Predictive value of skin prick tests using recombinant allergens for diagnosis of peanut allergy - 17/08/11
Reprint requests: Gisèle Kanny, MD, PhD, EA 3999 Maladies allergiques: Diagnostic et Thérapeutique, Laboratoire de Médecine et Thérapeutique Moléculaire, 15 rue du Bois de la Champelle, 54500 Vandoeuvre-lès-Nancy, France.Nancy, France, Durham, NC, and New York, NY
Abstract |
Background |
Current diagnosis of peanut allergy relies on natural extracts that lack standardization. Recombinant DNA technology allows production of pure biochemically characterized proteins. Their usefulness for peanut allergy diagnosis is not established.
Objective |
This study aimed to evaluate the diagnostic value of the 3 major recombinant peanut allergens.
Methods |
Recombinant (r) Ara h 1, rAra h 2, and rAra h 3 were produced according to the recommendations of good manufacturing practice for recombinant allergens. Skin prick tests (SPTs) and IgE ELISA assays were performed in 30 patients with peanut allergy and 30 control subjects without food allergy: 15 nonatopic and 15 sensitized to birch pollen. Disease severity was graded by clinical scoring.
Results |
All patients with peanut allergy showed positive SPT results to rAra h 2; 40% reacted with rAra h 1 and 27% with rAra h 3. No control subjects reacted with any of the recombinant allergens. Monosensitization to rAra h 2 was observed in 53% of patients. Neither SPT size nor levels of specific IgE were correlated with the disease severity. However, patients with monosensitization to rAra h 2 had a significantly lower severity score than polysensitized subjects and a lower level of specific IgE against peanut extract and rAra h 2.
Conclusion |
Skin prick tests to individual recombinant peanut allergens appear to be a safe and effective diagnostic tool. Cosensitization to rAra h 2 and rArah 1 and/or rAra h 3 is predictive of more severe reactions.
Clinical implications |
Recombinant peanut allergens can be used by SPTs for diagnosis and evaluation of allergy severity.
Le texte complet de cet article est disponible en PDF.Key words : Food allergy, peanut, diagnosis, recombinant allergens
Abbreviations used : AU, CPE, DBPCFC, FA, LAL, sIgE, SPT
Plan
| Supported in part by a grant from Allerbio and funding from the Ministry of Higher Education, Lorraine Region, and the Urban Community of Nancy. Disclosure of potential conflict of interest: A. W. Burks owns stock in Seer Pharmaceuticals, Inc. and has received grant support from the National Institutes of Health, Gerber Foundation, and Food Allergy and Anaphylaxis Network. H. A. Sampson has consultant arrangements with Seer Pharmaceuticals, Inc., owns stock in Seer Pharmaceuticals, Inc., has a patent licensing agreement for Ara h 3, and has received grant support from the National Institutes of Health. The rest of the authors have declared that they have no conflict of interest. |
Vol 118 - N° 1
P. 250-256 - juillet 2006 Retour au numéro
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