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The Evolution of Sesame Seed Allergy Over Time.

Ru-Xin Foong1,2,3, George Du Toit1,3, Henry T Bahnson1,4

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Summary

Sesame allergy (SA) prevalence increased in children, with most new cases developing after age three. Higher sesame-specific IgE (sIgE) and Ses i 1-sIgE levels predict SA development.

Keywords:
IgESes i 1‐sIgEbiomarkersfood allergymast cell activation testresolutionsesame allergy

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Area of Science:

  • Allergy and Immunology
  • Pediatric Allergy
  • Clinical Nutrition

Background:

  • The prevalence of sesame allergy (SA) is rising globally.
  • Understanding the natural history and changing biomarkers of SA is crucial.
  • Limited data exists on SA development and resolution in children over time.

Purpose of the Study:

  • To investigate the natural history of sesame allergy (SA) in children.
  • To analyze changes in sesame allergy biomarkers over time.
  • To compare biomarkers between children with SA and those sensitized but tolerant (SS).

Main Methods:

  • Longitudinal study of exclusively breastfed infants from 3 months to 7-12 years.
  • Assessment of clinical characteristics, skin prick tests (SPT), sesame-specific IgE (sIgE), Ses i 1-sIgE, and mast cell activation tests (MAT).
  • SA status determined at 7-12 years, with biomarker assessments at 12 months, 36 months, and 7-12 years.

Main Results:

  • Period prevalence of SA increased from 0.5% (12-36 months) to 1.5% (7-12 years), with 71.4% of cases emerging after 36 months.
  • Children with SA at 7-12 years showed larger SPT, higher sesame-sIgE, and Ses i 1-sIgE from 12 months onwards compared to SS children.
  • An increased rate of sesame-sIgE and Ses i 1-sIgE from 12 to 36 months predicted new SA development.

Conclusions:

  • Sesame allergy prevalence significantly increased in children between infancy and pre-adolescence.
  • Sesame-specific IgE (sIgE) and Ses i 1-sIgE are valuable biomarkers for predicting SA development, persistence, and resolution.
  • The findings highlight the importance of monitoring sIgE levels for early identification and management of pediatric sesame allergy.