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Background: To date, diagnosing food allergies in children still presents a diagnostic dilemma, leading to uncertainty concerning the definite diagnosis of peanut allergy, as well as to the need for strict diets and the potential need for adrenalin auto-injectors. This uncertainty in particular is thought to contribute to a lower quality of life. In the diagnostic process double-blind food challenges are considered the gold standard, but they are time-consuming as well as potentially hazardous. Other diagnostic tests have been extensively studied and among these component-resolved diagnostics appeared to present a promising alternative: Ara h2, a peanut storage protein in previous studies showed to have a significant predictive value.
Methods: Sixty-two out of 72 children, with suspected peanut allergy were analyzed using serum specific IgE and/or skin prick tests and specific IgE to several components of peanut (Ara h 1, 2, 3, 6, 8, 9). Subsequently, double-blind food challenges were performed. The correlation between the various diagnostic tests and the overall outcome of the double-blind food challenges were studied, in particular the severity of the reaction and the eliciting dose.
Results: The double-blind provocation with peanut was positive in 33 children (53 %). There was no relationship between the eliciting dose and the severity of the reaction. A statistically significant relationship was found between the skin prick test, specific IgE directed to peanut, Ara h 1, Ara h 2 or Ara h 6, and the outcome of the food challenge test, in terms of positive or negative (P < .001). However, we did not find any relationship between sensitisation to peanut extract or the different allergen components and the severity of the reaction or the eliciting dose. There was no correlation between IgE directed to Ara h 3, Ara h 8, Ara h 9 and the clinical outcome of the food challenge.
Conclusions: This study shows that component-resolved diagnostics is not superior to specific IgE to peanut extract or to skin prick testing. At present, it cannot replace double-blind placebo-controlled food challenges for determination of the eliciting dose or the severity of the peanut allergy in our patient group.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4891901 | PMC |
http://dx.doi.org/10.1186/s12887-016-0609-7 | DOI Listing |
Zhonghua Yu Fang Yi Xue Za Zhi
December 2024
Department of Clinical Laboratory of the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou510120, China.
Soybeans and peanuts belong to the leguminous family and are common causes of food anaphylaxis. Symptoms range from oral allergy syndrome to severe breathing difficulties, anaphylactic shock, and even death. But the allergens causing allergies are different, and the severity of symptoms are different.
View Article and Find Full Text PDFZhonghua Yu Fang Yi Xue Za Zhi
December 2024
Department of Allergy, National Clinical Research Center for Respiratory Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing100045, China.
This study aimed to analyze the test results and changing trend of specific IgE (sIgE) for common allergens in children in the hospital from 2019 to 2023, so as to provide a basis for the diagnosis and treatment of allergic diseases in children. The test results of children who were admitted to Beijing Children's Hospital, Capital Medical University and underwent serum allergen sIgE quantitative detection (Immuno CAP system) from January 1, 2019 to December 31, 2023 were retrospectively included. According to the allergen type, the allergens were divided into food allergens and inhaled allergens (dust mite group, mold group, animal dander group and pollen group).
View Article and Find Full Text PDFInt J Mol Sci
December 2024
Institute of Translational Pharmacology (IFT), National Research Council (CNR), 90146 Palermo, Italy.
The aim of this systematic review was to evaluate the diagnostic accuracy of molecular-based LTPs serum sIgE for the diagnosis of food allergies in patients with suspected allergy to one of the LTPs-containing foods. Cohort, prospective or retrospective cross-sectional studies were considered for inclusion in this review. Oral food challenge (both open and double-blind placebo-controlled) was the reference standard for the diagnosis.
View Article and Find Full Text PDFAllergy
December 2024
Department of Pediatrics, Martini Hospital, Groningen, The Netherlands.
Background: Double-blind placebo-controlled food challenge (DBPCFC) is widely regarded as the "gold standard" to diagnose food allergy. Maximum efforts are made to reduce bias, yet DBPCFCs are costly, time-, and resource-intensive. Less demanding open food challenges are increasingly used in clinical practice.
View Article and Find Full Text PDFAllergy
December 2024
Regeneron Pharmaceuticals Inc., Tarrytown, New York, USA.
Background: Peanut allergy is a potentially life-threatening food allergy in children. This study explored whether dupilumab, a human monoclonal immunoglobulin (Ig)G4 antibody that blocks the activity of interleukin (IL)-4/IL-13, improved safety and desensitization to peanut exposure in children with peanut allergy.
Methods: A Phase II, 24-week, multicenter, single-arm, open-label, proof-of-concept study was conducted in the USA and Canada (NCT03793608).
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