The value of specific IgE to peanut and its component Ara h 2 in the diagnosis of peanut allergy

J Allergy Clin Immunol Pract. Jul-Aug 2013;1(4):394-8. doi: 10.1016/j.jaip.2013.05.010. Epub 2013 Jun 28.

Abstract

Background: To avoid unnecessary oral food challenges, which are time consuming, stressful, and risky, improved in vitro diagnostic methods for food allergy such as component resolved diagnostics are still under investigation.

Objective: To investigate the role of whole peanut- and peanut-component (Ara h 1, Ara h 2, Ara h 3, Ara h 6 and Ara h 8)-specific IgE levels in the diagnostic procedure of peanut allergy as well as the diagnostic properties of peanut-specific IgG and IgG4.

Methods: Sixty-one children underwent oral peanut challenge tests for diagnostic purposes irrespective of their peanut-specific IgE levels. Peanut-specific serum IgE, IgG, and IgG4 levels were determined by ImmunoCAP FEIA and specific IgE against individual peanut proteins by Immuno Solid-phase Allergen Chip.

Results: Thirty-four of 61 patients (56%) had a peanut allergy. No significant difference was observed for peanut-specific IgG or peanut-specific IgG4 levels between patients who were allergic and tolerant patients, whereas peanut-specific IgE was significant higher in patients who were allergic than in tolerant patients (P < .005). Twenty-five of 61 children had peanut-specific IgE above a previously proposed cutoff level of 15 kUA/L; however, 7 of these 25 children (28%) were clinically tolerant. Ara h 2-specific IgE was significantly lower in tolerant than in patients with allergies (P < .0001). Interestingly, 94% of the patients with peanut allergies showed IgE-binding to Ara h 2. Unfortunately, 26% of the sensitized but tolerant patients have shown IgE binding to Ara h 2 too.

Conclusions: Neither the level of specific IgE to peanut nor to Ara h 2 was able to clearly distinguish patients with clinical relevant peanut allergy from those who were clinical tolerant in our population. As expected, peanut-specific IgG and IgG4 did not improve the diagnostic procedure.

Keywords: Ara h 1; Ara h 3; Ara h 6; Ara h 8; Ara h 2; Component-resolved diagnostics; IgE; IgG; IgG(4); Immuno Solid-phase Allergen Chip; Peanut allergy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • 2S Albumins, Plant / immunology*
  • Adolescent
  • Antigens, Plant / immunology*
  • Arachis / immunology*
  • Child
  • Child, Preschool
  • Female
  • Glycoproteins / immunology*
  • Humans
  • Immunoglobulin E / blood*
  • Immunoglobulin G / blood
  • Infant
  • Male
  • Peanut Hypersensitivity / diagnosis*

Substances

  • 2S Albumins, Plant
  • Antigens, Plant
  • Ara h 2 allergen, Arachis hypogaea
  • Glycoproteins
  • Immunoglobulin G
  • Immunoglobulin E