Clinical utility of microarray B‐cell epitope mapping in food allergies: A systematic review

Abstract

Background: Peptide microarray technology has been proposed as a useful tool for diagnosing food allergy. However, there is considerable heterogeneity in the clinical methods and analytical procedures used to assess its diagnostic and prognostic performance. We performed a systematic review of studies that have used B-cell epitopes by peptide microarray in food allergies to identify the clinical utility of this immunologic technique.Methods: Studies were screened in PubMed, Web of Science, and Embase according to an established keyword algorithm. Data extraction was performed, and information was collected in an Excel database. Descriptive analysis was carried out using Stata software.Results: Thirty relevant studies were identified. Most articles were cross-sectional (n = 24), included epitope mapping (n = 9), and assessed diagnostic utility (n = 11).All studies recruited allergic patients, and some included additional patients (sensitized, persistent, and tolerant). The primary microarray variables studied were IgE intensity (n = 29), IgG4 intensity (n = 15), and number of peptides (n = 17). Statistical approaches differed significantly between studies, with the Wilcoxon test being the most frequently used (n = 10).Conclusions: Sensitization to particular epitopes of milk, peanut, and shrimp allergens can be used to determine clinical reactivity, persistence, severity, or response to oral immunotherapy; however, important methodological questions need to be addressed before drawing definitive conclusions. More research is needed to address the accuracy and clinical benefits of microarray-based technology. Standards are required to improve consistency and reproducibility, and to allow for better understanding of research findings. K E Y W O R D Sclinical utility, epitope mapping, food allergy, peptide microarray, precision medicine

Improving Diagnostic Accuracy in Food Allergy

“…51,52 The evidence of clinical utility of such tests has been recently systematically reviewed. 53,54 The most recent studies have focused on peanut [55][56][57][58] and cow's milk 59,60 allergies as well as allergies to shellfish [61][62][63] and legumes. [64][65][66] Using a peptide microarray, Caubet et al 60 identified a greater intensity and broader diversity of IgE binding in children with persistent CMA, which decreased as children became tolerant.…”

Comments on vitamin D in asthma, milk allergy diagnosis, and stem cell transplantation in chronic granulomatous disease

“…Milk allergy represents a major burden for food-allergic children, 11,12 and further insight into the cross-reactivity of specific major allergens will allow better understanding of mechanisms of allergy, or tolerance induction involving major epitopes. 13 Chronic granulomatous disease (CGD) is a rare but severe primary immunodeficiency caused by defects in the genes coding for essential proteins involved in leucocyte phagocytosis. Hematopoietic stem cell transplantation is the only definitive treatment that can cure CGD.…”

“…Also, the competitive ELISA suggested the presence of common epitopes further investigated by amino acid sequencing. Milk allergy represents a major burden for food‐allergic children, 11,12 and further insight into the cross‐reactivity of specific major allergens will allow better understanding of mechanisms of allergy, or tolerance induction involving major epitopes 13

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Structure and IgE cross-reactivity among walnut and peanut vicilin leader sequences

“…Each SNR value was then converted into modified z-scores which are calculated using median and median absolute deviation (MAD) rather than mean and standard deviation. Z-scores represent a standardized signal intensity and are frequently used to report immunoglobulin binding to peptide microarray [53]. Median and MAD were calculated for each patient and leader sequence combination.…”