Ara h 2 and Ara h 6 sensitization predicts peanut allergy in Mediterranean pediatric patients.
BACKGROUND
Peanut allergy (PA) management was improved by the introduction of molecular allergology, but guidelines for Mediterranean patients are lacking. We aimed at evaluating peanut component-resolved diagnosis as a diagnostic and prognostic tool in children from Southern France.


METHODS
In 181 pediatric patients, PA diagnosis was founded on medical history, skin prick testing, serum-specific IgE to Arachis hypogea extract and components, Pru p 4, and plant carbohydrates, and oral food challenge. Allergen microarray was also performed in 68 of these patients.


RESULTS
In peanut-allergic children (n = 117), IgE to Ara h 6 were most prevalent (64%), followed by Ara h 2 (63%), Ara h 1 (60%), and Ara h 9 (52%). Ara h 6 was the best predictor of PA. The second best predictor was the ratio of Ara h 2 IgE to peanut IgE (cutoff 0.113). Persistent childhood PA was associated with complex molecular profiles. Comparison of singleplex and microarray results showed poor concordance for Ara h 2 and Ara h 9.


CONCLUSIONS
Ara h 6 and Ara h 2 are the best predictors of PA at diagnosis in Mediterranean pediatric patients. Ara h 1, Ara h 8, and molecular complexity are associated with PA persistence.
Multidisciplinary Pediatrics Department, APHM Assistance Publique Hôpitaux de Marseille, La Timone Hospital, Marseille, France.
Chantal
C
Agabriel
Ouafeh
O
Ghazouani
Joëlle
J
Birnbaum
Valérie
V
Liabeuf
Françoise
F
Porri
Marion
M
Gouitaa
Isabelle
I
Cleach
Jean-Jacques
JJ
Grob
Pierre
P
Bongrand
Jacques
J
Sarles
Joana
J
Vitte
D055516:2S Albumins, Plant / Q000276:immunology*; D000293:Adolescent; D052179:Antigens, Plant / Q000276:immunology*; D010367:Arachis; D002352:Carrier Proteins / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005602:France; D006023:Glycoproteins / Q000276:immunology*; D006801:Humans; D007114:Immunization; D007073:Immunoglobulin E / Q000097:blood; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D019083:Mediterranean Region; D046228:Microarray Analysis; D021183:Peanut Hypersensitivity / Q000175:diagnosis*; D010940:Plant Proteins / Q000276:immunology; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D011379:Prognosis
D055516:2S Albumins, Plant; D052179:Antigens, Plant; C500890:Ara h 2 allergen, Arachis hypogaea; C492737:Ara h 6 allergen, Arachis hypogaea; D002352:Carrier Proteins; D006023:Glycoproteins; D010940:Plant Proteins; C572509:Pru p 4 allergen, Prunus persica; D007073:Immunoglobulin E
Ara h 2; Ara h 6; Ara h 9; allergen microarray; component-resolved diagnosis; molecular allergology; molecular sensitization profile; nonspecific lipid transfer proteins; peanut allergy; storage proteins