van Erp F C, Klemans R J B, Meijer Y, van der Ent C K, Knulst A C
Department of Paediatric Pulmonology and Allergology, University Medical Centre Utrecht, Utrecht, The Netherlands ; Department of Paediatric Pulmonology and Allergology, University Medical Center Utrecht, Wilhelmina Children's Hospital, P O Box 85090, 3508 AB Utrecht, The Netherlands.
Department of Dermatology and Allergology, University Medical Centre Utrecht, Utrecht, The Netherlands.
Curr Treat Options Allergy. 2016;3:169-180. doi: 10.1007/s40521-016-0080-6. Epub 2016 Apr 7.
Instead of relying on crude peanut extract, component-resolved diagnostics (CRD) uses sensitization to allergenic proteins within peanut. In this review, we describe the recent advances and future perspectives of the use of CRD in the management of peanut-allergic patients. There is strong evidence that sensitization to Ara h 2 is the best predictor for clinically relevant peanut allergy in children and adults. Isolated sensitization to other peanut components is only rarely present in patients with systemic reactions to peanut. It is, however, important to remark that cut-off points of sIgE to Ara h 2 that predict tolerance or allergy vary between different study populations, different age groups and geographical regions, and validation studies performed in different settings are necessary to implement cut-offs in daily practice. Future studies should focus on the role of CRD in risk-assessment early in life, predicting long-term tolerance and monitoring treatment responses following immunotherapy.
组分分辨诊断（CRD）并非依赖于粗制花生提取物，而是利用对花生内致敏蛋白的致敏反应。在本综述中，我们描述了CRD在花生过敏患者管理中的最新进展和未来前景。有强有力的证据表明，对Ara h 2致敏是儿童和成人临床相关花生过敏的最佳预测指标。对花生其他组分的孤立致敏在对花生有全身反应的患者中很少见。然而，重要的是要指出，预测耐受或过敏的针对Ara h 2的sIgE截断值在不同研究人群、不同年龄组和地理区域之间有所不同，在不同环境中进行验证研究对于在日常实践中应用截断值是必要的。未来的研究应关注CRD在生命早期风险评估、预测长期耐受以及监测免疫治疗后治疗反应中的作用。
