Are peanut oral food challenges still useful? An evaluation of children with suspected peanut allergy, sensitization to Ara h 2 and controlled asthma
Abstract Background Sensitization to Ara h 2 has been proposed as a promising biological marker for the severity of peanut allergy and may reduce the need for oral food challenges. This study aimed to evaluate whether peanut oral food challenge is still a useful diagnostic tool for children with sus...
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | Allergy, Asthma & Clinical Immunology |
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| Online Access: | https://doi.org/10.1186/s13223-022-00743-6 |
| _version_ | 1811190450003902464 |
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| author | Iida Ojaniemi Susanna Salmivesi Antti Tikkakoski Jussi Karjalainen Lauri Lehtimäki Rüdiger Schultz |
| author_facet | Iida Ojaniemi Susanna Salmivesi Antti Tikkakoski Jussi Karjalainen Lauri Lehtimäki Rüdiger Schultz |
| author_sort | Iida Ojaniemi |
| collection | DOAJ |
| description | Abstract Background Sensitization to Ara h 2 has been proposed as a promising biological marker for the severity of peanut allergy and may reduce the need for oral food challenges. This study aimed to evaluate whether peanut oral food challenge is still a useful diagnostic tool for children with suspected peanut allergy and an elevated level of Ara h 2-specific IgE. Additionally, we assessed whether well-controlled asthma is an additional risk for severe reactions. Methods A retrospective analysis of 107 children with sensitization to Ara h 2-specific IgE (> 0.35 kU/l) undergoing open peanut challenges during 2012–2018 in the Tampere University Hospital Allergy Centre, Finland. Results Of the 107 challenges, 82 (77%) were positive. Serum levels of Ara h 2 -sIgE were higher in subjects with a positive challenge than in those who remained negative (median 32.9 (IQR 6.7–99.8) vs. 2.1 (IQR 1.0–4.9) kU/l), p < 0.001) but were not significantly different between subjects with and without anaphylaxis. No correlation was observed between the serum level of Ara h 2-sIgE and reaction severity grading. Well-controlled asthma did not affect the challenge outcome. Conclusions Elevated levels of Ara h 2-specific IgE are associated with a positive outcome in peanut challenges but not a reliable predictor of reaction severity. Additionally, well-controlled asthma is not a risk factor for severe reactions in peanut challenges in children with sensitization to Ara h 2. |
| first_indexed | 2024-04-11T14:50:18Z |
| format | Article |
| id | doaj.art-16ee32e32e0a4c0e8f647834a327df7d |
| institution | Directory Open Access Journal |
| issn | 1710-1492 |
| language | English |
| last_indexed | 2024-04-11T14:50:18Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Allergy, Asthma & Clinical Immunology |
| spelling | doaj.art-16ee32e32e0a4c0e8f647834a327df7d2022-12-22T04:17:28ZengBMCAllergy, Asthma & Clinical Immunology1710-14922022-11-011811810.1186/s13223-022-00743-6Are peanut oral food challenges still useful? An evaluation of children with suspected peanut allergy, sensitization to Ara h 2 and controlled asthmaIida Ojaniemi0Susanna Salmivesi1Antti Tikkakoski2Jussi Karjalainen3Lauri Lehtimäki4Rüdiger Schultz5Allergy Centre, Tampere University HospitalAllergy Centre, Tampere University HospitalDepartment of Clinical Physiology and Nuclear Medicine, Tampere University HospitalAllergy Centre, Tampere University HospitalAllergy Centre, Tampere University HospitalAllergy Centre, Tampere University HospitalAbstract Background Sensitization to Ara h 2 has been proposed as a promising biological marker for the severity of peanut allergy and may reduce the need for oral food challenges. This study aimed to evaluate whether peanut oral food challenge is still a useful diagnostic tool for children with suspected peanut allergy and an elevated level of Ara h 2-specific IgE. Additionally, we assessed whether well-controlled asthma is an additional risk for severe reactions. Methods A retrospective analysis of 107 children with sensitization to Ara h 2-specific IgE (> 0.35 kU/l) undergoing open peanut challenges during 2012–2018 in the Tampere University Hospital Allergy Centre, Finland. Results Of the 107 challenges, 82 (77%) were positive. Serum levels of Ara h 2 -sIgE were higher in subjects with a positive challenge than in those who remained negative (median 32.9 (IQR 6.7–99.8) vs. 2.1 (IQR 1.0–4.9) kU/l), p < 0.001) but were not significantly different between subjects with and without anaphylaxis. No correlation was observed between the serum level of Ara h 2-sIgE and reaction severity grading. Well-controlled asthma did not affect the challenge outcome. Conclusions Elevated levels of Ara h 2-specific IgE are associated with a positive outcome in peanut challenges but not a reliable predictor of reaction severity. Additionally, well-controlled asthma is not a risk factor for severe reactions in peanut challenges in children with sensitization to Ara h 2.https://doi.org/10.1186/s13223-022-00743-6Ara h 2Peanut allergyOral food challengeAsthmaAnaphylaxis |
| spellingShingle | Iida Ojaniemi Susanna Salmivesi Antti Tikkakoski Jussi Karjalainen Lauri Lehtimäki Rüdiger Schultz Are peanut oral food challenges still useful? An evaluation of children with suspected peanut allergy, sensitization to Ara h 2 and controlled asthma Allergy, Asthma & Clinical Immunology Ara h 2 Peanut allergy Oral food challenge Asthma Anaphylaxis |
| title | Are peanut oral food challenges still useful? An evaluation of children with suspected peanut allergy, sensitization to Ara h 2 and controlled asthma |
| title_full | Are peanut oral food challenges still useful? An evaluation of children with suspected peanut allergy, sensitization to Ara h 2 and controlled asthma |
| title_fullStr | Are peanut oral food challenges still useful? An evaluation of children with suspected peanut allergy, sensitization to Ara h 2 and controlled asthma |
| title_full_unstemmed | Are peanut oral food challenges still useful? An evaluation of children with suspected peanut allergy, sensitization to Ara h 2 and controlled asthma |
| title_short | Are peanut oral food challenges still useful? An evaluation of children with suspected peanut allergy, sensitization to Ara h 2 and controlled asthma |
| title_sort | are peanut oral food challenges still useful an evaluation of children with suspected peanut allergy sensitization to ara h 2 and controlled asthma |
| topic | Ara h 2 Peanut allergy Oral food challenge Asthma Anaphylaxis |
| url | https://doi.org/10.1186/s13223-022-00743-6 |
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