IgE, but not IgG4, antibodies to Ara h 2 distinguish peanut allergy from asymptomatic peanut sensitization

Xiumei Hong, D. Caruso, R. Kumar, R. Liu, X. Liu, Guoying Wang, J. A. Pongracic, Xiaobin Wang

Research output: Contribution to journalArticle

Abstract

Background There are no available clinical tests that can accurately predict peanut allergy (PA) and/or anaphylaxis. This study is aimed at evaluating whether the component-resolved diagnostic (CRD) IgE and IgG4 tests can (i) distinguish PA from asymptomatic peanut sensitization (PS) and (ii) differentiate anaphylactic from nonanaphylactic PA. Methods This study included 20 nonatopic controls, 58 asymptomatically peanut-sensitized children, 55 nonanaphylactic, and 53 anaphylactic PA cases from the Chicago Food Allergy Study. IgE and IgG4 to 103 allergens were measured using the ImmunoCAP ISAC technology and were compared among each group of children. The random forest test was applied to estimate each allergen's ability to predict PA and/or peanut anaphylaxis. Results Peanut allergy cases (with or without anaphylaxis) had significantly higher IgE reactivity to Ara h 1-3 (peanut allergens) and Gly m 5-6 (soy allergens) than asymptomatically sensitized children (P <0.00001). Similar but more modest relationships were found for IgG4 to Ara h 2 (P <0.01). IgE to Ara h 2 was the major contributor to accurate discrimination between PA and asymptomatic sensitization. With an optimal cutoff point of 0.65 ISU-E, it conferred 99.1% sensitivity, 98.3% specificity, and a 1.2% misclassification rate in the prediction of PA, which represented a higher discriminative accuracy than IgE to whole peanut extract (P = 0.008). However, none of the IgE and/or IgG4 tests could significantly differentiate peanut anaphylaxis from nonanaphylactic PA. Conclusions IgE to Ara h 2 can efficiently differentiate clinical PA from asymptomatic PS, which may represent a major step forward in the diagnosis of PA.

Original languageEnglish (US)
Pages (from-to)1538-1546
Number of pages9
JournalAllergy: European Journal of Allergy and Clinical Immunology
Volume67
Issue number12
DOIs
StatePublished - Dec 2012

Fingerprint

Peanut Hypersensitivity
Immunoglobulin E
Immunoglobulin G
Antibodies
Anaphylaxis
Allergens
Arachis
Food Hypersensitivity

Keywords

  • Ara h 2
  • component-resolved diagnostics
  • diagnostic performance
  • peanut allergy
  • peanut anaphylaxis

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy

Cite this

IgE, but not IgG4, antibodies to Ara h 2 distinguish peanut allergy from asymptomatic peanut sensitization. / Hong, Xiumei; Caruso, D.; Kumar, R.; Liu, R.; Liu, X.; Wang, Guoying; Pongracic, J. A.; Wang, Xiaobin.

In: Allergy: European Journal of Allergy and Clinical Immunology, Vol. 67, No. 12, 12.2012, p. 1538-1546.

Research output: Contribution to journalArticle

@article{9d98d13947a14b81ae500352f3e78a4f,
title = "IgE, but not IgG4, antibodies to Ara h 2 distinguish peanut allergy from asymptomatic peanut sensitization",
abstract = "Background There are no available clinical tests that can accurately predict peanut allergy (PA) and/or anaphylaxis. This study is aimed at evaluating whether the component-resolved diagnostic (CRD) IgE and IgG4 tests can (i) distinguish PA from asymptomatic peanut sensitization (PS) and (ii) differentiate anaphylactic from nonanaphylactic PA. Methods This study included 20 nonatopic controls, 58 asymptomatically peanut-sensitized children, 55 nonanaphylactic, and 53 anaphylactic PA cases from the Chicago Food Allergy Study. IgE and IgG4 to 103 allergens were measured using the ImmunoCAP ISAC technology and were compared among each group of children. The random forest test was applied to estimate each allergen's ability to predict PA and/or peanut anaphylaxis. Results Peanut allergy cases (with or without anaphylaxis) had significantly higher IgE reactivity to Ara h 1-3 (peanut allergens) and Gly m 5-6 (soy allergens) than asymptomatically sensitized children (P <0.00001). Similar but more modest relationships were found for IgG4 to Ara h 2 (P <0.01). IgE to Ara h 2 was the major contributor to accurate discrimination between PA and asymptomatic sensitization. With an optimal cutoff point of 0.65 ISU-E, it conferred 99.1{\%} sensitivity, 98.3{\%} specificity, and a 1.2{\%} misclassification rate in the prediction of PA, which represented a higher discriminative accuracy than IgE to whole peanut extract (P = 0.008). However, none of the IgE and/or IgG4 tests could significantly differentiate peanut anaphylaxis from nonanaphylactic PA. Conclusions IgE to Ara h 2 can efficiently differentiate clinical PA from asymptomatic PS, which may represent a major step forward in the diagnosis of PA.",
keywords = "Ara h 2, component-resolved diagnostics, diagnostic performance, peanut allergy, peanut anaphylaxis",
author = "Xiumei Hong and D. Caruso and R. Kumar and R. Liu and X. Liu and Guoying Wang and Pongracic, {J. A.} and Xiaobin Wang",
year = "2012",
month = "12",
doi = "10.1111/all.12047",
language = "English (US)",
volume = "67",
pages = "1538--1546",
journal = "Allergy: European Journal of Allergy and Clinical Immunology",
issn = "0105-4538",
publisher = "Wiley-Blackwell",
number = "12",

}

TY - JOUR

T1 - IgE, but not IgG4, antibodies to Ara h 2 distinguish peanut allergy from asymptomatic peanut sensitization

AU - Hong, Xiumei

AU - Caruso, D.

AU - Kumar, R.

AU - Liu, R.

AU - Liu, X.

AU - Wang, Guoying

AU - Pongracic, J. A.

AU - Wang, Xiaobin

PY - 2012/12

Y1 - 2012/12

N2 - Background There are no available clinical tests that can accurately predict peanut allergy (PA) and/or anaphylaxis. This study is aimed at evaluating whether the component-resolved diagnostic (CRD) IgE and IgG4 tests can (i) distinguish PA from asymptomatic peanut sensitization (PS) and (ii) differentiate anaphylactic from nonanaphylactic PA. Methods This study included 20 nonatopic controls, 58 asymptomatically peanut-sensitized children, 55 nonanaphylactic, and 53 anaphylactic PA cases from the Chicago Food Allergy Study. IgE and IgG4 to 103 allergens were measured using the ImmunoCAP ISAC technology and were compared among each group of children. The random forest test was applied to estimate each allergen's ability to predict PA and/or peanut anaphylaxis. Results Peanut allergy cases (with or without anaphylaxis) had significantly higher IgE reactivity to Ara h 1-3 (peanut allergens) and Gly m 5-6 (soy allergens) than asymptomatically sensitized children (P <0.00001). Similar but more modest relationships were found for IgG4 to Ara h 2 (P <0.01). IgE to Ara h 2 was the major contributor to accurate discrimination between PA and asymptomatic sensitization. With an optimal cutoff point of 0.65 ISU-E, it conferred 99.1% sensitivity, 98.3% specificity, and a 1.2% misclassification rate in the prediction of PA, which represented a higher discriminative accuracy than IgE to whole peanut extract (P = 0.008). However, none of the IgE and/or IgG4 tests could significantly differentiate peanut anaphylaxis from nonanaphylactic PA. Conclusions IgE to Ara h 2 can efficiently differentiate clinical PA from asymptomatic PS, which may represent a major step forward in the diagnosis of PA.

AB - Background There are no available clinical tests that can accurately predict peanut allergy (PA) and/or anaphylaxis. This study is aimed at evaluating whether the component-resolved diagnostic (CRD) IgE and IgG4 tests can (i) distinguish PA from asymptomatic peanut sensitization (PS) and (ii) differentiate anaphylactic from nonanaphylactic PA. Methods This study included 20 nonatopic controls, 58 asymptomatically peanut-sensitized children, 55 nonanaphylactic, and 53 anaphylactic PA cases from the Chicago Food Allergy Study. IgE and IgG4 to 103 allergens were measured using the ImmunoCAP ISAC technology and were compared among each group of children. The random forest test was applied to estimate each allergen's ability to predict PA and/or peanut anaphylaxis. Results Peanut allergy cases (with or without anaphylaxis) had significantly higher IgE reactivity to Ara h 1-3 (peanut allergens) and Gly m 5-6 (soy allergens) than asymptomatically sensitized children (P <0.00001). Similar but more modest relationships were found for IgG4 to Ara h 2 (P <0.01). IgE to Ara h 2 was the major contributor to accurate discrimination between PA and asymptomatic sensitization. With an optimal cutoff point of 0.65 ISU-E, it conferred 99.1% sensitivity, 98.3% specificity, and a 1.2% misclassification rate in the prediction of PA, which represented a higher discriminative accuracy than IgE to whole peanut extract (P = 0.008). However, none of the IgE and/or IgG4 tests could significantly differentiate peanut anaphylaxis from nonanaphylactic PA. Conclusions IgE to Ara h 2 can efficiently differentiate clinical PA from asymptomatic PS, which may represent a major step forward in the diagnosis of PA.

KW - Ara h 2

KW - component-resolved diagnostics

KW - diagnostic performance

KW - peanut allergy

KW - peanut anaphylaxis

UR - http://www.scopus.com/inward/record.url?scp=84869499864&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84869499864&partnerID=8YFLogxK

U2 - 10.1111/all.12047

DO - 10.1111/all.12047

M3 - Article

C2 - 23094689

AN - SCOPUS:84869499864

VL - 67

SP - 1538

EP - 1546

JO - Allergy: European Journal of Allergy and Clinical Immunology

JF - Allergy: European Journal of Allergy and Clinical Immunology

SN - 0105-4538

IS - 12

ER -