Clinical value of component‐resolved diagnostics in peanut‐allergic patients

Introduction As replacement for the oral food challenge, decision‐points for sensitization test have been established, but suboptimal sensitivity and/or specificity, as well as regional differences, have reduced the clinical usability. IgE toward specific peanut protein components has been reported...

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Vydané v:	Allergy (Copenhagen) Ročník 68; číslo 2; s. 190 - 194
Hlavní autori:	Eller, E., Bindslev‐Jensen, C.
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	Denmark Blackwell Publishing Ltd 01.02.2013
Predmet:	Adolescent Adult Allergens Antigens, Plant - immunology Ara h 2 Ara h 2 antigen Arachis - immunology Arachis hypogaea Case-Control Studies Child Child, Preschool Confidence Intervals Diagnostic tests diagnostic values Female Food allergies Humans Immune Tolerance - physiology Immunization Immunoglobulin E - immunology Immunoglobulins Infant Male peanut Peanut Hypersensitivity - diagnosis Peanut Hypersensitivity - immunology Peanuts Reference Values Retrospective Studies sensitization Severity of Illness Index Statistics, Nonparametric Young Adult
ISSN:	0105-4538, 1398-9995, 1398-9995
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Shrnutí:	Introduction As replacement for the oral food challenge, decision‐points for sensitization test have been established, but suboptimal sensitivity and/or specificity, as well as regional differences, have reduced the clinical usability. IgE toward specific peanut protein components has been reported to be of value, but data on correlation with clinical data are sparse. Our aim was to correlate IgE values with the outcome of peanut challenges. Method Data from 175 positive and 30 negative peanut challenges in patients aged 1–26 years were retrospectively correlated with the levels of specific IgE to peanut and peanut components (Ara h 1–3, h 8, and h 9). Result The best correlation between IgE and clinical thresholds was found for Ara h 2 (ρs = −0.30, P < 0.01). A cutoff of Ara h 2 > 1.63 kU/l yielded a specificity = 1.00, with a corresponding sensitivity of 0.70. Symptom severity elicited during challenge correlated significantly with the levels of Ara h 2 (ρs = 0.60, P < 0.0001), but large individual variation was found. Conclusion The level of IgE toward Ara h 2 can improve diagnostic accuracy by introducing a more clear‐cut decision‐point with an optimal specificity maintaining a high sensitivity. In our study, this would have reduced the necessary number of challenges to be performed from 205 to 92. Extrapolation between centers is difficult and decision‐points need to be addressed in relation to settings and population. Further component‐resolved diagnostic cannot replace oral challenge neither in determining thresholds nor in the assessment of severity of symptoms elicited during challenge.
Bibliografia:	Edited by: Antonella Muraro SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 14 ObjectType-Article-2 content type line 23
ISSN:	0105-4538 1398-9995 1398-9995
DOI:	10.1111/all.12075