Exercise-induced anaphylaxis

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 other NSAIDs).

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

EIA and wheat
Wheat dependent exercise-induced anaphylaxis is the result of an IgE mediated allergic response to the ω-gliadin component of wheat glutens (and homologous proteins of certain subspecies  Aegilopides speltoides genome BB) and is similar to another condition known as baker's asthma. Neither disease is necessarily linked to gluten intolerance, although both involve IgE subclass of immunoglobulin. 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). . Unlike gluten sensitivity, WDEIA does not appear to extend to rye or barley glutens, and IgE from patients recognize specifically the omega-gliadin (Gli-B1) gene product on chromosome 1B of wheat. The response of patients with wheat dependent urticaria appeared to parallel those of WDEIA.