Influence of age on IgE response in peanut‐allergic children and adolescents from the Mediterranean area

Abstract

Background Peanut allergens are common triggers of food allergy. Analyses of sensitization patterns, relationships with other allergens, clinical symptoms, and variation with age are needed. We studied sensitization to Ara h 2, Ara h 9, and Pru p 3 in a peanut allergic children/adolescents and the relationship with peach and pollen. Methods Peanut allergic patients aged between 1 and 20 years old were classified into two groups: A) allergic to peanut only and B) allergic to peach and peanut. The IgE response was measured to Ara h 2, Ara h 9, and Pru p 3. Results Of 964 subjects evaluated, 28% were allergic to peanut. From this group, 68% were also sensitized to pollen. Urticaria was the most frequent entity followed by anaphylaxis and OAS. Fifty‐eight percent had Ara h 2‐ and/or Ara h 9‐specific IgE. More than half reported symptoms with peanut alone (Group A) and 35% to peanut and peach (Group B). We observed significant differences in sex, age, onset of symptoms, and sensitization to Artemisia between groups. IgE response to Ara h 2 was more frequent in Group A, and Ara h 9 and Pru p 3 in Group B. We observed a decrease in sensitization to Ara h 2 and an increase to Ara h 9 and Pru p 3 with increasing age. Conclusion Peanut allergy is frequent in subjects with allergy to plant foods, with Ara h 2 and Ara h 9 being two important allergens. In younger patients, Ara h 2 predominates over Ara h 9. The reverse was observed in older patients.

Peanut Allergy in Spanish Children: Comparative Profile of Peanut Allergy versus Tolerance

“…A study also conducted on a pediatric population from Madrid showed that as children allergic to peanuts were growing older, sensitization to Ara h 2 was decreasing with an increase in sensitization to Ara h 9 and Pru p 3 [13]. When compared to these two Spanish studies on pediatric populations [3, 14], our results are more similar to the work previously published by Pedrosa et al [14].…”

“…Although panallergens like Pru p 3 may play an important role in peanut-allergic patients, they occur at later ages when children have become older [13]. Ara h 2 allows us to make a more accurate diagnosis, which could help avoid greater risks.…”

“…Ara h 8 and Ara h 9 appear to be the main allergens in Central Europe and in Western/Southern Europe, respectively [3, 12, 21-23]. Sensitization to seed storage proteins starts at an early age and is rarely acquired in adolescence and adulthood [12, 13]. …”

The clinical and immunological effects of Pru p 3 sublingual immunotherapy on peach and peanut allergy in patients with systemic reactions

“…In addition to apple, it has been widely reported that peach allergy is frequently accompanied by allergy to other plantderived foods such as peanut. Moreover, it has been shown that Pru p 3 sensitization becomes more prevalent with age, with Ara h 2 being relevant in younger patients (1-10 years) allergic to peanut [29,30], whereas Ara h 9 sensitization is most common in adolescents [29]. Ara h 2 sensitization has also been found in the Mediterranean area, but it seems to be restricted to patients with allergy only to peanut and with tolerance to peach [28].…”

Clinical Significance of Component Allergens in Fagales Pollen-Sensitized Peanut Allergy in Korea

“…In adults, sensitization and clinical patterns of peanut allergy are different from those in children 12. Peanut anaphylaxis (PA) is common in children; oral allergy syndrome (OAS) to peanut is common in adults.…”