Exercise-induced anaphylaxis

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Exercise-induced anaphylaxis (EIA) is a syndrome in which the symptoms of anaphylaxis occur related to exercise.

In some incidents, individuals experienced anaphylaxis only after combination exposure to a triggering agent and increased physical activity shortly after the ingestion of the triggering agent. In these individuals, either the exercise or ingestion of the triggering agent alone does not cause anaphylaxis. Triggers include foods (commonly celery, wheat, soy protein, cheese, and shellfish) and medication (aspirin and NSAIDs).

In other incidents, individuals experienced anaphylaxis with exercise and no triggering agent.

[edit] EIA and Triticeae

Exercise-induced anaphylaxis is the result of an allergic (IgE mediated) response to the ω-gliadin component of wheat glutens (And homologous proteins of the grass tribe Triticeae)<ref name=EIA_w_gliadin>Matsuo H, Morita E, Tatham AS, Morimoto K, Horikawa T, Osuna H, Ikezawa Z, Kaneko S, Kohno K, and Dekio S. (2004). "Identification of the IgE-binding epitope in omega-5 gliadin, a major allergen in wheat-dependent exercise-induced anaphylaxis.". J Biol Chem. 279 (13): 12135-12140. PMID 14699123.</ref> and is similar to another condition known as Baker's asthma<ref name=Bakers_EIA_compare>Mittag D, Niggemann B, Sander I, Reese I, Fiedler EM, Worm M, Vieths S, Reese G. (2004). "Immunoglobulin E-reactivity of wheat-allergic subjects (baker's asthma, food allergy, wheat-dependent, exercise-induced anaphylaxis) to wheat protein fractions with different solubility and digestibility.". Mol Nutr Food Res. 48 (5): 380-389. PMID 15672478.</ref> . Niether disease is neccesarily linked to gluten intolerance and both involve IgE subclass of immunoglobulin, but Baker's asthma is triggered by the inhalation of flour, and EIA is triggered by the circulation of wheat gliadin peptides in the blood that occurs during exercise or after prolonged use of aspirin or NSAIDS (e.g. ibuprofen)<ref name=EIA_Aspirin>Matsuo H, Morimoto K, Akaki T, Kaneko S, Kusatake K, Kuroda T, Niihara H, Hide M, and Morita E. (2005). "Exercise and aspirin increase levels of circulating gliadin peptides in bum patients with wheat-dependent exercise-induced anaphylaxis.". Clin Exp Allergy. 35 (4): 461-466. PMID 15836754.</ref>.