title: Predictive value of skin prick tests using recombinant allergens for diagnosis of peanut allergy.
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.
  
  
  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.
authors.affiliation: 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.
authors.forename: Catherine
authors.initials: C
authors.lastname: Astier
authors.forename: Martine
authors.initials: M
authors.lastname: Morisset
authors.forename: Olivier
authors.initials: O
authors.lastname: Roitel
authors.forename: Fanny
authors.initials: F
authors.lastname: Codreanu
authors.forename: Sandrine
authors.initials: S
authors.lastname: Jacquenet
authors.forename: Patricia
authors.initials: P
authors.lastname: Franck
authors.forename: Virginie
authors.initials: V
authors.lastname: Ogier
authors.forename: Nicolas
authors.initials: N
authors.lastname: Petit
authors.forename: Barbara
authors.initials: B
authors.lastname: Proust
authors.forename: Denise-Anne
authors.initials: DA
authors.lastname: Moneret-Vautrin
authors.forename: A Wesley
authors.initials: AW
authors.lastname: Burks
authors.forename: Bernard
authors.initials: B
authors.lastname: Bihain
authors.forename: Hugh A
authors.initials: HA
authors.lastname: Sampson
authors.forename: Gisèle
authors.initials: G
authors.lastname: Kanny
mesh_terms: 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
chemical_list: D000485:Allergens; D011994:Recombinant Proteins; D007073:Immunoglobulin E