Department of Allergy, Clinical Research Center for Allergology and Rheumatology, Sagamihara National Hospital, Sagamihara, Kanagawa, Japan.
Pediatr Allergy Immunol. 2012 Sep;23(6):573-81. doi: 10.1111/j.1399-3038.2012.01332.x. Epub 2012 Jul 26.
Food challenges are time-consuming, expensive, and not always possible to perform. Therefore, new tools to diagnose food allergy are desired. The aim was to evaluate IgE antibodies to peanut allergens in the diagnosis of peanut allergy in Japanese children using ImmunoCAP(®) and IgE immunoblotting.
The study included 2-13-yr-old consecutive patients (n = 57) referred to our specialist clinic for investigation of current peanut allergy using food challenge. All children had a previous doctor's diagnosis of peanut allergy and were on elimination diet. Serum samples were analyzed for IgE reactivity to peanut, recombinant (r) Ara h 1, 2, 3, 5, 8, and 9. IgE immunoblotting (n = 23) was performed using extracts from raw and roasted peanut.
Twenty-six of the children failed (allergic group), and 31 passed the peanut challenge (tolerant group). The rAra h 2 ImmunoCAP test was superior in its ability to differentiate between children in the allergic and tolerant groups with a sensitivity and specificity of 88% and 84%, respectively (cutoff, 0.35 kU(A)/l). The combination of rAra h 1, 2, and 3 resulted in a higher specificity (94%) when IgE to all of them was the criteria for positivity. ImmunoCAP generally showed a good agreement with immunoblotting using both raw and roasted peanut for IgE reactivity to Ara h 1, 2, and 3.
Measurement of IgE antibodies to rAra h 1, 2, and 3 is useful in the diagnosis of peanut allergy and in the investigation of reactions to raw and roasted peanut.
食物挑战既耗时又昂贵，而且并非总是可行。因此，需要新的工具来诊断食物过敏。本研究旨在使用 ImmunoCAP（®）和 IgE 免疫印迹法评估花生过敏原的 IgE 抗体在日本儿童中诊断花生过敏的价值。
该研究纳入了 57 例因怀疑当前患有花生过敏而接受食物挑战的 2-13 岁连续就诊患者。所有患儿均有既往医生诊断的花生过敏史，并正在接受饮食排除疗法。分析血清样本对花生、重组（r）Ara h 1、2、3、5、8 和 9 的 IgE 反应性。使用生花生和烤花生提取物进行 IgE 免疫印迹（n = 23）。
26 例患儿食物挑战失败（过敏组），31 例患儿食物挑战成功（耐受组）。rAra h 2 ImmunoCAP 试验在区分过敏组和耐受组患儿方面具有更高的能力，其敏感性和特异性分别为 88%和 84%（临界值为 0.35 kU(A)/l）。当所有 rAra h 1、2 和 3 的 IgE 为阳性标准时，rAra h 1、2 和 3 的组合具有更高的特异性（94%）。ImmunoCAP 通常与使用生花生和烤花生进行的免疫印迹具有良好的一致性，用于检测 Ara h 1、2 和 3 的 IgE 反应性。
测量 rAra h 1、2 和 3 的 IgE 抗体有助于诊断花生过敏，并有助于研究生花生和烤花生的过敏反应。
