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Thanh D Dang,
Mimi Tang,
Sharon Choo,
Paul V Licciardi,
Jennifer J Koplin,
Pamela E Martin, Tina Tan,
Lyle C Gurrin,
Anne-Louise Ponsonby,
Dean Tey,
Marnie Robinson,
Shyamali C Dharmage,
Katrina J Allen
[show abstract]
[hide abstract]
ABSTRACT: Measurement of whole peanut-specific IgE (sIgE) is often used to confirm sensitization but does not reliably predict allergy. Ara h 2 is the dominant peanut allergen detected in 90% to 100% of patients with peanut allergy and could help improve diagnosis.
We sought to determine whether Ara h 2 testing might improve the accuracy of diagnosing peanut allergy and therefore circumvent the need for an oral food challenge (OFC).
Infants from the population-based HealthNuts study underwent skin prick tests to determine peanut sensitization and subsequently underwent a peanut OFC to confirm allergy status. In a stratified random sample of 200 infants (100 with peanut allergy and 100 with peanut tolerance), whole peanut sIgE and Ara h 2 sIgE levels were quantified by using fluorescence enzyme immunoassay.
By using the previously published 95% positive predictive value of 15 kU(A)/L for whole peanut sIgE, a corresponding specificity of 98% (95% CI, 93% to 100%) was found in this study cohort. At the equivalent specificity of 98%, the sensitivity of Ara h 2 sIgE is 60% (95% CI, 50% to 70%), correctly identifying 60% of subjects with true peanut allergy compared with only 26% correctly identified by using whole peanut sIgE. We report that when using a combined approach of plasma sIgE testing for whole peanut followed by Ara h 2 for the diagnosis of peanut allergy, the number of OFCs required is reduced by almost two thirds.
Ara h 2 plasma sIgE test levels provide higher diagnostic accuracy than whole peanut plasma sIgE levels and could be considered a new diagnostic tool to distinguish peanut allergy from peanut tolerance, which might reduce the need for an OFC.
The Journal of allergy and clinical immunology 02/2012; 129(4):1056-63. · 9.17 Impact Factor
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Jennifer J Koplin,
Nicholas J Osborne,
Melissa Wake,
Pamela E Martin,
Lyle C Gurrin,
Marnie N Robinson,
Dean Tey,
Marjolein Slaa,
Leone Thiele,
Lucy Miles,
Deborah Anderson, Tina Tan,
Thanh D Dang,
David J Hill,
Adrian J Lowe,
Melanie C Matheson,
Anne-Louise Ponsonby,
Mimi L K Tang,
Shyamali C Dharmage,
Katrina J Allen
[show abstract]
[hide abstract]
ABSTRACT: Infant feeding guidelines have long recommended delaying introduction of solids and allergenic foods to prevent allergy in high-risk infants, despite a paucity of evidence.
We aimed to determine whether confirmed egg allergy in 12-month-old infants is associated with (1) duration of breast-feeding and (2) ages of introducing egg and solids.
In a population-based cross-sectional study (HealthNuts) parents reported on infant feeding and potential confounding factors before skin prick testing for egg white. Egg-sensitized infants were then offered an egg oral food challenge. Multiple logistic regression was used to investigate associations between diet and egg allergy adjusted for possible confounding factors.
A total of 2589 infants (73% response) participated. Compared with introduction at 4 to 6 months, introducing egg into the diet later was associated with higher risks of egg allergy (adjusted odds ratios [ORs], 1.6 [95% CI, 1.0-2.6] and 3.4 [95% CI, 1.8-6.5] for introduction at 10-12 and after 12 months, respectively). These findings persisted even in children without risk factors (OR, 3.3 [95% CI, 1.1-9.9]; 10-12 months). At age 4 to 6 months, first exposure as cooked egg reduced the risk of egg allergy compared with first exposure as egg in baked goods (OR, 0.2 [95% CI, 0.06-0.71]). Duration of breast-feeding and age at introduction of solids were not associated with egg allergy.
Introduction of cooked egg at 4 to 6 months of age might protect against egg allergy. Changes in infant feeding guidelines could have a significant effect on childhood egg allergy and possibly food allergy more generally.
The Journal of allergy and clinical immunology 10/2010; 126(4):807-13. · 9.17 Impact Factor
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Nicholas Osborne,
Lyle Gurrin,
Jennifer Koplin,
Pamela Martin,
Marnie Robinson,
Marjolein Slaa,
Leone Thiele,
Lucy Miles,
Deborah Dawson, Tina Tan,
Thanh Dang,
David Hill,
Adrian Lowe,
Melanie Matheson,
Anne-Louise Ponsonby,
Mimi Tang,
Melissa Wake,
Shyamali Dharmage,
Katrina Allen,
for_the_HealthNuts_Study_Group
EAACI, London, UK; 01/2010
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Pamela E Martin,
Nicholas J Osborne,
Jennifer J Koplin,
Lyle C Gurrin,
Marnie Robinson,
Marjolein Slaa,
Leone Thiele,
Lucy Miles,
Deborah Anderson, Tina Tan,
Thanh Dang,
David J Hill,
Adrian Lowe,
Melanie C Matheson,
Anne-Louise Ponsonby,
Mimi Tang,
Melissa Wake,
Shyamali C Dharmage,
Katrina J Allen
EAACI, London, UK; 01/2010
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Nicholas Osborne,
Lyle Gurrin,
Jennifer Koplin,
Pamela Martin,
Marnie Robinson,
Marjolein Slaa,
Leone Thiele,
Lucy Miles,
Deborah Dawson, Tina Tan,
Thanh Dang,
David Hill,
Adrian Lowe,
Melanie Matheson,
Anne-Louise Ponsonby,
Mimi Tang,
Melissa Wake,
Shyamali Dharmage,
Katrina Allen,
for_the_HealthNuts_Study_Group
Allergy. 01/2010; 65(Suppl. 92):375.
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Jennifer Koplin,
Nicholas Osborne,
Melissa Wake,
Pamela Martin,
Lyle Gurrin,
Marnie Robinson,
Dean Tey,
Leone Thiele,
Lucy Miles,
Deborah Anderson, Tina Tan,
Thanh Dang,
David Hill,
Adrian Lowe,
Melanie Matheson,
Anne-Louise Ponsonby,
Mimi Tang,
Shyamali Dhamage,
Katrina Allen
EAACI. 01/2010;