inhalation challenge with wheat flour did not elicit an asthmatic reaction, however both patients showed an early asthmatic reaction with the rye flour challenge. Rye flour-immunoblotting showed IgE-binding bands around 12-15 kDa, that correspond to rye flour enzymatic inhibitors which were not present in the wheat flour immunoblot. (Letrán 2008 ref.21632 7)

Letrán A, Palacín A, Barranco P, Salcedo G, Pascual C, Quirce S. Rye flour allergens: An emerging role in baker's asthma. Am J Ind Med 2008 May;51(5):324-8.

[ 4 ]

The aim of this study was to investigate the sensitization of wheat flour and other baking allergens (oat, barley, and rye flour) in traditional bakers and in cleaners in a big hospital in the same area. (Karkoulias 2007 ref.21596 2)

Karkoulias K, Patouchas D, Alahiotis S, Tsiamita M, Vrodakis K, Spiropoulos K. Specific sensitization in wheat flour and contributing factors in traditional bakers. Eur Rev Med Pharmacol Sci 2007 May-Jun;11(3):141-8.

[ 5 ]

This report describes the investigation of a baker with asthma who reported a workplace response to rye flour and none to wheat flour, despite co-reactivity to both wheat and rye antigen. Skin prick tests, RASTs and basophil stimulation tests were positive for both wheat and rye antigen, but quantitatively greater for rye than wheat. Bronchial challenge elicited a much greater response to the rye-wheat flour mix used in the bakery than to 100% wheat flour. The greater clinical response to rye than to wheat may be immunologically mediated, but could also be due to physical characteristics of rye flour such as greater dose of inhaled airborne particles or an irritative effect. (Ehrlich 2005 ref.21651 7)

Ehrlich R, Prescott R. Baker's asthma with a predominant clinical response to rye flour. Am J Ind Med 2005 Aug;48(2):153-5.

[ 6 ]

Cereal-induced anaphylaxis in an adult after eating a baby cereal formula. A 34-year-old man, a carpenter, with previously diagnosed occupational asthma due to rye flour added to wood boards, developed severe anaphylaxis after testing a spoonful of baby cereal food - a non-gluten rice and corn formula). He developed respiratory and gastrointestinal symptoms, paleness and decreased level of consciousness. Skin prick test was positive for wheat, barley, rye flour, peanut and mustard. Serum specific IgE were found for all of these. A DBPCFC was positive for 0.1g of the cereal. A 37 kDa protein band was demonstrated in the baby food, flours and mustard. In addition, a defined 23 kDa band was found in the corn flour. (Asensio 2004 ref.9960 8)

Asensio T, Armentia A, Lombardero M, Callejo A, Martin G, Castrodeza J. Cereal-induced anaphylaxis in an adult after eating a baby cereal formula. Allergol Immunopathol (Madr) 2004;32(5):310-1

[ 7 ]

Cereal flours are used in the wood industry to improve the quality of the glues necessary to produce veneer panels (wood manufacturing). Three individuals were found to be allergic to cereal alpha-amylase inhibitors, which are important occupational allergens responsible for baker's asthma, and which are members of the alpha-amylase inhibitor family which are allergenic proteins in rye, barley and wheat. (Lopez-Rico 1998 ref.5518 8)

Lopez-Rico R, Moneo I, Rico A, Curiel G, Sanchez-Monge R, Salcedo G. Cereal alpha-amylase inhibitors cause occupational sensitization in the wood industry. Clin Exp Allergy 1998;28(10):1286-91

[ 8 ]

Rhinitis, conjunctivitis, wheal and flare reactions. Bakers with workplace-related respiratory symptoms showed sensitization to wheat flour (64%), rye flour (52%), soy bean flour (25%), and alpha-amylase (21%). The correlation between these sensitizations and asthma case history and inhalative challenge test responses was significant. (Baur 1998 ref. 3702 1)

Baur X, Degens PO, Sander I Baker's asthma: still among the most frequent occupational respiratory disorders. J Allergy Clin Immunol 1998;102(6 Pt 1):984-97

[ 9 ]

Occupational protein contact dermatitis. (Iliev 1998 ref.2097 6)

Iliev D, Wüthrich B. Occupational protein contact dermatitis with type I allergy to different kinds of meat and vegetables. Int Arch Occup Environ Health 1998;71(4):289-292

[ 10 ]

Occupational allergy to rye flour in carpenters. A report of nine atopic patients exposed to wood dust and suffering with occupational allergy (asthma, rhinoconjuncitivis) that seemed to be caused by the rye flour used in the manufacture of agglomerate boards. No reaction was found in most patients (7/9) in skin prick tests when different wood dust extracts were used. One was skin prict test positive to Western red cedar and ramin and another to Western red cedar and iroko. By contrast, all subjects showed positive reactions with the commercial rye flour extract, both in the skin prick and in the conjunctival test, and five of them also in bronchial challenge tests. Three purified rye allergens, which belong to the cereal a-amylase inhibitor family, were also reactive, particularly Sec c 1 (8/9 patients). (Armentia 1997 ref.2244 0)

These inhibitors, as well as their wheat and barley homologs, have been identified as prominent allergens associated with baker's asthma. (Garcia-Casado 1995 ref.1880 7)

(Armentia 1997 ref.2244 6)

Armentia A, Garcia Casado G, Vega J, Sanchez-Monge R, Mendez J, Salcedo G. Occupational allergy to rye flour in carpenters. Allergy 1997;52(11):1151-1152

[ 11 ]

Fourteen bakers suffering from workplace-related respiratory symptoms and sensitized to soybean were studied. Twelve of them were also allergic to wheat flour, 10 to rye flour, and five to alpha-amylase of Aspergillus oryzae (Asp o 2). IgE estimation by RAST strongly indicated that the trypsin inhibitor and lipoxidase are major allergens of soybean. The trypsin inhibitor is an important inhalative soybean allergen recognized by IgE antibodies in the sera of 86% of the examined sensitized bakers. (Baur 1996 ref.1412 2)

Baur X, Pau M, Czuppon A, Fruhmann G. Characterization of soybean allergens causing sensitization of occupationally exposed bakers. Allergy 1996;51(5):326-30

[ 12 ]

Asthma related to exposure to cereal flour contained in animal formula feeds. (Valdivieso 1988 ref.1885 64)

Valdivieso R, Pola J, Zapata C, Puyana J, Cuesta J et al. Farm animal feeders: another group affected by cereal flour asthma. Allergy 1988;43(6):406-410

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