| Title: |
Accurate prediction of peanut allergy in one-third of adults using a validated Ara h 2 cutoff |
| Authors: |
Kansen, Hannah M; van Erp, Francine C; Knulst, André C; Ehlers, Anna M; Lyons, Sarah A; Knol, Edward F; Meijer, Yolanda; Otten, Henny G; van der Ent, Cornelis K; Le, Thuy-My; Longziekten onderzoek 1; Unit Opleiding Dermatologie; MS Dermatologie/Allergologie; Infection & Immunity; CTI Otten; CTI; CTI Research; Child Health; Longziekten patientenzorg; CDL Patiëntenzorg MI; Speerpunt Child Health |
| Publication Year: |
2021 |
| Subject Terms: |
Adults; Ara h 2; Ara h 6; Component-resolved diagnostics; Food challenge; Peanut allergy; Peanut components; Specific IgE; Immunology and Allergy; Journal Article |
| Description: |
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 kU A/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. |
| Document Type: |
article in journal/newspaper |
| File Description: |
text/plain |
| Language: |
English |
| ISSN: |
2213-2201 |
| Relation: |
https://dspace.library.uu.nl/handle/1874/441275 |
| Availability: |
https://dspace.library.uu.nl/handle/1874/441275 |
| Rights: |
info:eu-repo/semantics/OpenAccess |
| Accession Number: |
edsbas.48DA1BE1 |
| Database: |
BASE |