Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, United Kingdom; Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom.
Benaroya Research Institute, Seattle, Wash.
J Allergy Clin Immunol Pract. 2023 Nov;11(11):3485-3492.e2. doi: 10.1016/j.jaip.2023.07.023. Epub 2023 Jul 24.
A precise diagnosis of peanut allergy is extremely important. We identified 4 Ara h 2 peptides that improved Ara h 2-specific IgE (sIgE) diagnostic accuracy.
To assess the diagnostic utility of sIgE to the mixture of these peptides and their role in mast cell response to peanut allergens.
sIgE to the peptide mix was determined using ImmunoCAP. Its diagnostic utility was compared with Ara h 2-sIgE and sIgE to the individual peptides. The functional relevance of the peptides was tested on the mast cell activation test using laboratory of allergic diseases 2 cell line and flow cytometry.
A total of 52 peanut-allergic (PA), 36 peanut-sensitized but tolerant, and 9 nonsensitized nonallergic children were studied. Peptide mix-sIgE improved the diagnostic performance of Ara h 2-sIgE compared with Ara h 2-sIgE alone (area under the receiver operating characteristic curve .92 vs .89, respectively; P = .056). The sensitivity and specificity of Ara h 2-sIgE combined with the peptide mix were 85% and 96%, respectively. sIgE to individual peptides had the highest specificity (91%-96%) but the lowest sensitivity (10%-52%) compared with Ara h 2-sIgE (69% specificity and 87% sensitivity) or with peptide mix-sIgE (82% specificity and 63% sensitivity). Peptide 3 directly induced mast cell activation, and the peptide mix inhibited Ara h 2-induced activation of mast cells sensitized with plasma from Ara h 2-positive PA patients.
sIgE to the peptide mix improved the diagnostic performance of Ara h 2-sIgE similarly to sIgE to individual peptides. The peptides interfered with Ara h 2-induced mast cell activation, confirming its relevance in peanut allergy.
准确诊断花生过敏极为重要。我们鉴定了 4 种 Ara h 2 肽，可提高 Ara h 2 特异性 IgE（sIgE）的诊断准确性。
评估这些肽混合物的 sIgE 的诊断效用及其在对花生过敏原的肥大细胞反应中的作用。
使用 ImmunoCAP 测定肽混合物的 sIgE。将其诊断效用与 Ara h 2-sIgE 和单独的肽 sIgE 进行比较。使用实验室过敏症 2 细胞系和流式细胞术，在肥大细胞激活试验中测试了肽的功能相关性。
共研究了 52 名花生过敏（PA）患儿、36 名花生致敏但耐受患儿和 9 名非致敏非过敏患儿。与单独的 Ara h 2-sIgE 相比，肽混合物-sIgE 提高了 Ara h 2-sIgE 的诊断性能（曲线下面积，分别为.92 和.89；P=.056）。Ara h 2-sIgE 与肽混合物的组合的敏感性和特异性分别为 85%和 96%。与 Ara h 2-sIgE（69%的特异性和 87%的敏感性）或肽混合物-sIgE（82%的特异性和 63%的敏感性）相比，单独的肽 sIgE 具有最高的特异性（91%-96%），但敏感性最低（10%-52%）。肽 3 直接诱导了肥大细胞的激活，肽混合物抑制了对 Ara h 2 阳性 PA 患者的血浆进行敏化的肥大细胞对 Ara h 2 诱导的激活。
与单独的肽 sIgE 相比，肽混合物的 sIgE 提高了 Ara h 2-sIgE 的诊断性能。这些肽干扰了 Ara h 2 诱导的肥大细胞激活，证实了其在花生过敏中的相关性。
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