Sensitization profiles to peanut allergens in Belgium; cracking the code in infants, children and adults

Abstract

Objectives: Peanut allergy shows distinct clinical patterns that can be predicted by component resolved diagnosis. However, data about peanut sensitization profiles in populations with a broad age stratification are scarce.

Methods: Sera of 89 peanut allergic patients (age 1–70 years), 21 infants (<1 year) with atopic dermatitis (AD) sensitized to peanut, 24 age matched peanut-tolerant individuals with positive specific IgE (sIgE) to peanut and 15 healthy individuals were tested for sIgE reactivity to rAra h 1, rAra h 2, rAra h 3, rAra h 8, rAra h 9 and rBet v 1 (FEIA ImmunoCAP, Thermo Fisher Scientific).

Results: In infants with AD, Ara h 1, Ara h 2 and Ara h 3 enabled to explain 14/21 (67%) of peanut sensitizations. No sensitization to Ara h 8 or Bet v 1 was observed. Patients with generalized reactions were more frequently sensitized to Ara h 1, Ara h 2 and Ara h 3 compared to patients with an oral allergy syndrome (OAS) and peanut-tolerant patients. Sensitization to Ara h 8 was significantly more observed in patients with an OAS. Ara h 2 showed to be the best marker to distinguish patients with generalized reactions from patients with an OAS and/or peanut sensitized patients but tolerating the legume.

Conclusion: Sensitization to Ara h 1, Ara h 2 and Ara h 3 can have an early onset and is predominantly associated with a more severe outcome. Ara h 2 is the best marker of a generalized peanut allergy.

Keywords:

• Ara h 2
• Component resolved diagnosis
• Food allergy
• Peanut allergy

Acknowledgement

The authors thank Mrs Christel Mertens for her technical skills and Karin Van Cotthem for her contribution to the sIgE determination. Vito Sabato is a Clinical Researcher of the Research Foundation Flanders (FWO: 1700614N). Didier Ebo is a Senior Clinical Researcher of the Research Foundation Flanders (FWO: 1800614N).