title: Predictive values of component-specific IgE for the outcome of peanut and hazelnut food challenges in children.
abstract: BACKGROUND
  Oral challenges are the gold standard in food allergy diagnostic, but time-consuming. Aim of the study was to investigate the role of peanut- and hazelnut-component-specific IgE in the diagnostics of peanut and hazelnut allergy and to identify cutoff levels to make some challenges superfluous.
  
  
  METHODS
  In a prospective and multicenter study, children with suspected peanut or hazelnut allergy underwent oral challenges. Specific IgE to peanut, hazelnut, and their components (Ara h 1, Ara h 2, Ara h 3, and Ara h 8, Cor a 1, Cor a 8, Cor a 9, and Cor a 14) were determined by ImmunoCAP-FEIA.
  
  
  RESULTS
  A total of 210 children were challenged orally with peanut and 143 with hazelnut. 43% of the patients had a positive peanut and 31% a positive hazelnut challenge. With an area under the curve of 0.92 and 0.89, respectively, Ara h 2 and Cor a 14-specific IgE discriminated between allergic and tolerant children better than peanut- or hazelnut-specific IgE. For the first time, probability curves for peanut and hazelnut components have been calculated. A 90% probability for a positive peanut or hazelnut challenge was estimated for Ara h 2-specific IgE at 14.4 kU/l and for Cor a 14-specific IgE at 47.8 kU/l. A 95% probability could only be estimated for Ara h 2 at 42.2 kU/l.
  
  
  CONCLUSIONS
  Ara h 2- and Cor a 14-specific IgE are useful to estimate the probability for a positive challenge outcome in the diagnostic work-up of peanut or hazelnut allergy making some food challenges superfluous.
authors.affiliation: Department of Pediatric Pneumology and Immunology, Charité Universitätsmedizin Berlin, Berlin, Germany; Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: K
authors.initials: K
authors.lastname: Beyer
authors.forename: L
authors.initials: L
authors.lastname: Grabenhenrich
authors.forename: M
authors.initials: M
authors.lastname: Härtl
authors.forename: A
authors.initials: A
authors.lastname: Beder
authors.forename: B
authors.initials: B
authors.lastname: Kalb
authors.forename: M
authors.initials: M
authors.lastname: Ziegert
authors.forename: A
authors.initials: A
authors.lastname: Finger
authors.forename: N
authors.initials: N
authors.lastname: Harandi
authors.forename: R
authors.initials: R
authors.lastname: Schlags
authors.forename: M
authors.initials: M
authors.lastname: Gappa
authors.forename: L
authors.initials: L
authors.lastname: Puzzo
authors.forename: H
authors.initials: H
authors.lastname: Röblitz
authors.forename: M
authors.initials: M
authors.lastname: Millner-Uhlemann
authors.forename: S
authors.initials: S
authors.lastname: Büsing
authors.forename: H
authors.initials: H
authors.lastname: Ott
authors.forename: L
authors.initials: L
authors.lastname: Lange
authors.forename: B
authors.initials: B
authors.lastname: Niggemann
mesh_terms: D000485:Allergens; D000918:Antibody Specificity; D052179:Antigens, Plant; D010367:Arachis / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D031211:Corylus / Q000009:adverse effects*; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis* / Q000276:immunology*; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology*; D008297:Male; D021183:Peanut Hypersensitivity / Q000175:diagnosis / Q000276:immunology; D011446:Prospective Studies; D012372:ROC Curve
chemical_list: D000485:Allergens; D052179:Antigens, Plant; D007073:Immunoglobulin E
keywords: Ara h 2; Cor a 14; allergen components; hazelnut allergy; peanut