title: The relevance of basophil allergen sensitivity testing to distinguish between severe and mild peanut-allergic children.
abstract: BACKGROUND
  Peanut sensitization is common in children. However, it is difficult to assess which children will react mildly and which severely. This study evaluated the relevance of basophil allergen sensitivity testing to distinguish the severity of peanut allergy in children.
  
  
  METHODS
  Twenty-seven peanut-sensitized children with symptoms varying from mild symptoms to severe anaphylaxis underwent peanut CD63 dose-response curve analysis with the inclusion of basophil allergen sensitivity calculation (CD-sens) and peanut component immunoglobulin E (IgE) testing.
  
  
  RESULTS
  Eleven children who had experienced anaphylaxis to peanuts showed a markedly higher peanut CD63 response at submaximal allergen concentrations and CD-sens (median 1,667 vs. 0.5; p < 0.0001) than 16 children who experienced a milder reaction. Furthermore, a negative or low CD-sens to peanuts unambiguously excluded anaphylactic peanut allergy. Children with anaphylaxis have higher levels of Ara h 1, 2, 3 and 9 IgE, but comparable levels of IgE to Ara h 8 and whole-peanut extract. The diagnostic specificity calculated with a receiver operating characteristic analysis reached 100% for CD-sens and 73% for Ara h 2.
  
  
  CONCLUSIONS
  We demonstrated that severe peanut allergy is significantly associated with higher basophil allergen sensitivity. This cellular test should facilitate a more accurate diagnosis of peanut allergy.
authors.affiliation: Department of Pediatrics, University Medical Center, Maribor, Slovenia.
authors.forename: Matjaž
authors.initials: M
authors.lastname: Homšak
authors.forename: Mira
authors.initials: M
authors.lastname: Silar
authors.forename: Vojko
authors.initials: V
authors.lastname: Berce
authors.forename: Maja
authors.initials: M
authors.lastname: Tomazin
authors.forename: Maja
authors.initials: M
authors.lastname: Skerbinjek-Kavalar
authors.forename: Nina
authors.initials: N
authors.lastname: Celesnik
authors.forename: Mitja
authors.initials: M
authors.lastname: Košnik
authors.forename: Peter
authors.initials: P
authors.lastname: Korošec
mesh_terms: D000293:Adolescent; D000485:Allergens / Q000235:genetics / Q000276:immunology*; D010367:Arachis / Q000276:immunology*; D001491:Basophils / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D021183:Peanut Hypersensitivity / Q000175:diagnosis* / Q000276:immunology* / Q000503:physiopathology; D011994:Recombinant Proteins / Q000235:genetics / Q000378:metabolism
chemical_list: D000485:Allergens; D011994:Recombinant Proteins; D007073:Immunoglobulin E