title: IgE recognition patterns in peanut allergy are age dependent: perspectives of the EuroPrevall study.
abstract: BACKGROUND
  We tested the hypothesis that specific molecular sensitization patterns correlate with the clinical data/manifestation in a European peanut-allergic population characterized under a common protocol.
  
  
  METHODS
  Sixty-eight peanut-allergic subjects and 82 tolerant controls from 11 European countries were included. Allergy to peanut and lowest symptom-eliciting dose was established by double-blind placebo-controlled food challenge in all but anaphylactic subjects. Information of early or late (before or after 14 years of age) onset of peanut allergy was obtained from standardized questionnaires. IgE to peanut allergens rAra h 1-3, 6, 8-9, profilin and CCD was determined using ImmunoCAP.
  
  
  RESULTS
  Seventy-eight percent of peanut allergics were sensitized to peanut extract and 90% to at least one peanut component. rAra h 2 was the sole major allergen for the peanut-allergic population. Geographical differences were observed for rAra h 8 and rAra h 9, which were major allergens for central/western and southern Europeans, respectively. Sensitization to rAra h 1 and 2 was exclusively observed in early-onset peanut allergy. Peanut-tolerant subjects were frequently sensitized to rAra h 8 or 9 but not to storage proteins. Sensitization to Ara h 2 ≥ 1.0 kUA /l conferred a 97% probability for a systemic reaction (P = 0.0002). Logistic regression revealed a significant influence of peanut extract sensitization and region on the occurrence of systemic reactions (P = 0.0185 and P = 0.0436, respectively).
  
  
  CONCLUSIONS
  Sensitization to Ara h 1, 2 and 3 is usually acquired in childhood. IgE to Ara h 2 ≥ 1.0 kUA /l is significantly associated with the development of systemic reactions to peanut.
authors.affiliation: Allergy Unit, Department of Dermatology, University Hospital, Zürich, Switzerland.
authors.forename: B K
authors.initials: BK
authors.lastname: Ballmer-Weber
authors.forename: J
authors.initials: J
authors.lastname: Lidholm
authors.forename: M
authors.initials: M
authors.lastname: Fernández-Rivas
authors.forename: S
authors.initials: S
authors.lastname: Seneviratne
authors.forename: K M
authors.initials: KM
authors.lastname: Hanschmann
authors.forename: L
authors.initials: L
authors.lastname: Vogel
authors.forename: P
authors.initials: P
authors.lastname: Bures
authors.forename: P
authors.initials: P
authors.lastname: Fritsche
authors.forename: C
authors.initials: C
authors.lastname: Summers
authors.forename: A C
authors.initials: AC
authors.lastname: Knulst
authors.forename: T M
authors.initials: TM
authors.lastname: Le
authors.forename: I
authors.initials: I
authors.lastname: Reig
authors.forename: N G
authors.initials: NG
authors.lastname: Papadopoulos
authors.forename: A
authors.initials: A
authors.lastname: Sinaniotis
authors.forename: S
authors.initials: S
authors.lastname: Belohlavkova
authors.forename: T
authors.initials: T
authors.lastname: Popov
authors.forename: T
authors.initials: T
authors.lastname: Kralimarkova
authors.forename: F
authors.initials: F
authors.lastname: de Blay
authors.forename: A
authors.initials: A
authors.lastname: Purohit
authors.forename: M
authors.initials: M
authors.lastname: Clausen
authors.forename: M
authors.initials: M
authors.lastname: Jedrzejczak-Czechowcz
authors.forename: M L
authors.initials: ML
authors.lastname: Kowalski
authors.forename: R
authors.initials: R
authors.lastname: Asero
authors.forename: R
authors.initials: R
authors.lastname: Dubakiene
authors.forename: L
authors.initials: L
authors.lastname: Barreales
authors.forename: E N
authors.initials: EN
authors.lastname: Clare Mills
authors.forename: R
authors.initials: R
authors.lastname: van Ree
authors.forename: S
authors.initials: S
authors.lastname: Vieths
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000485:Allergens / Q000276:immunology; D000707:Anaphylaxis / Q000097:blood / Q000276:immunology; D052179:Antigens, Plant / Q000276:immunology; D010367:Arachis / Q000009:adverse effects; D002648:Child; D003430:Cross-Sectional Studies; D005060:Europe; D005260:Female; D006801:Humans; D007108:Immune Tolerance / Q000276:immunology; D007114:Immunization; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology*; D008297:Male; D016017:Odds Ratio; D021183:Peanut Hypersensitivity / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology*; D010936:Plant Extracts / Q000008:administration & dosage / Q000276:immunology; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000485:Allergens; D052179:Antigens, Plant; D010936:Plant Extracts; D007073:Immunoglobulin E
keywords: component-resolved diagnosis; food allergy; food challenge; peanut; threshold dose