Children with peanut allergy recognize predominantly Ara h2 and Ara h6, which remains stable over time.
BACKGROUND
In peanut-allergic adults, IgE is mainly directed to Ara h1 and Ara h2. More recently, a role for Ara h6 has been suggested. In contrast to adults, IgE in children can fluctuate over time. Therefore, children may have a more dynamic reactivity to peanut.


OBJECTIVE
To examine the IgE reactivity to major peanut allergens in peanut-allergic children at two subsequent time-points.


METHODS
Twenty children (3-15 years old) with peanut allergy, confirmed by a double-blind placebo-controlled food challenge (DBPCFC), were included. Just before and 20 months after DBPCFC, IgE reactivity to purified Ara h1, Ara h2, Ara h3 and Ara h6 was studied by immunoblots and skin prick tests (SPTs).


RESULTS
Before DBPCFC, all peanut-allergic children showed IgE reactivity to Ara h2; Ara h6 was recognized by 16 children, and Ara h1 and Ara h3 by 10 children. After 20 months, peanut-specific IgE levels (median 23 kU/L) and the individual recognition of major allergens were comparable with the levels and recognition before challenge (median 28.2 kU/L). SPT with Ara h2 and Ara h6 was positive in most children, whereas SPT with Ara h1 and Ara h3 was positive in approximately half of the children. Ara h6 induced the largest weals. None of the parameters were related to the severity of peanut allergy.


CONCLUSIONS
Ara h2 and Ara h6 are the most frequently recognized major peanut allergens in children. The individual reactivity to the major peanut allergens remained stable over time, despite DBPCFC.
Flinterman
A E
AE
Department of Dermatology/Allergology, University Medical Centre Utrecht, The Netherlands.
van Hoffen
E
E
den Hartog Jager
C F
CF
Koppelman
S
S
Pasmans
S G
SG
Hoekstra
M O
MO
Bruijnzeel-Koomen
C A
CA
Knulst
A C
AC
Knol
E F
EF
D055516:2S Albumins, Plant; D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000276:immunology*; D000918:Antibody Specificity / Q000276:immunology; D052179:Antigens, Plant; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006023:Glycoproteins / Q000276:immunology*; D006801:Humans; D015151:Immunoblotting; D007073:Immunoglobulin E / Q000276:immunology*; D008297:Male; D008565:Membrane Proteins; D021183:Peanut Hypersensitivity / Q000276:immunology*; D010940:Plant Proteins / Q000276:immunology*; D055314:Seed Storage Proteins; D012882:Skin Tests; D013997:Time Factors
D055516:2S Albumins, Plant; D000485:Allergens; D052179:Antigens, Plant; C500889:Ara h 1 protein, Arachis hypogaea; C500890:Ara h 2 allergen, Arachis hypogaea; C492737:Ara h 6 allergen, Arachis hypogaea; D006023:Glycoproteins; D008565:Membrane Proteins; D010940:Plant Proteins; D055314:Seed Storage Proteins; C118207:allergen Ara h3; D007073:Immunoglobulin E