Zambrano Ibarra Gabriela, Fuentes Aparicio Victoria, Infante Herrero Sonsoles, Blanca Miguel, Zapatero Remon Lydia
Allergy Department, Hospital del Tajo, Madrid, Spain,
Pediatric Allergy Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Int Arch Allergy Immunol. 2019;178(4):370-376. doi: 10.1159/000495579. Epub 2019 Jan 24.
Peanut storage proteins (Ara h 1, Ara h 2, and Ara h 3) have been described as the major peanut allergens in children, although not all peanut-sensitized individuals have clinical reactivity after exposure.
We studied the sensitization profile of peanut-allergic and peanut-tolerant children in a pediatric cohort.
The clinical features and sensitization profile to the peanut storage proteins Ara h 9 and Pru p 3 were compared between peanut-allergic and peanut-tolerant children using component-resolved diagnostics.
Thirty-three peanut-sensitized children were included: 22 allergic and 11 tolerant patients. Seventy-two percent of the peanut-allergic children were sensitized to at least one peanut storage protein. The rates of sensitization to Ara h 1, Ara h 2, and Ara h 3 were 63.6, 68.1, and 68.1%, respectively, among the peanut-allergic children and 27.2, 18.1, and 45.4% among the peanut-tolerant children. IgE from the sera of 18% of the peanut-allergic patients recognized Ara h 9, whereas no sensitization to Ara h 9 was detected in the peanut-tolerant children. A total of 59% of the peanut-allergic and 27% of the peanut-tolerant children were sensitized to Pru p 3. Sensitization to Ara h 1 and Ara h 2 was more frequent among the peanut-allergic children (p < 0.05). Although the levels of specific IgE against peanut storage proteins were higher in peanut allergy, there were not statistically significantly different from the levels in peanut tolerance, probably due to the small number of patients included.
In our population, the peanut-allergic children were mainly sensitized to peanut storage proteins, and Ara h 2 sensitization allows a more accurate diagnosis of clinical reactivity to peanuts. More than half of the peanut-allergic patients were sensitized to peach Pru p 3, and 50% of them had fruit allergy at the time of the study.
花生储存蛋白（Ara h 1、Ara h 2和Ara h 3）已被描述为儿童主要的花生过敏原，尽管并非所有对花生敏感的个体在接触后都会出现临床反应。
我们在一个儿科队列中研究了花生过敏和耐受儿童的致敏情况。
使用组分分辨诊断法比较花生过敏和耐受儿童对花生储存蛋白Ara h 9和Pru p 3的临床特征和致敏情况。
纳入了33名对花生敏感的儿童：22名过敏患者和11名耐受患者。72%的花生过敏儿童对至少一种花生储存蛋白致敏。花生过敏儿童中对Ara h 1、Ara h 2和Ara h 3的致敏率分别为63.6%、68.1%和68.1%，花生耐受儿童中分别为27.2%、18.1%和45.4%。18%的花生过敏患者血清IgE识别Ara h 9，而花生耐受儿童中未检测到对Ara h 9的致敏。总共59%的花生过敏儿童和27%的花生耐受儿童对Pru p 3致敏。花生过敏儿童中对Ara h 1和Ara h 2的致敏更常见（p<0.05）。虽然花生过敏患者中针对花生储存蛋白的特异性IgE水平较高，但与花生耐受患者的水平相比无统计学显著差异，可能是由于纳入的患者数量较少。
在我们的人群中，花生过敏儿童主要对花生储存蛋白致敏，对Ara h 2致敏有助于更准确地诊断对花生的临床反应性。超过一半的花生过敏患者对桃Pru p 3致敏，其中50%在研究时患有水果过敏。
