A COMPREHENSIVE SYSTEMATIC REVIEW OF THE RELATIONSHIP BETWEEN EXERCISE-INDUCED ALLERGY AND FOOD-DEPENDENT EXERCISE-INDUCED ANAPHYLAXIS
Keywords:
Food-dependent exercise-induced anaphylaxis, exercise-induced anaphylaxis, omega-5 gliadin, non-specific lipid transfer protein, cofactor-enhanced food allergyAbstract
Introduction: Exercise-induced anaphylaxis (EIA) and food-dependent exercise-induced anaphylaxis (FDEIA) represent physically triggered hypersensitivity disorders with contested nosological positioning. FDEIA has historically been classified as a physical allergy subtype, yet accumulating evidence suggests it constitutes a high-threshold, cofactor-dependent food allergy. This systematic review synthesized all primary interventional and observational evidence describing the epidemiological, immunological, diagnostic, mechanistic, and prognostic relationship between these entities.
Methods: The study strictly adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020 guidelines. Eligibility was restricted a priori to randomized controlled trials, interventional/provocation studies, cohort, case-control, cross-sectional, and epidemiological survey designs. Two reviewers independently screened, extracted, and appraised records using a dual risk-of-bias architecture (modified Newcastle-Ottawa/JBI composite and RoB 2/ROBINS-I), with GRADE certainty grading across fifteen prespecified outcome domains.
Results: Fifty primary studies (up to 2026), encompassing >6,900 patients and >600,000 surveyed children, met eligibility. Population prevalence rose from 0.0047% in elementary to 0.017–0.018% in junior-high students, with male predominance in adolescence. Wheat was the dominant culprit globally; non-specific lipid transfer proteins (nsLTP) predominated in Mediterranean populations (66.3–78%). Component-resolved serology achieved 80–91% sensitivity and 92% specificity for omega-5 gliadin, rising to 93.8% sensitivity/92.9% specificity with recombinant high-molecular-weight glutenin. Exercise lowered median eliciting gluten dose from 48g to 24g (−63%) and increased severity from 1.1 to 2.3; aspirin reduced threshold by 83%, exercise-plus-aspirin by 87%. Structured avoidance prevented further anaphylaxis in 91.7% (elimination) and 87.0% (temporal separation), yet 20–33% continued to react. Diagnostic delay ranged from 16 months to >5 years. Overall GRADE certainty was moderate for diagnostic-accuracy and cofactor-threshold domains, low-to-very-low for prevalence, treatment, and prognostic domains.
Discussion: FDEIA is reconceptualized as a cofactor-dependent, high-threshold IgE-mediated food allergy rather than a physical allergy, positioning EIA and FDEIA on a single mechanistic continuum modulated by allergen dose, cofactor load, and epithelial permeability. Two molecular archetypes dominate: gliadin/glutenin in East Asia and Northern Europe, nsLTP in the Mediterranean. Cofactor hierarchy (exercise+aspirin > aspirin > exercise > alcohol) provides the first quantitative framework for clinical risk counseling. Persistent limitations include absence of randomized evidence, heterogeneous protocols, and geographical under-representation.
Conclusion: Exercise-induced allergy and FDEIA are mechanistically inseparable expressions of a shared cofactor-dependent hypersensitivity continuum. Component-resolved diagnostics, cofactor-augmented titrated challenge, and structured allergen-exercise temporal separation constitute current evidence-based standards, but residual breakthrough risk mandates universal adrenaline auto-injector provision. Priority research includes randomized cofactor-controlled protocols, validated pediatric molecular panels, prospective registries in under-represented regions, and biologic/immunotherapeutic trials.
References
Kidd JM 3rd, Cohen SH, Sosman AJ, Fink JN. Food-dependent exercise-induced anaphylaxis. J Allergy Clin Immunol. 1983;71(4):407–11. Available from: https://consensus.app/papers/details/2270c52b663451d9b093cb6daa426276/
Dohi M, Suko M, Sugiyama H, Yamashita N, Tadokoro K, Juji F, et al. Food-dependent, exercise-induced anaphylaxis: a study on 11 Japanese cases. J Allergy Clin Immunol. 1991;87(1 Pt 1):34–40. Available from: https://consensus.app/papers/details/baca9ae4642750b587d43936c0246dc4/
Tanaka S. An epidemiological survey on food-dependent exercise-induced anaphylaxis in kindergartners, schoolchildren and junior high school students. Asia Pac J Public Health. 1994;7(1):26–30. Available from: https://consensus.app/papers/details/c820d6e74a085a5da03c22dc58e95964/
Romano A, Di Fonso M, Giuffreda F, Quaratino D, Papa G, Palmieri V, et al. Diagnostic work-up for food-dependent, exercise-induced anaphylaxis. Allergy. 1995;50(10):817–24. Available from: https://consensus.app/papers/details/320159fba9715391baf6bb1a032901e9/
Palosuo K, Alenius H, Varjonen E, Koivuluhta M, Mikkola J, Keskinen H, et al. A novel wheat gliadin as a cause of exercise-induced anaphylaxis. J Allergy Clin Immunol. 1999;103(5 Pt 1):912–7. Available from: https://consensus.app/papers/details/ff7007cb868e5c5fa551387c8f81e68b/
Shadick NA, Liang MH, Partridge AJ, Bingham CO 3rd, Wright E, Fossel AH, et al. The natural history of exercise-induced anaphylaxis: survey results from a 10-year follow-up study. J Allergy Clin Immunol. 1999;104(1):123–7. Available from: https://consensus.app/papers/details/0f6a9cef25955b59821e1b6b20bccb7e/
Harada S, Horikawa T, Icihashi M. [A study of food-dependent exercise-induced anaphylaxis by analyzing the Japanese cases reported in the literature]. Arerugi. 2000;49(11):1066–73. Japanese. Available from: https://consensus.app/papers/details/9622c259d9b15fdeb4332b0bd064e12a/
Aihara Y, Takahashi Y, Kotoyori T, Mitsuda T, Ito R, Aihara M, et al. Frequency of food-dependent, exercise-induced anaphylaxis in Japanese junior-high-school students. J Allergy Clin Immunol. 2001;108(6):1035–9. Available from: https://consensus.app/papers/details/968910cbe8cb5486b083c9790bdbe72a/
Aihara Y. [Food-dependent exercise-induced anaphylaxis]. Arerugi. 2004;53(4):390–6. Japanese. Available from: https://consensus.app/papers/details/d9f4bca2478255619fa3946b443c2ee4/
Matsuo H, Morimoto K, Akaki T, Kaneko S, Kusatake K, Kuroda T, et al. Exercise and aspirin increase levels of circulating gliadin peptides in patients with wheat-dependent exercise-induced anaphylaxis. Clin Exp Allergy. 2005;35(4):461–6. Available from: https://consensus.app/papers/details/e923df23e75459c1ab46e0a75ce20451/
Matsuo H, Kohno K, Niihara H, Morita E. Specific IgE determination to epitope peptides of omega-5 gliadin and high molecular weight glutenin subunit is a useful tool for diagnosis of wheat-dependent exercise-induced anaphylaxis. J Immunol. 2005;175(12):8116–22. Available from: https://consensus.app/papers/details/ac33e0740fbf5646b0d8afaf3fe2d246/
Matsuo H, Dahlström J, Tanaka A, Kohno K, Takahashi H, Furumura M, et al. Sensitivity and specificity of recombinant omega-5 gliadin-specific IgE measurement for the diagnosis of wheat-dependent exercise-induced anaphylaxis. Allergy. 2008;63(2):233–6. Available from: https://consensus.app/papers/details/0d578db02d87520fbd942bc59886f737/
Morita E, Matsuo H, Chinuki Y, Takahashi H, Dahlström J, Tanaka A. Food-dependent exercise-induced anaphylaxis — importance of omega-5 gliadin and HMW-glutenin as causative antigens for wheat-dependent exercise-induced anaphylaxis. Allergol Int. 2009;58(4):493–8. Available from: https://consensus.app/papers/details/a16148bc5a8055b383503b5998f8b4a7/
Matsuo H, Yokooji T, Morita H, Ooi M, Urata K, Ishii K, et al. Effects of non-steroidal anti-inflammatory drugs (NSAIDs) on serum allergen levels after wheat ingestion. J Dermatol Sci. 2009;53(3):241–3. Available from: https://consensus.app/papers/details/da6ba17fd83955f28a1962aa397f09fe/
Inoue Y, Adachi A, Ueno M, Fukumoto T, Nishitani N, Fujiwara N, et al. [The inhibition effect of a synthetic analogue of prostaglandin E1 to the provocation by aspirin in the patients of WDEIA]. Arerugi. 2009;58(11):1418–25. Japanese. Available from: https://consensus.app/papers/details/0cecf480a78a549d94c0d2693bf740cd/
Fukutomi Y, Itagaki Y, Taniguchi M, Saito A, Yasueda H, Nakazawa T, et al. Rhinoconjunctival sensitization to hydrolyzed wheat protein in facial soap can induce wheat-dependent exercise-induced anaphylaxis. Clin Transl Allergy. 2011;1(Suppl 1). Available from: https://consensus.app/papers/details/8f751fdd572d5b1e840e0139f0ebee06/
Chinuki Y, Takahashi H, Dekio I, Kaneko S, Tokuda R, Nagao M, et al. CD203c expression-based basophil activation test for diagnosis of wheat-dependent exercise-induced anaphylaxis. J Allergy Clin Immunol. 2012;129(5):1404–6. Available from: https://consensus.app/papers/details/81ba7b04b87c53edb7e016834d2f5fd9/
Takahashi H, Matsuo H, Chinuki Y, Kohno K, Tanaka A, Maruyama N, et al. Recombinant high molecular weight-glutenin subunit-specific IgE detection is useful in identifying wheat-dependent exercise-induced anaphylaxis complementary to recombinant omega-5 gliadin-specific IgE test. Clin Exp Allergy. 2012;42(8):1293–8. Available from: https://consensus.app/papers/details/1c13ab25d6625ac0beae79f54be3893c/
Romano A, Scala E, Rumi G, Gaeta F, Caruso C, Alonzi C, et al. Lipid transfer proteins: the most frequent sensitizer in Italian subjects with food-dependent exercise-induced anaphylaxis. Clin Exp Allergy. 2012;42(11):1643–53. Available from: https://consensus.app/papers/details/17e7cfe685705c69abb7c31283da28d4/
Pascal M, Muñoz-Cano R, Reina Z, Palacín A, Vilella R, Picado C, et al. Lipid transfer protein syndrome: clinical pattern, cofactor effect and profile of molecular sensitization to plant-foods and pollens. Clin Exp Allergy. 2012;42(10):1529–39. Available from: https://consensus.app/papers/details/610f733068e5510780ebf9455fc5414b/
Hiragun M, Ishii K, Hiragun T, Shindo H, Mihara S, Matsuo H, et al. The sensitivity and clinical course of patients with wheat-dependent exercise-induced anaphylaxis sensitized to hydrolyzed wheat protein in facial soap — secondary publication. Allergol Int. 2013;62(3):351–8. Available from: https://consensus.app/papers/details/afe8d75335465e0d953fdc01dce92e9b/
Yokooji T, Kurihara S, Murakami T, Chinuki Y, Takahashi H, Morita E, et al. Characterization of causative allergens for wheat-dependent exercise-induced anaphylaxis sensitized with hydrolyzed wheat proteins in facial soap. Allergol Int. 2013;62(4):435–45. Available from: https://consensus.app/papers/details/4f191c9c575154c885855824cf973dd7/
Kohno K, Matsuo H, Takahashi H, Niihara H, Chinuki Y, Kaneko S, et al. Serum gliadin monitoring extracts patients with false negative results in challenge tests for the diagnosis of wheat-dependent exercise-induced anaphylaxis. Allergol Int. 2013;62(2):229–38. Available from: https://consensus.app/papers/details/5f77e7a4bcb5571490ffe1e54a70dc3f/
Pastorello EA, Farioli L, Stafylaraki C, Scibilia J, Mirone C, Pravettoni V, et al. Wheat-dependent exercise-induced anaphylaxis caused by a lipid transfer protein and not by omega-5 gliadin. Ann Allergy Asthma Immunol. 2014;112(4):386–7. Available from: https://consensus.app/papers/details/ec9f2d1a0d99504092c558bab5d49624/
Brockow K, Kneissl D, Valentini L, Zelger O, Grosber M, Kugler C, et al. Using a gluten oral food challenge protocol to improve diagnosis of wheat-dependent exercise-induced anaphylaxis. J Allergy Clin Immunol. 2015;135(4):977–84. Available from: https://consensus.app/papers/details/93c4ca6b1121519392224c244baef4b2/
Kobayashi T, Ito T, Kawakami H, Fuzishiro K, Hirano H, Okubo Y, et al. Eighteen cases of wheat allergy and wheat-dependent exercise-induced urticaria/anaphylaxis sensitized by hydrolyzed wheat protein in soap. Int J Dermatol. 2015;54(8):e302–5. Available from: https://consensus.app/papers/details/80b4524f9ec35e21927c7c8942b16f65/
Sugiyama A, Kishikawa R, Nishie H, Takeoka A, Hama T, Oda N, et al. Angiotensin-converting enzyme genotype is a risk factor for wheat-dependent exercise-induced anaphylaxis sensitized with hydrolyzed wheat protein. Allergol Int. 2015;64(4):395–6. Available from: https://consensus.app/papers/details/36a146738cfc5c56b0786d83e22781e1/
Manabe T, Oku N, Aihara Y. Food-dependent exercise-induced anaphylaxis among junior high school students: a 14-year epidemiological comparison. Allergol Int. 2015;64(3):285–6. Available from: https://consensus.app/papers/details/88686127c2ee5d9ead9655603dc68e60/
Hiragun M, Hiragun T, Ishii K, Suzuki H, Tanaka A, Yanase Y, et al. Remission rate of patients with wheat allergy sensitized to hydrolyzed wheat protein in facial soap. Allergol Int. 2016;65(1):109–11. Available from: https://consensus.app/papers/details/fafe9a4e5e8a5f4aaad1b366ce2d5156/
Le TA, Al Kindi M, Tan JA, Smith A, Heddle RJ, Kette FE, et al. The clinical spectrum of omega-5-gliadin allergy. Intern Med J. 2016;46(6):710–6. Available from: https://consensus.app/papers/details/b9038c3e803a508ebf431eb36add8716/
Motomura C, Matsuzaki H, Ono R, Iwata M, Odajima H. Aspirin is an enhancing factor for food-dependent exercise-induced anaphylaxis in children. Clin Exp Allergy. 2017;47(11):1497–500. Available from: https://consensus.app/papers/details/f4226ba1f0485824b6470939de9c0613/
Song S, Kim S, Lee E, Yang HK, Kim J, Ahn K. Food-dependent exercise-induced anaphylaxis in children: a single center experience. J Allergy Clin Immunol. 2017;139(2 Suppl):AB236. Available from: https://consensus.app/papers/details/474cb3c6573c585aa328d188569e104e/
Manabe T, Oku N, Aihara Y. Food-dependent exercise-induced anaphylaxis in Japanese elementary school children. Pediatr Int. 2018;60(3):329–33. Available from: https://consensus.app/papers/details/670de92deaac553396a6322165a6896f/
Christensen MJ, Eller E, Mortz CG, Brockow K, Bindslev-Jensen C. Exercise lowers threshold and increases severity, but wheat-dependent, exercise-induced anaphylaxis can be elicited at rest. J Allergy Clin Immunol Pract. 2018;6(2):514–20. Available from: https://consensus.app/papers/details/ba464b3ce35e591ab37b959b63c72b16/
Kennard L, Thomas I, Rutkowski K, Azzu V, Yong PFK, Kasternow B, et al. A multicenter evaluation of diagnosis and management of omega-5 gliadin allergy (also known as wheat-dependent exercise-induced anaphylaxis) in 132 adults. J Allergy Clin Immunol Pract. 2018;6(6):1892–7. Available from: https://consensus.app/papers/details/f60daf2892d652dcad92d17d06ab9458/
Jiang N, Yin J, Wen L, Li H. A new diagnostic criteria of wheat-dependent, exercise-induced anaphylaxis in China. Chin Med J (Engl). 2018;131(17):2049–54. Available from: https://consensus.app/papers/details/7d6adbf20d3656948384254742f2c269/
Christensen MJ, Eller E, Mortz CG, Brockow K, Bindslev-Jensen C. Wheat-dependent cofactor-augmented anaphylaxis: a prospective study of exercise, aspirin, and alcohol efficacy as cofactors. J Allergy Clin Immunol Pract. 2019;7(1):114–21. Available from: https://consensus.app/papers/details/8cf746ee8b0d57dabcf21da722f1a3bf/
Scherf KA, Lindenau AC, Valentini L, Collado MC, García-Mantrana I, Christensen M, et al. Cofactors of wheat-dependent exercise-induced anaphylaxis do not increase highly individual gliadin absorption in healthy volunteers. Clin Transl Allergy. 2019;9:19. Available from: https://consensus.app/papers/details/e6eb523d8e6c5ac7adaaf48f3e7fbc79/
Thongngarm T, Wongsa C, Pacharn P, Piboonpocanun S, Sompornrattanaphan M. Clinical characteristics and proposed wheat-cofactor challenge protocol with a high diagnostic yield in adult-onset IgE-mediated wheat allergy. J Asthma Allergy. 2020;13:355–62. Available from: https://consensus.app/papers/details/296e411647715fe3a1d303df67b6c343/
Ruano-Zaragoza M, Somoza ML, Jiménez-Rodriguez TW, Soriano-Gomis V, González-Delgado P, Esteban-Rodriguez A, et al. Lipid transfer protein sensitization: risk of anaphylaxis and molecular sensitization profile in Pru p 3-sensitized patients. Int Arch Allergy Immunol. 2021;182(5):425–32. Available from: https://consensus.app/papers/details/f5756393321b540ab18e9281db011a54/
Du Z, Gao X, Yin J. Clinical features and outcomes of patients with wheat-dependent exercise-induced anaphylaxis: a retrospective study. Allergy Asthma Clin Immunol. 2022;18(1):58. Available from: https://consensus.app/papers/details/5f4b5920f8375ff8b8b5cb35cc67f655/
Morita E, Chinuki Y, Takahashi H, Yokooji T. Cofactors of wheat-dependent exercise-induced anaphylaxis increase gastrointestinal gliadin absorption by an inhibition of prostaglandin production. Clin Exp Allergy. 2022;52(6). Available from: https://consensus.app/papers/details/12c7e9de89e55563adedec44356d92a5/
Chiang V, Wong JCY, Yeung MHY, Kan AKC, Au EYL, Lam KW, et al. Epidemiology, outcomes, and disproportionate burden of food-dependent exercise-induced anaphylaxis from the Hong Kong Multidisciplinary Anaphylaxis Management Initiative (HK-MAMI). J Allergy Clin Immunol Glob. 2023;2(3):100109. Available from: https://consensus.app/papers/details/289b503e01a157a7bc58cb8267b9e183/
Chinuki Y, Yagami A, Adachi A, Matsunaga K, Ugajin T, Yokozeki H, et al. Efficacy and safety of omalizumab in adult patients with wheat-dependent exercise-induced anaphylaxis: reduction of in vitro basophil activation and allergic reaction to wheat. Allergol Int. 2023;72(4):561–8. Available from: https://consensus.app/papers/details/1b930ad93aec58afa717714d31d7d3e1/
Aoki Y, Chinuki Y, Nakano N, Fukunaga A, Morita E, Ogawa H, et al. Alpha/beta gliadin MM1 is a novel antigen for wheat-dependent exercise-induced anaphylaxis. Int Arch Allergy Immunol. 2023;184(9):897–906. Available from: https://consensus.app/papers/details/c0bb6ea7f82959f6801a3f615ec6bd38/
Dölle-Bierke S, Höfer V, Francuzik W, Näher AF, Bilo MB, Cichocka-Jarosz E, et al. Food-induced anaphylaxis: data from the European Anaphylaxis Registry. J Allergy Clin Immunol Pract. 2023;11(7):2069–79. Available from: https://consensus.app/papers/details/2909b0853dad5d7480b7c76a0b8f5c53/
Scala E, Villalta D, Caprini E, Abeni D, Cecchi L, Guerra EC, et al. Food-dependent exercise-induced allergic reactions in lipid transfer protein (LTP) hypersensitive subjects: new data and a critical reappraisal. Eur Ann Allergy Clin Immunol. 2024. Available from: https://consensus.app/papers/details/405627a886b351c2b39d6ab9191d6db0/
Rymarczyk B, Glück J, Rogala B. Does a healthy diet always mean a safe diet? Food allergy as an obstacle to a healthy lifestyle. Alergologia Polska — Polish J Allergol. 2025. Available from: https://consensus.app/papers/details/ef9148fde64b592891dd6c3fd70de6a0/
Mukai M, Nagakura K, Sato S, Yanagida N, Ebisawa M. Factors associated with false negative exercise provocation tests following exercise-induced allergic reactions in children desensitized to wheat. Pediatr Allergy Immunol. 2026;37(1). Available from: https://consensus.app/papers/details/921fa220171a51bc82d90e42a9911ca1/
Sridhara S, Chandran A, Kelly K, Craig T. WDEIA case series: do unique clinical presentations suggest mechanistic differences? J Allergy Clin Immunol Glob. 2026. Available from: https://consensus.app/papers/details/fe8b738a70d45d469c9b4b9ea561423a/
Palosuo K, Varjonen E, Nurkkala J, Kalkkinen N, Harvima R, Reunala T, et al. Transglutaminase-mediated cross-linking of a peptic fraction of omega-5 gliadin enhances IgE reactivity in wheat-dependent, exercise-induced anaphylaxis. J Allergy Clin Immunol. 2003;111(6):1386–92. Available from: https://consensus.app/papers/details/714fb40cbc1c5867b93a61218f38444a/
Yokooji T, Fukushima T, Hamura K, Ninomiya N, Ohashi R, Taogoshi T, et al. Intestinal absorption of the wheat allergen gliadin in rats. Allergol Int. 2019;68(2):247–53. Available from: https://consensus.app/papers/details/cf7a8adab3f45df2849cae3b3e25a4fe/
Kulthanan K, Ungprasert P, Jirapongsananuruk O, Rujitharanawong C, Munprom K, Trakanwittayarak S, et al. Food-dependent exercise-induced wheals, angioedema, and anaphylaxis: a systematic review. J Allergy Clin Immunol Pract. 2022;10(9):2280–96. Available from: https://consensus.app/papers/details/45d0b31b821354eea4c2d5069cf78ffe/
Kulthanan K, Ungprasert P, Jirapongsananuruk O, Rujitharanawong C, Munprom K, Trakanwittayarak S, et al. Food-dependent exercise-induced wheals/angioedema, anaphylaxis, or both: a systematic review of phenotypes. J Allergy Clin Immunol Pract. 2023;11(3). Available from: https://consensus.app/papers/details/36b7d1454fc05c148e46fee707699be3/
Turner PJ, Baumert JL, Beyer K, Boyle RJ, Chan CH, Clark AT, et al. Risk factors for severe reactions in food allergy: rapid evidence review with meta-analysis. Allergy. 2022;77(9):2634–52. Available from: https://consensus.app/papers/details/103f431d06f95a0d8f58c01bd10f1d78/
Srisuwatchari W, Kanchanaphoomi K, Nawiboonwong J, Thongngarm T, Sompornrattanaphan M. Food-dependent exercise-induced anaphylaxis: a distinct form of food allergy — an updated review of diagnostic approaches and treatments. Foods. 2023;12(20):3768. Available from: https://consensus.app/papers/details/2cf5a03b614e5da08a8cbaeb64176605/
Scherf KA, Brockow K, Biedermann T, Koehler P, Wieser H. Wheat-dependent exercise-induced anaphylaxis. Clin Exp Allergy. 2016;46(1):10–20. Available from: https://consensus.app/papers/details/896ceece2e28534581d3022e8028a60e/
Faihs V, Kugler C, Schmalhofer V, Scherf KA, Zimmermann P, Biedermann T, et al. Wheat-dependent exercise-induced anaphylaxis: subtypes, diagnosis, and management. J Dtsch Dermatol Ges. 2023;21(10):1131–5. Available from: https://consensus.app/papers/details/28896bfa067b54b1ad147344f081cda7/
Ansley L, Bonini M, Delgado L, Del Giacco S, Du Toit G, Khaitov M, et al. Pathophysiological mechanisms of exercise-induced anaphylaxis: an EAACI position statement. Allergy. 2015;70(10):1212–21. Available from: https://consensus.app/papers/details/0fb85fa524b754cab53c1c57ae3c7a76/
Feldweg AM. Food-dependent, exercise-induced anaphylaxis: diagnosis and management in the outpatient setting. J Allergy Clin Immunol Pract. 2017;5(2):283–8. Available from: https://consensus.app/papers/details/0fa10939a8d95f0bb28f64067fb45fe8/
Skypala IJ, Bartra J, Ebo DG, Antje Faber M, Fernández-Rivas M, Gomez F, et al. The diagnosis and management of allergic reactions in patients sensitized to non-specific lipid transfer proteins. Allergy. 2021;76(8):2433–46. Available from: https://consensus.app/papers/details/de1971554db357e998da37c15df5cf5d/
Srisuwatchari W, Vichyanond P, Piboonpocanun S, Pacharn P. Molecular diagnosis to IgE-mediated wheat allergy and wheat-dependent exercise-induced anaphylaxis. Clin Rev Allergy Immunol. 2025;68(1). Available from: https://consensus.app/papers/details/abf99de53d7e5f69b910cbc6945e8611/
Mota I, Gaspar Â, Benito-Garcia F, Correia M, Chambel M, Morais-Almeida M. Anaphylaxis caused by lipid transfer proteins: an unpredictable clinical syndrome. Allergol Immunopathol (Madr). 2018;46(6):565–70. Available from: https://consensus.app/papers/details/9908fc27a2065163962d5e5356095a08/
Benito-Garcia F, Mota I, Gaspar Â, Chambel M, Morais-Almeida M. Anaphylaxis caused by lipid transfer proteins: an emerging and unsettling syndrome. World Allergy Organ J. 2020;13(8). Available from: https://consensus.app/papers/details/341524827c8c5b23b1ec30a769a80c92/
Ridolo E, Pucciarini F, Nizi MC, Makri E, Kihlgren P, Panella L, et al. Lipid transfer protein syndrome: how to save a life through careful education. World Allergy Organ J. 2022;15(6):100621. Available from: https://consensus.app/papers/details/08a65aad3b365d528c8a5a5b708578ca/
Giannetti MP. Exercise-induced anaphylaxis: literature review and recent updates. Curr Allergy Asthma Rep. 2018;18(12):72. Available from: https://consensus.app/papers/details/3aa4d64dd61f50f1bd035e3e97220d28/
Bartra J, Turner PJ, Muñoz-Cano RM. Interaction between foods and nonsteroidal anti-inflammatory drugs and exercise in the induction of anaphylaxis. Curr Opin Allergy Clin Immunol. 2018;18(4):310–6. Available from: https://consensus.app/papers/details/d889d1a43065569bb2dde0b04380786f/
Christensen MJ, Eller E, Mortz CG, Bindslev-Jensen C. Exercise-induced anaphylaxis: causes, consequences, and management recommendations. Expert Rev Clin Immunol. 2019;15(3):265–73. Available from: https://consensus.app/papers/details/77f0fa37b59e58539a108efa9a7527a4/
Mohta A, Sharma A, Gupta P. Pediatric cofactor-enhanced food anaphylaxis: a narrative review of epidemiology, pathophysiology, and clinical phenotypes. Pediatr Allergy Immunol. 2025;36(6). Available from: https://consensus.app/papers/details/f1e1e6af5d59566d94dee7c79bcdc4ed/
Chinuki Y, Morita E. Wheat-dependent exercise-induced anaphylaxis sensitized with hydrolyzed wheat protein in soap. Allergol Int. 2012;61(4):529–37. Available from: https://consensus.app/papers/details/9529e71fd9dd59a58cf0c3a66bd876d3/
Carlisle A, Lieberman J. Getting in shape: updates in exercise anaphylaxis. Curr Allergy Asthma Rep. 2024;24(3). Available from: https://consensus.app/papers/details/1ef90abfca4b5551890eb8db78ee4830/
Jiang N, Xiang L, Huang H, Zhang X. The management of exercise-induced anaphylaxis in a Chinese child with biologics: a case report. Front Allergy. 2024;5. Available from: https://consensus.app/papers/details/8ca78abe9f4556889d2cebaf8270e131/
Geller M. Clinical management of exercise-induced anaphylaxis and cholinergic urticaria. J Allergy Clin Immunol Pract. 2020;8(7):2209–14. Available from: https://consensus.app/papers/details/26342c5c48035643b10750f9b408877f/
Povesi Dascola C, Caffarelli C. Exercise-induced anaphylaxis: a clinical view. Ital J Pediatr. 2012;38:43. Available from: https://consensus.app/papers/details/d2e69cddef905980a1030ed288aef3eb/
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