Omega 5-Gliadin Allergy in Patients with Recurrent Acute Urticaria.

To the Editor, omega-5 gliadin (O5G), Tri a 19, allergy is usually responsible for wheat-dependent exercised-induced anaphylaxis (WDEIA) (1-4) but not all episodes are characterised by a systemic anaphylactic reaction (5) and factors modulating the reaction severity are elusive (6).We evaluated the prevalence and clinical/laboratory features of O5G in patients presenting with recurrent acute urticaria in a retrospective study in an Italian tertiary referral centre.We enrolled all consecutive adult patients referred in 2021-2023 for recurrent acute urticaria (3), i.e., >1 episode of acute urticaria over 6 months, not induced by physical factors and not present daily and continuously for >6 weeks (7).Patients underwent skin prick tests for aero-and food-allergens (Lofarma, Italy) according to clinical history and specific IgE (FEIA, ImmunoCAP®, Thermo fischer, Sweden), to wheat, O5G, gluten/gliadin were systematically performed.Patients underwent screening for H.