Wheat-related allergic reactions: causes of prevalence differences and allergenicity reduction methods review

Wheat, a significant source of protein, can also induce various wheat-related allergic reactions (WRARs). Statistical data show significant spatiotemporal and geographical variations in the prevalence of WRARs. Studies reveal that hexaploid wheat exhibits notably higher allergenicity. Early childhood is associated with a higher prevalence rate, although some symptoms may alleviate or disappear with age. Additionally, living environments and certain allergic diseases influence the prevalence of WRARs, potentially related to dietary patterns, microbial exposure, and immune regulation. Among methods to reduce wheat protein allergenicity, biological modification is preferred over physical processing and chemical modification. Fermentation and enzymatic treatment are currently mainstream choices, while gene editing holds the most promise for a definitive solution to WRARs. Unfortunately, no effective alternative to a gluten-free diet currently exists as a treatment measure. This article aims to review the prevalence of WRARs and the factors influencing their occurrence, summarize the various methods employed to reduce wheat allergenicity, and offer insights for the development of low-allergenicity wheat products and potential treatments for WRARs.