title: Basophil allergen threshold sensitivity, CD-sens, IgE-sensitization and DBPCFC in peanut-sensitized children.
abstract: BACKGROUND
  Immunoglobulin E (IgE)-sensitization to peanut is common and can indicate an allergy. A positive test needs to be confirmed by a double-blind, placebo-controlled food challenge (DBPCFC), which is regarded as 'the gold standard'. The aim of the study was to evaluate the basophil allergen threshold sensitivity (CD-sens) and antibodies to peanut allergen components in relation to DBPCFC in the diagnoses of peanut allergy in children.
  
  
  METHODS
  Thirty-eight children with suspected peanut allergy underwent a DBPCFC. CD-sens to peanut and Ara h 2 were analysed as well as IgE-antibody to peanut and some of its allergen components (Ara h 1, 2, 3, 8 and 9).
  
  
  RESULTS
  Twenty-five children had a positive DBPCFC, and 92% of these were positive in CD-sens to peanut and Ara h 2. Two children with a positive DBPCFC were classified as 'low-responders' and were not further evaluated. Children positive in DBPCFC had higher CD-sens values to peanut (median 1.3; range 0.4-29, n = 21) compared with children negative in DBPCFC (median 0; range 0-0.5, n = 13) (P < 0.0001). A positive DBPCFC correspond with increased levels of IgE-antibody to Ara h 1, 2 and 3 compared with those with a negative challenge (P < 0.0001 for all). All children with a negative CD-sens were negative in DBPCFC.
  
  
  CONCLUSIONS
  In this study, a negative CD-sens to peanut excluded peanut allergy. Both tests, CD-sens to peanut and immunoassay for IgE-antibody to the peanut components, appear to be safe, time saving and cost-effective complements to DBPCFC.
authors: Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Sweden.
authors: S
authors: S
authors: Glaumann
authors: A
authors: A
authors: Nopp
authors: S G O
authors: SG
authors: Johansson
authors: M
authors: M
authors: Rudengren
authors: M P
authors: MP
authors: Borres
authors: C
authors: C
authors: Nilsson
mesh_terms: D055516:2S Albumins, Plant / Q000276:immunology; D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000276:immunology*; D052179:Antigens, Plant / Q000276:immunology; D010367:Arachis / Q000737:chemistry / Q000276:immunology; D001491:Basophils / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006023:Glycoproteins / Q000276:immunology; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology*; D008297:Male; D021183:Peanut Hypersensitivity / Q000175:diagnosis* / Q000276:immunology*; D055815:Young Adult
chemical_list: D055516:2S Albumins, Plant; D000485:Allergens; D052179:Antigens, Plant; C500890:Ara h 2 allergen, Arachis hypogaea; D006023:Glycoproteins; D007073:Immunoglobulin E