Peanut component Ara h 8 sensitization and tolerance to peanut - 30/07/12
, Caroline Nilsson, MD, PhD c, e, Jonas Lidholm, PhD f, Susanne Glaumann, MD c, e, Eva Östblom, MD, PhD c, d, e, Gunilla Hedlin, MD, PhD b, d, Marianne van Hage, MD, PhD g, Gunnar Lilja, MD, PhD c, Magnus Wickman, MD, PhD a, c, d
Corresponding author: Anna Asarnoj, MD, PhD, National Institute of Environmental Medicine, Karolinska Institutet, PO Box 210, SE-171 77 Stockholm, Sweden.Abstract |
Background |
Isolated Ara h 8 sensitization is suggested to be associated with no or mild symptoms among peanut-sensitized subjects.
Objective |
We sought to investigate the occurrence of systemic reactions in children with isolated sensitization to Ara h 8.
Methods |
Participants were 144 children sensitized to Ara h 8 (≥0.35 kUA/L) but not to Ara h 1, Ara h 2, or Ara h 3 (<0.35 kUA/L). An open oral challenge with peanut was performed in those subjects who did not consume peanut regularly, and an extended IgE reactivity profile was obtained. If the child had a documented history of systemic reactions up to grade I anaphylaxis, double-blind, placebo-controlled food challenges were performed.
Results |
One hundred twenty-nine (89.5%) children were either peanut consumers or did not react to peanut challenge. Another 14 (9.7%) children experienced oral cavity symptoms at the first 2 but not subsequent challenge doses. At the time of the double-blind, placebo-controlled food challenge, 1 boy with a previous mild systemic reaction to peanut experienced lip swelling, stomach cramping, and objective tiredness. Reanalysis of IgE levels showed an increase in peanut IgE levels from 1.5 to 8.8 kUA/L, but IgE levels to Ara h 8 remained stable and IgE levels to Ara h 1, Ara h 2, and Ara h 3 were all still less than 0.35 kUA/L. The IgE level to Ara h 6 was 0.45 kUA/L.
Conclusion |
Isolated Ara h 8 sensitization indicates tolerance to peanuts in almost all cases. However, sensitization against thus far unidentified determinants in peanut might cause symptoms in rare cases.
Le texte complet de cet article est disponible en PDF.Key words : Ara h 1, Ara h 2, Ara h 3, Ara h 6, Ara h 8, Ara h 9, component-resolved diagnostics, molecular allergology, oral food challenge, peanut allergy, sensitization
Abbreviations used : DBPCFC, OAS, OOFC
Plan
| Supported by the Swedish Asthma and Allergy Association’s Research Foundation, the Foundation for Health Care Sciences and Allergy Research, the Centre for Allergy Research (CfA), the Stockholm County Council, and the Swedish Research Council, Sweden. Thermo Fisher Scientific kindly provided the reagents for the study and performed some of the IgE determinations. |
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| Disclosure of potential conflict of interest: A. Asarnoj has received research support from Thermo Fisher Scientific. J. Lidholm is employed by Thermo Fisher Scientific. M. van Hage has received lecture fees from Thermo Fisher Scientific. M. Wickman has received lecture fees from ALK-Abelló and has received research support from Thermo Fisher Scientific. The rest of the authors declare that they have no relevant conflicts of interest. |
Vol 130 - N° 2
P. 468-472 - août 2012 Retour au numéro
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