Predictive values of component-specific IgE for the outcome of peanut and hazelnut food challenges in children
Predictive values of component-specific IgE for the outcome of peanut and hazelnut food challenges in children
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DOI：
10.1111/all.12530
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发表时间：
2015-01-01
期刊：
影响因子：
12.4
通讯作者：
Niggemann, B.
中科院分区：
文献类型：
--
作者：
Beyer, K.;Grabenhenrich, L.;Niggemann, B.
背景：口腔挑战是食物过敏诊断的金标准，但耗时。本研究的目的是研究花生和榛子成分特异性IgE在花生和榛子过敏诊断中的作用，并确定临界值以使某些挑战不必要。方法：在一项前瞻性和多中心研究中，怀疑花生或榛子过敏的儿童进行了口腔挑战。采用免疫cap - feia法测定花生、榛子及其组分（Ara h 1、Ara h 2、Ara h 3、Ara h 8、Cor a 1、Cor a 8、Cor a 9、Cor a 14）的特异性IgE。结果：共210名儿童口服花生，143名儿童口服榛子。43%的患者有花生阳性，31%的患者有榛子阳性。曲线下面积分别为0.92和0.89，Ara h 2和Cor a 14特异性IgE比花生或榛子特异性IgE更好地区分过敏和耐受儿童。首次计算了花生和榛子成分的概率曲线。据估计，花生或榛子对Ara 2特异性IgE的阳性概率为14.4 kU/l，对Cor 14特异性IgE的阳性概率为47.8 kU/l。95%的概率只能估计为42.2 kU/l的Ara h2。结论：在花生或榛子过敏的诊断检查中，Ara h 2和Cor a 14特异性IgE可用于估计阳性应答结果的概率，使某些食物应答成为多余的。
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.