Faculty Opinions recommendation of The diagnostic value of specific IgE to Ara h 2 to predict peanut allergy in children is comparable to a validated and updated diagnostic prediction model.

Abstract Background Specific IgE (sIgE) against the peanut component Arachis hypogaea (Ara h) 2 has been shown to be the most important allergen to discriminate between peanut allergy and peanut tolerance. Several studies determined sIgE cut off values for Ara h 2, determined by singleplex measurements. However, cut off values for Ara h 2 from multiplex arrays are less well defined. The aim of this study was to evaluate the correlation between Ara h 2 sIgE determined by singleplex versus multiplex measurements and to assess the diagnostic value of the different peanut components included in Immuno Solid-phase Allergen Chip (ISAC) multiplex analysis in children with a suspected peanut allergy. Methods In this retrospective study we analyzed Ara h 2 sIgE values with singleplex Fluorescence Enzyme Immunoassay (FEIA, ImmunoCap) and multiplex microarray (ISAC) measurements in 117 children with a suspected peanut allergy. Also, other peanut components measured by ISAC were analyzed. Double blinded placebo controlled oral food challenges were used as golden standard. Results Among all studied peanut components FEIA Ara h 2 sIgE showed the highest area under the curve (AUC, 0.922), followed by ISAC Ara h 6 and Ara h 2 sIgE with AUCs of respectively 0.906 and 0.902. Best cut off values to diagnose peanut allergy were 4.40 kU/l for FEIA Ara h 2 sIgE and, 7.43 ISU and 8.13 ISU for respectively Ara h 2 and Ara h 6 sIgE in ISAC microarray. Ara h 2 sIgE determined in FEIA and ISAC showed a good correlation (r = 0.88; p < 0.01). Conclusion Ara h 6 and Ara h 2 sIgE in multiplex ISAC are both good predictors of clinical peanut allergy in Dutch children, and their performance is comparable to the use of Ara h 2 in singleplex FEIA. The simultaneous measurement of different peanut components using ISAC is an advantage and clinically useful to detect peanut allergic children that are Ara h 2 negative but sensitized to other peanut proteins such as Ara h 6.

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Peanut Components Measured by ISAC: Comparison With ImmunoCap and Clinical Relevance in Peanut Allergic Children

10.21203/rs.3.rs-458708/v1 ◽

2021 ◽

Author(s):

Kim Brand ◽

Marco Schreurs ◽

Joyce Emons ◽

Roy Gerth van Wijk ◽

Hans de Groot ◽

...

Keyword(s):

Peanut Allergy ◽

Solid Phase ◽

Area Under The Curve ◽

Specific Ige ◽

Diagnostic Value ◽

Ara H 2 ◽

Golden Standard ◽

Ara H 6 ◽

Food Challenges ◽

Double Blinded

Abstract BackgroundSpecific IgE (sIgE) against the peanut component Arachis hypogaea (Ara h) 2 has been shown to be the most important allergen to discriminate between peanut allergy and peanut tolerance. Several studies determined sIgE cut off values for Ara h 2, determined by singleplex measurements. However, cut off values for Ara h 2 from multiplex arrays are less well defined. The aim of this study was to evaluate the correlation between Ara h 2 sIgE determined by singleplex versus multiplex measurements and to assess the diagnostic value of the different peanut components included in Immuno Solid-phase Allergen Chip (ISAC) multiplex analysis in children with a suspected peanut allergy.Methods In this retrospective study we analyzed Ara h 2 sIgE values with singleplex Fluorescence Enzyme Immunoassay (FEIA, ImmunoCap) and multiplex microarray (ISAC) measurements in 117 children with a suspected peanut allergy. Also, other peanut components measured by ISAC were analyzed. Double blinded placebo controlled oral food challenges were used as golden standard.Results Among all studied peanut components FEIA Ara h 2 sIgE showed the highest area under the curve (AUC, 0.922), followed by ISAC Ara h 6 and Ara h 2 sIgE with AUCs of respectively 0,906 and 0,902. Best cut off values to diagnose peanut allergy were 4.40 kU/l for FEIA Ara h 2 sIgE and, 7.43 ISU and 8.13 ISU for respectively Ara h 2 and Ara h 6 sIgE in ISAC microarray. Ara h 2 sIgE determined in FEIA and ISAC showed a good correlation (r=0.88. p<0.01). ConclusionAra h 6 and Ara h 2 sIgE in multiplex ISAC are both good predictors of clinical peanut allergy, and their performance is comparable to the use of Ara h 2 in singleplex FEIA. The simultaneous measurement of Ara h 6 and Ara h 2 sIgE using ISAC is an advantage and clinically useful to detect peanut allergic children that are monosensitized to Ara h 6.

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Measurement of specific IgE antibody to Ara h 2 and its usefulness as a diagnostic tool for peanut allergy

Nihon Shoni Arerugi Gakkaishi The Japanese Journal of Pediatric Allergy and Clinical Immunology ◽

10.3388/jspaci.27.621 ◽

2013 ◽

Vol 27 (4) ◽

pp. 621-628

Author(s):

Motohiro Ebisawa ◽

Komei Ito

Keyword(s):

Diagnostic Tool ◽

Peanut Allergy ◽

Specific Ige ◽

Ara H 2 ◽

Ige Antibody

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Is Ara h 2 indeed the best predictor for peanut allergy in Dutch children?

Diagnosis ◽

10.1515/dx-2015-0032 ◽

2016 ◽

Vol 3 (1) ◽

pp. 31-35 ◽

Cited By ~ 3

Author(s):

Mirjam Schots ◽

Amerik C. de Mol ◽

Henricus J. Vermeer ◽

Yvonne M. Roosen ◽

Aldonse W. Vriesman

Keyword(s):

Prediction Model ◽

Peanut Allergy ◽

Immunoglobulin E ◽

Food Challenge ◽

Discriminative Ability ◽

Double Blind ◽

Ara H 2 ◽

Receiver Operating Characteristic Curves ◽

Specific Immunoglobulin E ◽

Predicting Factor

AbstractSpecific immunoglobulin E to Ara h 2 (sIgE to Ara h 2) is described as an upcoming predicting factor for diagnosing peanut allergy in children. The gold standard for diagnosing peanut allergy is a double blind placebo controlled food challenge, however this is time consuming and potentially harmful. We investigate Ara h 2 as a preliminary less invasive diagnostic tool for diagnosing peanut allergy in a general population of peanut sensitized children.Children (n=52) with peanut sensitization were retrospectively included. An oral food challenge (OFC) confirmed peanut allergy or tolerance, as primary outcome. Individual candidate predictors were identified by univariate regression analysis and used in a prediction model. Different cut-off values were obtained and receiver operating characteristic curves were plotted.Multivariate analyses resulted in Ara h 2 as best predictor, with a discriminative ability of 0.87 (95% confidence interval, 0.77–0.97). Sensitivity and specificity of 55% and 95%, respectively, were found for a sIgE to Ara h 2 cut-off value of 4.25 kU/L. The highest positive predictive value of 100% was reached at 5.61 kU/L. No absolute relation was found between the value of Ara h 2 and the severity of the reaction during OFC.This study developed a prediction model in which sIgE to Ara h 2 was the best predictor for peanut allergy in sensitized children in a general hospital. Therefore depending on the history and the Ara h 2 results, an OFC is not always needed to confirm the diagnosis.

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