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Updated: Aug 15, 2025
Basophil Activation Test for Allergy Diagnosis
Published on: May 31, 2021
Ara h 2-Specific IgE Presence Rather Than Its Function Is the Best Predictor of Mast Cell Activation in Children
Chen Ji1, Yue Huang1, Long Him Yeung1
1Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, United Kingdom.
Background:
Ara h 2-specific IgE (Arah2-sIgE) is an excellent serologic marker for peanut allergy. However, not all subjects with detectable Arah2-sIgE react clinically.
Objective:
To assess the importance of functional characteristics of Arah2-sIgE for Ara h 2-induced mast cell activation.
Methods:
We studied a cohort of children assessed for peanut allergy. We determined Arah2-sIgE levels, Ara h 2/total IgE ratios and IgE avidity for Ara h 2 using ImmunoCAP (Thermo Fisher) and mast cell activation to Ara h 2 using flow cytometry.
Results:
Samples from 61 of 100 children (46 peanut-allergic [PA] and 15 peanut-sensitized tolerant) who had Arah2-sIgE levels 0.10 kU/L or greater were studied. Arah2-sIgE and Ara h 6-specific IgE levels, Ara h 2/total IgE ratios, and the diversity of IgE for Ara h 2 epitopes were higher in PA compared with peanut-sensitized tolerant samples. The levels of IgE to peanut, Ara h 1, and Ara h 3 were not significantly different between groups. Results from the mast cell activation test to Ara h 2 strongly correlated with Arah2-sIgE levels (r = 0.722; P < .001) and Ara h 2/total IgE ratios (r = 0.697; P < .001) and moderately with Arah2-sIgE diversity (r = 0.540; P < .001). On a linear regression model, Arah2-sIgE levels (standardized β-coefficient = 0.396; P = .008) and Ara h 2/total IgE ratios (standardized β-coefficient = 0.0.669; P = .002) were the main determinants of mast cell response to Ara h 2.
Conclusions:
Most children sensitized to Ara h 2 are PA. Ara h 2-specific IgE titers and specific activity are the major determinants of mast cell response to Ara h 2.
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