Article

Quantification of specific IgE to whole peanut extract and peanut components in prediction of peanut allergy.

University of Manchester, Manchester Academic Health Science Centre, NIHR Translational Research Facility in Respiratory Medicine, University Hospital of South Manchester NHS Foundation Trust, Manchester, United Kingdom.
The Journal of allergy and clinical immunology (Impact Factor: 12.05). 03/2011; 127(3):684-5. DOI: 10.1016/j.jaci.2010.12.012
Source: PubMed
1 Bookmark
 · 
140 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Allergische Reaktionen gegen Erdnuss (Arachis hypogaea, Ara h) beruhen auf IgE-vermittelten Sensibilisierungen gegen verschiedene Proteine. Ihre Stabilität und relativer Anteil in der Erdnuss bestimmen das Risiko für bedrohliche Reaktionen. Risikosensibilisierungen gegen Samenspeicherproteine (S2-Albumine [Ara h 2, 6 und 7] > andere Speicherproteine [Ara h 1 und 3] > Oleosine [Ara h 10 und 11]) lassen sich von Sensibilisierungen gegen das Lipidtransfer-Protein (Ara h 9) mit mittlerem Risiko und von Kreuzsensibilisierungen gegen Bet-v-1-homologes PR-10 Protein (Ara h 8) und gegen Pro filin (Ara h 5) mit niedrigem Risiko abgrenzen. Ein gezielter Immunglobulin-E (IgE)-Test, z. B. gegen Ara h 2 bei Verdacht oder zum Ausschluss einer systemischen Reaktion, kann die Risikoeinschätzung erleichtern. Die Ergebnisse sind allerdings nur bei korrespondierenden Symptomen klinisch relevant. IgE-Sensibilisierungen gegen Erdnussextrakt ohne bedrohliche Reaktionen beruhen hierzulande hau fig auf Bet-v-1-bedingten Kreuzreaktionen (bei Birkenpollenallergikern), kreuzreaktiven p flanzlichen Kohlehydrat-Epitopen (CCD) oder Pro filinsensibilisierungen. Im Zweifelsfall lässt sich die klinische Relevanz nur durch eine orale Provokation sichern, zumal noch nicht alle Erdnussallergene (z. B. Oleosine) zur Diagnostik verfügbar sind.
    Allergo Journal International. 08/2014; 23:158-63.
  • Source
    European annals of allergy and clinical immunology 09/2014; 46(5):181-3.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Most of the peanut-sensitized children do not have clinical peanut allergy. In equivocal cases, oral food challenges (OFCs) are required. However, OFCs are laborious and not without risk; thus, a test that could accurately diagnose peanut allergy and reduce the need for OFCs is desirable. Objective To assess the performance of basophil activation test (BAT) as a diagnostic marker for peanut allergy. Methods Peanut-allergic (n = 43), peanut-sensitized but tolerant (n = 36) and non–peanut-sensitized nonallergic (n = 25) children underwent skin prick test (SPT) and specific IgE (sIgE) to peanut and its components. BAT was performed using flow cytometry, and its diagnostic performance was evaluated in relation to allergy versus tolerance to peanut and validated in an independent population (n = 65). Results BAT in peanut-allergic children showed a peanut dose-dependent upregulation of CD63 and CD203c while there was no significant response to peanut in peanut-sensitized but tolerant (P < .001) and non–peanut-sensitized nonallergic children (P < .001). BAT optimal diagnostic cutoffs showed 97% accuracy, 95% positive predictive value, and 98% negative predictive value. BAT allowed reducing the number of required OFCs by two-thirds. BAT proved particularly useful in cases in which specialists could not accurately diagnose peanut allergy with SPT and sIgE to peanut and to Arah2. Using a 2-step diagnostic approach in which BAT was performed only after equivocal SPT or Arah2-sIgE, BAT had a major effect (97% reduction) on the number of OFCs required. Conclusions BAT proved to be superior to other diagnostic tests in discriminating between peanut allergy and tolerance, particularly in difficult cases, and reduced the need for OFCs.
    Journal of Allergy and Clinical Immunology 09/2014; · 11.25 Impact Factor