|SANTOS, ALEXANDRA - King College|
|NUNO, BARBOSA-MORIAS - Universidade Lurio|
|SNEHA, RAMASWAMY - King College|
|KWOK, MATTHEW - King College|
|BAHNSON, HENRY - King College|
|JAMES, LOUIS - King College|
|LACK, GIDEON - King College|
|GOULD, HANNAH - King College|
|SUTTON, BRIAN - King College|
Submitted to: Allergy
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 2/20/2020
Publication Date: 4/6/2020
Citation: Santos, A., Nuno, B., Hurlburt, B.K., Sneha, R., Kwok, M., Bahnson, H., Cheng, H., James, L., Maleki, S.J., Lack, G., Gould, H., Sutton, B. 2020. IgE to epitopes of Ara h 2 enhance the diagnostic accuracy of Ara h 2-specific IgE. Allergy. https://doi.org/10.1111/all.14301
Interpretive Summary: Peanut allergy is a serious medical condition world wide. Current methods of diagnosing peanut allergy include: skin-prick test, immunocap assay, ISAC assay and oral food challenge. Only oral food challenge is 100 % accurate but it is dangerous to do for the patient. The work described in this paper shows that IgE antibodies directed against certain peptides of peanut allergen Ara h 2 enhance the diagnosis of allergy and may be used to avoid food challenge tests.
Technical Abstract: Only one out of five UK children with peanut-specific IgE have peanut allergy. Understanding the discrepancy between IgE sensitization and allergic reactions to peanut could improve diagnosis and lead to novel means of treating peanut allergy. On a peptide microarray covering the whole sequence of peanut allergens Ara h 1-11, seven peptides on Ara h 1, Ara h 2 and Ara h 3 emerged as being bound more by IgE of peanut allergic (PA) compared to peanut-sensitized tolerant (PS) patients. Using ImmunoCAP, we validated these findings and precisely quantified IgE and IgG4 levels. In a multivariate model, IgE to the Ara h 2 peptides enhanced the diagnostic accuracy of Ara h 2-specific IgE, which is currently the best serologic biomarker for peanut allergy. Ratios of IgG4/IgE to 5 out of the 7 peptides were higher in PS than in PA subjects, indicating that the ability of peptide-specific IgG4 to surmount their IgE counterpart seems to be important in established peanut tolerance.