Sensitization profiles to peanut allergens in Belgium; cracking the code in infants, children and adults

Area of Science:

• Allergy and Immunology
• Clinical Diagnostics
• Molecular Allergology

Background:

• Peanut allergy exhibits diverse clinical presentations.
• Component-resolved diagnosis aids in predicting peanut allergy phenotypes.
• Limited data exists on peanut sensitization profiles across broad age groups.

Purpose of the Study:

• To investigate peanut sensitization profiles in a diverse age cohort.
• To correlate specific peanut allergen sensitization with clinical outcomes.
• To identify reliable biomarkers for predicting peanut allergy severity.

Main Methods:

• Serum specific IgE (sIgE) reactivity to peanut allergens (rAra h 1, 2, 3, 8, 9) and birch pollen allergen (rBet v 1) was measured.
• Tested populations included peanut-allergic patients, sensitized infants with atopic dermatitis, peanut-tolerant individuals, and healthy controls.
• ImmunoCAP FEIA assay was utilized for sIgE testing.

Main Results:

• In infants with atopic dermatitis, Ara h 1, Ara h 2, and Ara h 3 explained 67% of peanut sensitizations.
• Sensitization to Ara h 1, Ara h 2, and Ara h 3 was more frequent in patients with generalized reactions compared to oral allergy syndrome (OAS) or tolerant individuals.
• Ara h 2 was the most effective marker distinguishing generalized reactions from OAS and/or tolerance.

Conclusions:

• Sensitization to Ara h 1, Ara h 2, and Ara h 3 can manifest early and is linked to more severe peanut allergy.
• Ara h 2 serves as a key biomarker for identifying generalized peanut allergy.
• Component-resolved diagnosis provides valuable insights into peanut allergy phenotypes and severity.