Sensitization to Cor a 9 and Cor a 14 is highly specific for a hazelnut allergy with objective symptoms in Dutch children and adults
Sensitization to Cor a 9 and Cor a 14 is highly specific for a hazelnut allergy with objective symptoms in Dutch children and adults
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DOI：
10.1016/j.jaci.2013.02.024
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发表时间：
2013-08-01
影响因子：
14.2
通讯作者：
Pasmans, Suzanne G. M. A.
中科院分区：
文献类型：
--
作者：
Masthoff, Laury J. N.;Mattsson, Lars;Pasmans, Suzanne G. M. A.
背景：成分分辨诊断有助于提高食物过敏的诊断水平。目的：我们试图评价成分分辨诊断是否有助于识别对榛子有客观过敏反应风险的患者。方法：161例榛子过敏患者包括：40名儿童和15名成人在双盲、安慰剂控制的食物挑战(DBPCFC)上有客观症状，24名有令人信服的客观病史的成年人与41名儿童和41名成人(组在DBPCFCs上没有或主观症状)进行比较。结果：有客观症状的儿童对榛子提取物的免疫球蛋白E水平明显高于无症状或主观症状儿童。在有客观症状的13%的儿童和49%的成人中，只观察到对rCor a 1.04的致敏，而对其他水溶性过敏原没有致敏。对rCor a 8的致敏作用很少见，这与rCor a 1相反。对NCoR a 9和/或rCor a 14的致敏作用与有客观症状的榛子过敏密切相关。通过使用适应的截止水平，获得了严重程度组之间的诊断区分。IgE水平NCoRa9≥1 Kua/L或rCoRa14/5 Kua/L>(儿童)，IgE水平NCoRa9≥1 Kua/L或rCoRa14≥1 Kua/L(成人)的特异性>90%，占有客观症状的儿童和成人的83%和44%。结论：对于有客观症状的患者，对Cor A9和Cor A14的致敏具有很高的特异性，可作为较严重的榛子过敏表型的标志。
Background: Component-resolved diagnosis has been shown to improve the diagnosis of food allergy.Objective: We sought to evaluate whether component-resolved diagnosis might help to identify patients at risk of objective allergic reactions to hazelnut.Method: A total of 161 hazelnut-sensitized patients were included: 40 children and 15 adults with objective symptoms on double-blind, placebo-controlled food challenges (DBPCFCs) and 24 adults with a convincing objective history were compared with 41 children and 41 adults with no or subjective symptoms on DBPCFCs (grouped together). IgE levels to hazelnut extract and single components were analyzed with ImmunoCAP.Results: IgE levels to hazelnut extract were significantly higher in children with objective than with no or subjective symptoms. In 13% of children and 49% of adults with hazelnut allergy with objective symptoms, only sensitization to rCor a 1.04 was observed and not to other water-soluble allergens. Sensitization to rCor a 8 was rare, which is in contrast to rCor a 1. Sensitization to nCor a 9, rCor a 14, or both was strongly associated with hazelnut allergy with objective symptoms. By using adapted cutoff levels, a diagnostic discrimination between severity groups was obtained. IgE levels to either nCor a 9 of 1 kUA/L or greater or rCor a 14 of 5 kUA/L or greater (children) and IgE levels to either nCor a 9 of 1 kUA/L or greater or rCor a 14 of 1 kUA/L or greater (adults) had a specificity of greater than 90% and accounted for 83% of children and 44% of adults with hazelnut allergy with objective symptoms.Conclusion: Sensitization to Cor a 9 and Cor a 14 is highly specific for patients with objective symptoms in DBPCFCs as a marker for a more severe hazelnut allergic phenotype.