Ana o 3-specific IgE is a good predictor for clinically relevant cashew allergy in children

Lange, Lars; Lasota, L.; Finger, Antje; Vlajnic, Dejan; Büsing, Susanne; Meister, Jochen; Broekaert, Ilse; Pfannenstiel, Claus; Friedrichs, Frank; Price, Mareike; Trendelenburg, Valérie; Niggemann, B.; Beyer, Kirsten

doi:10.1111/all.13050

Cited by 75 publications

(75 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Sensitization to Ana o 3 is predictive of cashew nut allergy [26]. Studies from Lange et al [15] have shown a probability curve for a positive cashew nut OFC result by Ana o 3. But Ana o 3 can only be measured for research in Japan; therefore examining cashew nut sIgE is useful.…”

Section: Discussionmentioning

confidence: 99%

“…However, there are few reports summarizing the results of OFC for cashew nuts and the risk factors for a positive cashew nut OFC result. Lange et al [15] reported the probability curve of cashew nut specific IgE (sIgE) but there is a possibility that the probability curve may change depending on whether or not the patient has a history of immediate reactions to cashew nuts. Therefore, we analyzed the risk factors for symptom induction during a cashew nut OFC and the probability curve of cashew nut sIgE for patients with or without a history of immediate reactions to cashew nuts.…”

Section: Risk Factors and Clinical Features In Cashew Nut Oral Food Cmentioning

confidence: 99%

See 1 more Smart Citation

Risk Factors and Clinical Features in Cashew Nut Oral Food Challenges

Inoue

Ogura²,

Takahashi³

et al. 2018

Int Arch Allergy Immunol

View full text Add to dashboard Cite

Background: Cashew nuts (CN) are capable of causing severe allergic reactions. However, little has been reported about the details of CN oral food challenges (OFC). Methods: CN-specific IgE (sIgE) levels were measured for 1 year in 66 patients who underwent an OFC with >3 g CN for diagnosis or confirmation of tolerance acquisition between June 2006 and August 2014. We retrospectively analyzed the OFC and patient background. Results: The median (IQR) age of the 66 patients (48 boys/men and 18 girls/women) was 7.0 years (5.7-8.8). Twelve patients (18.2%) had a positive OFC result; 6 of 8 (75%) patients with a history of an immediate reaction to CN failed the OFC. Anaphylaxis was experienced by 5 of these 12 (42%) patients. A history of an immediate reaction to CN and the CN sIgE levels were significantly different for patients with a positive or negative OFC result (p < 0.01). Among patients without a previous immediate reaction to CN, the 95% positive predictive value (PPV) for the CN sIgE level for a positive OFC result was 66.1 kU_A/L. Conclusions: A history of an immediate reaction to CN and high CN sIgE were risk factors for a positive OFC result. The number of positive OFC results was relatively low, but there was a high probability of anaphylaxis. We should consider the indication of OFC carefully for patients with a history of immediate reactions to CN and avoid OFC for patients without such a history whose CN sIgE values are >66.1 kU_A/L (95% PPV).

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Risk Factors and Clinical Features In Cashew Nut Oral Food Cmentioning

confidence: 99%

Risk Factors and Clinical Features in Cashew Nut Oral Food Challenges

Inoue

Ogura²,

Takahashi³

et al. 2018

Int Arch Allergy Immunol

View full text Add to dashboard Cite

show abstract

“…This pattern of sensitization has been associated with both mild and severe systemic reactions. Serum sIgE to cashew components in children performs better than cashew‐specific IgE or SPT and Ana o 3 appears the best predictor of cashew nut allergy .…”

Section: Diagnosismentioning

confidence: 94%

BSACI guideline for the diagnosis and management of peanut and tree nut allergy

Stiefel

Anagnostou

Boyle

et al. 2017

Clin Experimental Allergy

115

134

View full text Add to dashboard Cite

SummaryPeanut nut and tree nut allergy are characterised by IgE mediated reactions to nut proteins. Nut allergy is a global disease. Limited epidemiological data suggest varying prevalence in different geographical areas. Primary nut allergy affects over 2% of children and 0.5% of adults in the UK. Infants with severe eczema and/or egg allergy have a higher risk of peanut allergy. Primary nut allergy presents most commonly in the first five years of life, often after the first known ingestion with typical rapid onset IgE-mediated symptoms. The clinical diagnosis of primary nut allergy can be made by the combination of a typical clinical presentation and evidence of nut specifc IgE shown by a positive skin prick test (SPT) or specific IgE (sIgE) test. Pollen food syndrome is a distinct disorder, usually mild, with oral/pharyngeal symptoms, in the context of hay fever or pollen sensitisation, which can be triggered by nuts. It can usually be distinguish clinically from primary nut allergy. The magnitude of a SPT or sIgE relates to the probability of clinical allergy, but does not relate to clinical severity. SPT of ≥ 8 mm or sIgE ≥ 15 KU/L to peanut is highly predictive of clinical allergy. Cut off values are not available for tree nuts. Test results must be interpreted in the context of the clinical history. Diagnostic food challenges are usually not necessary but may be used to confirm or refute a conflicting history and test result. As nut allergy is likely to be a long-lived disease, nut avoidance advice is the cornerstone of management. Patients should be provided with a comprehensive management plan including avoidance advice, patient specific emergency medication and an emergency treatment plan and training in administration of emergency medication. Regular re-training is required.

show abstract

“…21 Furthermore, the Australian HealthNuts cohort reported that at 12 months only 11% of almond-, 19% of hazelnut-, and 39% of cashew-sensitized patients had a positive OFC. 22 New diagnostic component data have highlighted and supported the clinical value of Cor a 9, Cor a 14 for hazelnut allergy, Jug r 1 for walnut allergy, and Ana o 3 for cashew and possibly pistachio allergy [23][24][25] in addition to well-established peanut data. 26,27 A Europe-wide approach to study hazelnut allergy suggested that combinations of component-resolved diagnosis (CRD)-based approaches with clinical history and extract data are superior to CRD alone.…”

Section: Novel Data On Clinical Markers and Biomarkers Of Food Allergymentioning

confidence: 99%

Recent developments and highlights in food allergy

Eiwegger

Hung

Diego

et al. 2019

Allergy

View full text Add to dashboard Cite

The achievement of long-lasting, safe treatments for food allergy is dependent on the understanding of the immunological basis of food allergy. Accurate diagnosis is essential for management. In recent years, data from oral food challenges have revealed that routine allergy testing is poor at predicting clinical allergy for tree nuts, almonds in particular. More advanced antigen-based tests including component-resolved diagnostics and epitope reactivity may lead to more accurate diagnosis and selection of therapeutic intervention. Additional diagnostic accuracy may come from cellular tests such as the basophil activation test or mast cell approaches. In the context of clinical trials, cellular tests have revealed specific T-cell and B-cell populations that are more abundant in food-allergic individuals with distinct mechanistic features.Awareness of clinical markers, such as the ability to eat baked forms of milk and egg, continues to inform the understanding of natural tolerance development.Mouse models have allowed for investigation into multiple mechanisms of food allergy including modification of epithelial metabolism, and the induction of regulatory cell subsets and the microbiome. Increasing numbers of children who underwent food immunotherapy enlarged the body of evidence on mechanisms and predictors of treatment success. Experimental immunological markers in conjunction with clinical determinants such as lower age and lower initial specific IgE appear to be of benefit.More research on the optimal dose, preparation, and route of application integrating a high-level safety and efficacy is demanded. Alternatively, biologics blocking TSLP, IL-33, IL-4 and IL-13, or IgE may help to achieve that. K E Y W O R D Sallergy treatment, biologics, food allergy, immune tolerance, immunotherapy | 2357 EIWEGGER Et al.

show abstract

Ana o 3-specific IgE is a good predictor for clinically relevant cashew allergy in children

Abstract: Specific IgE to Ana o 3 is a valuable tool for the diagnosis of cashew allergy. Considering its positive predictive value, it might allow to make a considerable number of oral challenges superfluous.

Cited by 75 publications

References 21 publications

Risk Factors and Clinical Features in Cashew Nut Oral Food Challenges

Risk Factors and Clinical Features in Cashew Nut Oral Food Challenges

BSACI guideline for the diagnosis and management of peanut and tree nut allergy

Recent developments and highlights in food allergy

Contact Info

Product

Resources

About