Ara h 2 and Ara h 6 sensitization predicts peanut allergy in Mediterranean pediatric patients

Area of Science:

• Immunology
• Allergology
• Pediatrics

Background:

• Molecular allergology has advanced peanut allergy (PA) management.
• Guidelines for Mediterranean pediatric patients are needed.
• This study evaluates peanut component-resolved diagnosis in Southern France.

Purpose of the Study:

• To assess peanut component-resolved diagnosis as a diagnostic and prognostic tool in pediatric patients.
• To identify key peanut allergens for diagnosis and persistence prediction.
• To establish diagnostic criteria for Mediterranean children.

Main Methods:

• 181 pediatric patients underwent medical history, skin prick testing, serum-specific IgE testing (extract and components), and oral food challenges.
• Allergen microarray was performed on 68 patients.
• Specific IgE to Arachis hypogea components like Ara h 1, 2, 6, 8, 9, and Pru p 4 were analyzed.

Main Results:

• In 117 peanut-allergic children, IgE to Ara h 6 (64%), Ara h 2 (63%), Ara h 1 (60%), and Ara h 9 (52%) were most prevalent.
• Ara h 6 was the strongest predictor of PA, followed by the Ara h 2/peanut IgE ratio.
• Complex molecular profiles and IgE to Ara h 1, 8 were associated with persistent childhood PA.

Conclusions:

• Ara h 6 and Ara h 2 are the primary predictors for diagnosing PA in Mediterranean pediatric patients.
• Ara h 1, Ara h 8, and molecular complexity correlate with PA persistence.
• Component-resolved diagnosis aids in understanding PA in this population.