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Component‐resolved diagnostics for the evaluation of peanut allergy in a low‐prevalence area
Author(s) -
Suratan Narissara,
Ngamphaiboon Jarungchit,
Wongpiyabovorn Jongkonnee,
Puripokai Panitchaya,
Chatchatee Pantipa
Publication year - 2013
Publication title -
pediatric allergy and immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.269
H-Index - 89
eISSN - 1399-3038
pISSN - 0905-6157
DOI - 10.1111/pai.12125
Subject(s) - peanut allergy , medicine , allergy , allergen , sensitization , immunology , population , predictive value , anaphylaxis , food allergy , environmental health
Abstract Background Major allergenic components of peanut from distinct geographical regions are widely dispersed. Most of the diagnostic studies are from countries with a high prevalence. There have been only few reports of allergen component sensitizations from countries with a low prevalence of peanut allergy. We aimed to investigate roles of component‐resolved diagnostic ( CRD ) to differentiate peanut allergy and peanut tolerance in the A sian population from a country with low prevalence of peanut allergy. Methods Participants with peanut sensitization were enrolled. Clinical reactions were determined. Skin prick test ( SPT ) and specific I g E ( sIgE ) to peanut and related allergen components were performed. Results Forty subjects with peanut sensitization were included. The mean wheal sizes of SPT and peanut sIgE were not good predictors for differentiating peanut reactions. S I g E to rA ra h 2 was more often found in patients with peanut allergy and anaphylaxis. s I g E to r A ra h 9 was also more frequent in the peanut‐allergic group but not related to severe reactions. In the peanut‐tolerant group, despite positive SPT and/or s I g E to peanut, 90% had negative s I g E to r A ha h 2 and r A ra h 9. Combining r A ra h 2 and r A ra h 9 resulted in high performance of the test with sensitivity, specificity, positive predictive value, and negative predictive value of 84%, 90%, 0.89, and 0.86, respectively. The ratio between r A ra h 2 s I g E to peanut s I g E of 0.6 can be helpful in predicting patients who will develop severe reaction. SIgE to cross‐reactive carbohydrate determinants ( CCD ) was exclusively found in the peanut‐tolerant group (33.3% vs. 0%, p = 0.012). Conclusions Our study identifies three allergen components: r A ra h 2, r A ra h 9, and CCD as important components in the diagnosis of peanut allergy in an Asian country with low prevalence. The ratio between r A rah h 2 s I g E to peanut s I g E can be used for predicting patients who will develop anaphylaxis.