Predictive value of skin prick tests using recombinant allergens for diagnosis of peanut allergy.
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.


CONCLUSIONS
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.


CONCLUSIONS
Recombinant peanut allergens can be used by SPTs for diagnosis and evaluation of allergy severity.
Astier
Catherine
C
EA3999 Allergic Diseases: Diagnosis and Therapeutics Department of Internal Medicine, Clinical Immunology and Allergology, University Hospital, Central Hospital, 15 rue du Bois de la Champelle, 54500 Vandoeuvre-les-Nancy, France.
Morisset
Martine
M
Roitel
Olivier
O
Codreanu
Fanny
F
Jacquenet
Sandrine
S
Franck
Patricia
P
Ogier
Virginie
V
Petit
Nicolas
N
Proust
Barbara
B
Moneret-Vautrin
Denise-Anne
DA
Burks
A Wesley
AW
Bihain
Bernard
B
Sampson
Hugh A
HA
Kanny
Gisèle
G
D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000276:immunology*; D010367:Arachis / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D003429:Cross Reactions; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D021183:Peanut Hypersensitivity / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011994:Recombinant Proteins / Q000276:immunology; D012882:Skin Tests
D000485:Allergens; D011994:Recombinant Proteins; D007073:Immunoglobulin E