Accurate Prediction of Peanut Allergy in One-Third of Adults Using a Validated Ara h 2 Cutoff.
| Title: | Accurate Prediction of Peanut Allergy in One-Third of Adults Using a Validated Ara h 2 Cutoff. |
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| Authors: | Kansen HM; Department of Dermatology and Allergology, University Medical Center, Utrecht University, Utrecht, the Netherlands; Department of Pediatric Pulmonology and Allergology, Wilhelmina Children's Hospital, University Medical Center, Utrecht University, Utrecht, the Netherlands. Electronic address: h.m.kansen-2@umcutrecht.nl.; van Erp FC; Department of Dermatology and Allergology, University Medical Center, Utrecht University, Utrecht, the Netherlands.; Knulst AC; Department of Dermatology and Allergology, University Medical Center, Utrecht University, Utrecht, the Netherlands; Center of Translational Immunology, University Medical Center Utrecht, Utrecht, the Netherlands.; Ehlers AM; Department of Dermatology and Allergology, University Medical Center, Utrecht University, Utrecht, the Netherlands; Center of Translational Immunology, University Medical Center Utrecht, Utrecht, the Netherlands.; Lyons SA; Department of Dermatology and Allergology, University Medical Center, Utrecht University, Utrecht, the Netherlands.; Knol EF; Department of Dermatology and Allergology, University Medical Center, Utrecht University, Utrecht, the Netherlands; Center of Translational Immunology, University Medical Center Utrecht, Utrecht, the Netherlands.; Meijer Y; Department of Pediatric Pulmonology and Allergology, Wilhelmina Children's Hospital, University Medical Center, Utrecht University, Utrecht, the Netherlands.; Otten HG; Center of Translational Immunology, University Medical Center Utrecht, Utrecht, the Netherlands.; van der Ent CK; Department of Pediatric Pulmonology and Allergology, Wilhelmina Children's Hospital, University Medical Center, Utrecht University, Utrecht, the Netherlands.; Le TM; Department of Dermatology and Allergology, University Medical Center, Utrecht University, Utrecht, the Netherlands; Center of Translational Immunology, University Medical Center Utrecht, Utrecht, the Netherlands. |
| Source: | The journal of allergy and clinical immunology. In practice [J Allergy Clin Immunol Pract] 2021 Apr; Vol. 9 (4), pp. 1667-1674.e3. Date of Electronic Publication: 2020 Nov 26. |
| Publication Type: | Journal Article; Randomized Controlled Trial |
| Language: | English |
| Journal Info: | Publisher: Elsevier Inc Country of Publication: United States NLM ID: 101597220 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2213-2201 (Electronic) NLM ISO Abbreviation: J Allergy Clin Immunol Pract Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: New York, NY : Elsevier Inc., [2013]- |
| MeSH Terms: | Peanut Hypersensitivity*/diagnosis; 2S Albumins, Plant ; Adult ; Allergens ; Antigens, Plant ; Arachis ; Child ; Glycoproteins ; Humans ; Immunoglobulin E |
| Abstract: | Background: The diagnostic value of peanut components is extensively studied in children, but to a lesser extent in adults with suspected peanut allergy. The use of peanut components in daily practice may reduce the need for double-blind placebo-controlled food challenges (DBPCFCs); however, validation studies are currently lacking.; Objective: To evaluate the diagnostic value of (combined) peanut components and validate a previously found Ara h 2 cutoff level with 100% positive predictive value (PPV) in adults with suspected peanut allergy.; Methods: Adults who underwent a peanut DBPCFC were included: 84 patients from a previous study (2002-2012) and 70 new patients (2012-2019). Specific IgE (sIgE) to peanut extract, Ara h 1, 2, 3, 6, and 8 was measured using ImmunoCAP. Diagnostic value was assessed with an area under the curve (AUC) analysis.; Results: In total, 95 (62%) patients were peanut allergic. sIgE to Ara h 2 and Ara h 6 were the best predictors with an AUC (95% confidence interval) of 0.85 (0.79-0.91) and 0.85 (0.79-0.92), respectively. The Ara h 2 cutoff level with 100% PPV (≥1.75 kUA/L) was validated in the 70 new patients. Thirty percent of all included patients could be classified correctly as peanut allergic using this validated cutoff level.; Conclusion: sIgE to Ara h 2 and Ara h 6 have equally high discriminative ability. Peanut allergy can be predicted accurately in one-third of adults using a validated cutoff level of sIgE to Ara h 2.; (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.) |
| Contributed Indexing: | Keywords: Adults; Ara h 2; Ara h 6; Component-resolved diagnostics; Food challenge; Peanut allergy; Peanut components; Specific IgE |
| Substance Nomenclature: | 0 (2S Albumins, Plant); 0 (Allergens); 0 (Antigens, Plant); 0 (Glycoproteins); 37341-29-0 (Immunoglobulin E) |
| Entry Date(s): | Date Created: 20201128 Date Completed: 20210524 Latest Revision: 20210524 |
| Update Code: | 20260130 |
| DOI: | 10.1016/j.jaip.2020.11.024 |
| PMID: | 33248282 |
| Database: | MEDLINE |
Journal Article; Randomized Controlled Trial