Abstract:Peanut allergy (PNA) is an IgE-mediated immune disorder, which merits particular attention due to its impact on the health and quality of life of millions of patients worldwide.Peanut allergy is particularly widespread in the younger population and affects almost ¼ of children with food allergy (FA). 1 Although PNA tends to develop in early life, it resolves in only 20% of children. 2 The overall prevalence of PNA is estimated as 0.4% in Europe and 0.6% in the United States. 3,4 The frequency of PNA by self-re… Show more
“…In terms of specific food allergies in children, one of the allergenic foods that has had greater focus in terms of diagnostic studies over the last decade has been peanut 35…”
Section: Peanut Allergymentioning
confidence: 99%
“…In terms of specific food allergies in children, one of the allergenic foods that has had greater focus in terms of diagnostic studies over the last decade has been peanut 35 but recent data have emerged on other foods, including hazelnut, cashew and sesame. The focus on peanut may have been influenced by the increasing prevalence of peanut allergy in the last decade with approximately 0.4%‐3% of children in developed countries being affected as well as it being one of the most common causes of anaphylactic reactions in children 35 …”
Section: Diagnostic Spt Sige and Component Testing For Specific Foodmentioning
Food allergy is increasing in prevalence, affecting up to 10% of children in developed countries. Food allergy can significantly affect the quality of life and well‐being of patients and their families; therefore, an accurate diagnosis is of extreme importance. Some food allergies can spontaneously resolve in 50%‐60% of cow’s milk and egg‐allergic, 20% of peanut‐allergic and 9% of tree nut‐allergic children by school age. For that reason, food‐allergic status should be monitored over time to determine when to reintroduce the food back into the child’s diet. The gold‐standard to confirm the diagnosis and the resolution of food allergy is an oral food challenge; however, this involves the risk of causing an acute‐allergic reaction and requires clinical experience and resources to treat allergic reactions of any degree of severity. In the clinical setting, biomarkers have been used and validated to enable an accurate diagnosis when combined with the clinical history, deferring the oral food challenge, whenever possible. In this review, we cover the tools available to support the diagnosis of food allergies and to predict food allergy resolution over time. We review the latest evidence on different testing modalities and how effective they are in guiding clinical decision making in practice. We also evaluate predictive test cut‐offs for the more common food allergens to try and provide guidance on when challenges might be most successful in determining oral tolerance in children.
“…In terms of specific food allergies in children, one of the allergenic foods that has had greater focus in terms of diagnostic studies over the last decade has been peanut 35…”
Section: Peanut Allergymentioning
confidence: 99%
“…In terms of specific food allergies in children, one of the allergenic foods that has had greater focus in terms of diagnostic studies over the last decade has been peanut 35 but recent data have emerged on other foods, including hazelnut, cashew and sesame. The focus on peanut may have been influenced by the increasing prevalence of peanut allergy in the last decade with approximately 0.4%‐3% of children in developed countries being affected as well as it being one of the most common causes of anaphylactic reactions in children 35 …”
Section: Diagnostic Spt Sige and Component Testing For Specific Foodmentioning
Food allergy is increasing in prevalence, affecting up to 10% of children in developed countries. Food allergy can significantly affect the quality of life and well‐being of patients and their families; therefore, an accurate diagnosis is of extreme importance. Some food allergies can spontaneously resolve in 50%‐60% of cow’s milk and egg‐allergic, 20% of peanut‐allergic and 9% of tree nut‐allergic children by school age. For that reason, food‐allergic status should be monitored over time to determine when to reintroduce the food back into the child’s diet. The gold‐standard to confirm the diagnosis and the resolution of food allergy is an oral food challenge; however, this involves the risk of causing an acute‐allergic reaction and requires clinical experience and resources to treat allergic reactions of any degree of severity. In the clinical setting, biomarkers have been used and validated to enable an accurate diagnosis when combined with the clinical history, deferring the oral food challenge, whenever possible. In this review, we cover the tools available to support the diagnosis of food allergies and to predict food allergy resolution over time. We review the latest evidence on different testing modalities and how effective they are in guiding clinical decision making in practice. We also evaluate predictive test cut‐offs for the more common food allergens to try and provide guidance on when challenges might be most successful in determining oral tolerance in children.
“…Taken individually, each omics-approach has assets and drawbacks (reviewed by ( 127 , 128 ) but together they might unfold their full potential. Unbiased machine-learning, integrated data analysis of heterogeneous datasets as well as network-based approaches will be required to establish algorithms for providing insights in disease pathophysiology and for inferring biomarkers or biomarker signatures being predictive for reaction phenotypes ( 33 , 127 , 129 , 130 ). Finally, those insights shall advance the stratification of individuals prior to selection for oral immunotherapy or early food introduction for prevention, both pioneer areas research in PA ( 131 , 132 ).…”
Section: Conclusion: Perspective Toward New Integrative Approachesmentioning
Food allergy is a collective term for several immune-mediated responses to food. IgE-mediated food allergy is the best-known subtype. The patients present with a marked diversity of clinical profiles including symptomatic manifestations, threshold reactivity and reaction kinetics. In-vitro predictors of these clinical phenotypes are evasive and considered as knowledge gaps in food allergy diagnosis and risk management. Peanut allergy is a relevant disease model where pioneer discoveries were made in diagnosis, immunotherapy and prevention. This review provides an overview on the immune basis for phenotype variations in peanut-allergic individuals, in the light of future patient stratification along emerging omic-areas. Beyond specific IgE-signatures and basophil reactivity profiles with established correlation to clinical outcome, allergenomics, mass spectrometric resolution of peripheral allergen tracing, might be a fundamental approach to understand disease pathophysiology underlying biomarker discovery. Deep immune phenotyping is thought to reveal differential cell responses but also, gene expression and gene methylation profiles (eg, peanut severity genes) are promising areas for biomarker research. Finally, the study of microbiome-host interactions with a focus on the immune system modulation might hold the key to understand tissue-specific responses and symptoms. The immune mechanism underlying acute food-allergic events remains elusive until today. Deciphering this immunological response shall enable to identify novel biomarker for stratification of patients into reaction endotypes. The availability of powerful multi-omics technologies, together with integrated data analysis, network-based approaches and unbiased machine learning holds out the prospect of providing clinically useful biomarkers or biomarker signatures being predictive for reaction phenotypes.
“…Component‐resolved diagnostics (CRD) is an important tool in the investigation of suspected peanut allergy. Primary sensitization to peanut, generally characterized by sensitization to the storage proteins Ara h 1, Ara h 2, Ara h 3 and/or Ara h 6, is associated with severe allergic symptoms to peanut 1,2 . On the other hand, cross‐reactive pollen sensitization may confound the interpretation of IgE tests to peanut.…”
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