424 Wheat-dependent Exercise-induced Anaphylaxis Occurred in OAS Patient after Using Soap Containing Hydrolyzed Wheat Proteins: Effect of Soap on Keratinocyte Inflammasome

BACKGROUND: We present a case of Wheat-dependent Exercise-induced anaphylaxis (WDEIA) occurred in a patient previously suffering from atopic dermatitis (AD), pollen allergy and Oral allergy syndrome (OAS) after using face soap containing hydrolyzed wheat proteins (HWP) . METHODS: A 16-year old woman had contact urticaria after using face soap containing HWP and developed urticaria and dyspnea after ingestion of wheat products. We performed skin prick test, provocation test and serum IgE analysis by Western blotting. RESULTS: Provovation test, skin prick test for soap solution and HWP were positive and serum IgE molecules reacting to HWP were detected in the patient's sera. CONCLUSIONS: WDEIA in this patient was considered to be induced after percutaneous sensitization with HWP in the soap. OAS is a Class 2 food allergy which is often shown in AD patients, and it is suggested that these patients have possibility to develop food allergy by percutaneous sensitization with various hydrolyzed food protein in cosmetics. We also examine the direct effects of the soap solution on keratinocytes inflammasome in vitro to explain the formation of percutaneous sensitization in this case.