Is there indeed no allergy to rice? Actually, there is allergy to rice, only it is more common in Asia, less so in Europe and North America (, below from 2),
“The association of rice seed proteins with allergic reaction was first reported from Japan for patients with history of asthma induced by exposure to rice flour and eczema exacerbated by rice ingestion (Shibasaki et al., 1979 ). IgE-mediated rice allergy is estimated at about 10% in atopic subjects in Japan (Besler et al., 2001 ). In Malaysia, next to shrimp, rice is the most common allergenic food. Rice is the fourth most important allergen after shellfish, peanut and soy in Thailand, whereas in Japan and Indonesia it is ranked fifth and sixth, respectively, as an allergen (Hill et al., 1997). Prevalence of rice allergy is much lower in Europe and the USA, where rice is primarily recognized as a cereal associated allergen source (Lehrer et al., 1999 ; Andre et al., 1994 ; Varjonen et al., 1995 ). Rice hypersensitivity has also been reported from countries like France, Sweden, Denmark, Estonia, Lithuania, and Russia (Andre et al., 1994 ; Eriksson et al., 2004 ).”
A 2017 study from India reports ~7% of those with allergy as [skin prick test] positive for rice (3).
Clinically confirmed allergy to a particular cereal is more likely the more people consume it. More wheat consumed in Europe and North America, more wheat allergy there, more rice consumed in Asia, more rice allergy there (below from 4).
- Barley, buckwheat, corn, millet, oats, rice, rye and wheat, all major cereals are implicated in IgE-mediated cereal allergy and rice is not, repeat not, an exception. Rather, IgE-mediated cereal allergy attributable to rice is well recognized (5, 6).
- Rice, along with soy and cow milk based formulas, is also implicated in a non-IgE food hypersensitivity in infants called food protein-induced enterocolitis syndrome (FPIES), which manifests as either acute (profuse vomiting, diarrhea, dehydration) or chronic (failure to thrive, weight loss) (7, ).
- Allergy to any one substance isn’t random. Specific immune response to a specific allergen also targets similar molecules, a phenomenon called cross-reactivity. Cereals are related grasses (taxonomic order being wheat – rye – barley – rice – corn – sorghum) and cereal proteins that are typical targets of allergic immune responses are often structurally related. This may be why children with positive skin prick test to rice have often also been observed to have positive SPTs to buckwheat, corn or millet (9).
- The fact that the food allergen panel for standard skin prick tests includes rice among other cereals also confirms it is clinically considered and indeed observed to be a food allergen on par with other cereals (below from ).
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2. Kumar, Raj, et al. “Rice (Oryza sativa) allergy in rhinitis and asthma patients: a clinico-immunological study.” Immunobiology 212.2 (2007): 141-147.
3. Shaikh, Wiqar, and Shifa Wiqar Shaikh. “Allergies in India: A Clinician’s Viewpoint.” Allergy and Allergen Immunotherapy. Apple Academic Press, 2017. 315-328.
4. Jędrychowski, Lucjan. “General characteristics of food allergens.” Chemical and Biological Properties of Food Allergens. CRC Press, 2009. 201-208.
5. González-De-Olano, David, et al. “Occupational allergy to rice involving α-amylase inhibitor as the relevant allergen.” Annals of Allergy, Asthma & Immunology 109.1 (2012): 71-72.
6. Goliáš, Jaroslav, et al. “Identification of rice proteins recognized by the IgE antibodies of patients with food allergies.” Journal of agricultural and food chemistry 61.37 (2013): 8851-8860.
7. Feuille, Elizabeth, and Anna Nowak-Węgrzyn. “Food protein-induced enterocolitis syndrome, allergic proctocolitis, and enteropathy.” Current allergy and asthma reports 15.8 (2015): 50.
9. Cantani, Arnaldo. Pediatric allergy, asthma and immunology. Springer Science & Business Media, 2008. page 628.
10. Macchia, Donatella, et al. “Guidelines for the use and interpretation of diagnostic methods in adult food allergy.” Clinical and Molecular Allergy 13.1 (2015): 27.