Component-Resolved IgE Profiles in Austrian Patients with a Convincing History of Peanut Allergy

Abstract

Background: Peanut allergy develops after primary sensitization to peanut allergens and/or IgE cross-sensitization with homologous allergens from various plants. Therefore, heterogeneous patterns of sensitization to individual peanut allergens are observed in different countries. The aim of this study was to examine the IgE sensitization patterns of Austrian peanut-allergic patients. Methods: Sera from 65 peanut-allergic patients and 20 peanut-tolerant atopics were obtained in four Austrian allergy clinics.Sensitization patterns against peanut allergens Ara h 1-3, 6, 8 and 9 were identified by ImmunoCAP and ImmunoCAP ISAC. Results: Austrian peanut-allergic patients were sensitized to Ara h 2 and 6 (71%), followed by Ara h 1 (62%), Ara h 8 (45%), Ara h 3 (35%) and Ara h 9 (11%). All sera containing Ara h 2-specific IgE were also positive for Ara h 6, with Ara h 6-specific IgE levels significantly (p < 0.05) higher compared with Ara h 2. Twelve percent displayed IgE reactivity exclusively to Ara h 8. Peanut extract and Ara h 8 showed low diagnostic specificities of 25 and 10%, respectively. The other peanut allergens showed 100% specificity. Diagnostic sensitivities determined by ImmunoCAP ISAC and ImmunoCAP were highly similar for Ara h 2, 3 and 8. Conclusions: Themajority of symptomatic peanut-allergic patients are sensitized to Ara h 2 and Ara h 6. In peanut-symptomatic patients with additional birch pollen allergy, other peanut allergens, especially Ara h 8, should be tested when IgE reactivity to Ara h 2 is absent.

Mono-sensitisation to peanut component Ara h 6: a case series of five children and literature review

“…Allergy , 2007 (25)Clinical history of peanut allergySPT ratio ≥0.25 or positive peanut sIgE30 adults25 performed22 positive22 positive to at least Ara h 2 and Ara h 6 (73.3 %)5 mono-sensitisation to Ara h 2 (16.7 %)0 mono-sensitisation to Ara h 6 (-)Flinterman, Van Hoffen et al Clinical and Exp. Allergy , 2007 (10)Positive DBPCFC peanutSPT ratio ≥0.25Positive peanut sIgE20 children20 performed20 positive16 positive to at least Ara h 2 and Ara h 6 (80 %)4 mono-sensitisation to Ara h2 (20 %)0 mono-sensitisation to Ara h 6 (-)Codreanu, Collignon et al Int Arch Allergy Immunol , 2011 (7)Positive DBPCFC peanut166 children166 performedAll positive149 positive to at least Ara h 2 and Ara h 6 (89.7 %)10 mono-sensitisation to Ara h 2 (6.0 %)3 mono-sensitisation to Ara h 6 (1.8 %)Asarnoj, Glaumann et al Int Arch Allergy Immunol , 2012 (4)Clinical history of peanut allergyPositive peanut sIgE5 children5 performed5 positive0 positive to at least Ara h 2 and Ara h 6 (-)0 mono-sensitisation to Ara h 2 (-)1 sensitisation to Ara h 6 and Ara h 8 (20 %)Klemans, Knol et al Allergy , 2014 (13)DBPCFC peanut between 2002 and 2013Leftover serum107 adults107 performed65 positive48 positive to at least Ara h 2 and Ara h 6 (44.8 %)1 mono-sensitisation to Ara h 2 (0.9 %)4 mono-sensitisation to Ara h 6 (3.7 %)Kukkonen, Pelkonen et al Allergy , 2015(18)Peanut-sensitisation or a high suspicion of peanut allergy102 children102 performed69 positive No specification Ballmer-Weber, Lidholm et al Allergy, 2015 (5)DBPCFC peanut positive or history peanut allergy68 children and adults28 performed 50 positive to at least Ara h 2 and 6 ( 74  %) 0 mono - sensitisation to Ara h 6 No DBPCFC performedAgabriel, Ghazouani et al Pediatr Allergy Immunol , 2015 (2)Clinical history of peanut allergy in last 6 monthsSPT wheel ≥4 mm and/or positive peanut sIgE117 children–73 positive to Ara h 2 (63 %)74 positive to Ara h 6 (64 %) No specification Ackerbauer, Bublin et al Int Arch Allergy Immunol , 2015 (1)History of peanut allergyPositive SPT and/or positive peanut sIgE33 adults32 children–46 positive to at least Ara h 2 and Ara h 6 (70.7 %) No specification Pedrosa, Boyono-Martinez et al Ann Allergy Asthma Immunol, 2015 (24)History of peanut allergyPositive SPT and positive peanut sIgE22 childr...…”

“…Ackerbauer et al performed a study on 65 peanut allergic patients [1]. Sensitisation patterns against peanut allergens Ara h 1, 2, 3, 6, 8 and 9 were measured with ImmunoCAP ISAC.…”

Detection of the Peanut Allergens Ara h 2 and Ara h 6 in Human Breast Milk: Development of 2 Sensitive and Specific Sandwich ELISA Assays

“…Currently, the storage protein Ara h 2 is acknowledged as the most relevant marker allergen, associated with severe, sometimes fatal reactions [9,10,11,12]. Likewise, Ara h 6 is considered to predict peanut allergy with similar accuracy as both proteins belong to the 2S albumins with 59% sequence homology [13,14,15]. …”

Component-Resolved Diagnosis of Peanut Allergy and Its Possible Origins of Sensitization in China

“…On the other hand, Swedish patients had relatively high IgE-positive responses to Ara h 8, a member of the PR-10 family and Bet v 1 homologue, which may be correlated with a high prevalence of birch pollinosis [6] and rarity of severe reactions. Ara h 1 and 2 are major peanut allergens in Austria, where anaphylaxis is the most common peanut-associated reaction [7]. In North America, most people were allergic to Ara h 1-3 (56.7-90.0%) and have a young onset age and severe symptoms [4].…”