Food allergies to grains: Epidemiology and mechanisms of reactions to wheat, rye, oats, corn, barley, buckwheat, rice, lupine, quinoa

Introduction The prevalence of food allergies can reach up to 10% in children in Western countries, with cereals being a significant group of allergens. While wheat is the most commonly associated with allergic reactions, allergies to other grains such as rye, oats, and maize are less studied. Aim The aim of this study was to systematically review allergic reactions to wheat, rye, oats, barley, maize, buckwheat, rice, lupin, and quinoa, with the goal of enhancing understanding of their prevalence, identifying established allergens, and optimizing treatment and preventive strategies. Material and methods The study is based on a review of literature and case reports on allergic reactions to various grains, focusing on their prevalence, allergenicity, and clinical manifestations. Results and discussion Wheat has the highest prevalence of allergic reactions among cereals, with incidence in children ranging from 0.2% to 9%, depending on region and age. It contains the most allergenic proteins. Rye allergies are rare, with few cases of bronchial asthma or combined reactions to wheat and rye. Oats and maize are also weak allergens, with few reported clinical cases. Barley ranks third in causing allergic reactions among children in Japan, but reports are scarce. Buckwheat and rice allergens are well-studied, with rice being more prevalent due to its widespread consumption. Rice allergies rank 4th to 6th in some countries. Lupin and quinoa allergies are extremely rare. Conclusions Thus, allergies to rye, oats, maize, lupin, and quinoa are rare, allergic reactions to barley, buckwheat, rice have a medium frequency; wheat remains one of the major food allergens.