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IgE binding to linear epitopes of Ara h 2 in peanut allergic preschool children undergoing oral Immunotherapy
Author(s) -
Dreskin Stephen C.,
Germinaro Matthew,
Reinhold Dominik,
Chen Xueni,
Vickery Brian P.,
Kulis Michael,
Burks A. Wesley,
Negi Surendra S.,
Braun Werner,
Chambliss Jeffery M.,
Eglite Spodra,
McNulty Caitlin M. G.
Publication year - 2019
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.13117
Subject(s) - medicine , epitope , immunoglobulin e , peanut allergy , immunology , immunotherapy , allergy , antibody , immune system
Abstract Background For patients with peanut allergy, there are currently no methods to predict who will develop sustained unresponsiveness (SU) after oral immunotherapy (OIT). Objective Assess IgE binding to peanut (PN), Ara h 2, and specific linear epitopes of Ara h 2 as predictors of the important clinical parameters: eliciting dose threshold and attainment of SU following OIT. Methods Samples and clinical data were collected from children undergoing OIT. PN‐ and Ara h 2‐sIgE were quantified by ImmunoCAP ® . IgE binding to linear peptides of Ara h 2 and Ara h 6 was measured with peptide microarrays. Results Values of PN‐sIgE correlated with eliciting dose ( P = .001) and with a higher likelihood of achieving SU ( P < .0001), but these relationships were lost at higher values for PN‐sIgE (≥14 kIU for eliciting dose and ≥35 kIU/L for SU). In subjects with PN‐sIgE ≥ 14 kIU/L, binding of IgE to epitopes 5 and 6 of Ara h 2 was associated with a lower eliciting dose at baseline challenge ( P < .001; P c < .02). In subjects with PN‐sIgE ≥ 35 kIU/L, a combined model of IgE binding to epitopes 1, 5 and 6 with PN‐sIgE was highly predictive of attainment of SU (AUC of 0.86; P = .0067). Conclusion In young patients with peanut allergy, measurement of PN‐sIgE and IgE binding to specific linear epitopes of Ara h 2 in baseline samples may allow stratification of patients regarding sensitivity to challenge and outcome of OIT.