Component‐resolved diagnostics demonstrates that most peanut‐allergic individuals could potentially introduce tree nuts to their diet

Uotila, Riikka; Kukkonen, Kaarina; Blom, W. Marty; Remington, Benjamin C.; Westerhout, Joost; Pelkonen, Anna; Mäkelä, Mika J.

doi:10.1111/cea.13101

Cited by 33 publications

(43 citation statements)

References 36 publications

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“…8,13,14,23,52 The differentiation between clinical cross-reactivity (co-allergy) and serologic crossreactivity in the absence of clinically manifest co-allergy is a wellknown diagnostic challenge in food allergy to peanut, tree nuts, and other seeds. 14,23,52 Molecular cross-reactivity relies on the presence of conserved epitope structures of proteins and is hence observed in general among closely related members of the same protein family. 29,53 We observed a moderate correlation 54 between the 2S albumins Cor a 14 and Jug r 1 from walnut ( Table 3).…”

Section: Discussionmentioning

confidence: 99%

Sensitization profiles to hazelnut allergens across the United States

Valcour

Lidholm

Borres

et al. 2019

Annals of Allergy, Asthma & Immunology

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A B S T R A C TBackground: Measurement of IgE antibody to hazelnut components can aid in the prediction of allergic responses to the food. Objective: To investigate the association between patient demographics (age, location) and patterns of allergic sensitization to hazelnut components across the United States and to investigate the degree of correlation between hazelnut sensitization with sensitization to other tree nuts, peanuts, and their components. Methods: Serum samples from 10,503 individuals with hazelnut extract specific IgE (sIgE) levels of 0.35 kU A /L or higher were analyzed for IgE antibodies to Cor a 1, 8, 9, and 14 by ImmunoCAP. A subset of these patients were analyzed for IgE antibodies to peanut, walnut, and cashew nut IgE along with associated components. Results: Among hazelnut sensitized individuals, children ( < 3 years old) were predominantly sensitized to Cor a 9 and Cor a 14. Conversely, Cor a 1 sIgE sensitization was much higher in adults than children, especially in the Northeastern United States. Cor a 8 sensitization was relatively constant (near 10%) across all ages. Cosensitization of hazelnut with other tree nuts and peanuts was related to correlation of IgE concentrations of individual component families. Conclusion:We conclude that sensitization to individual hazelnut components is highly dependent on age and/ or geographic location. Component correlations suggest that cosensitization to hazelnut and walnut may be caused by their pathogenesis-related protein 10 allergens, nonspecific lipid transfer proteins, or seed storage proteins, whereas hazelnut and peanut cosensitization is more often caused by cross-reactivity of pathogenesisrelated protein 10 (Cor a 1 and Ara h 8) and nonspecific lipid transfer proteins (Cor a 8 and Ara h 9).

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Section: Discussionmentioning

confidence: 99%

Sensitization profiles to hazelnut allergens across the United States

Valcour

Lidholm

Borres

et al. 2019

Annals of Allergy, Asthma & Immunology

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“…Extensive research is available describing patients with a high probability of reactivity to peanut showing either mono-sensitization to Ara h 2 or sensitization to both Ara h 2 and h 6, however there is little research describing mono-sensitization to Ara h 6 alone. 9,10 Due to its similarity to Ara h 2 in that they are both 2S albumins, Ara h 6 is also a component that has a high probability of reactivity with exposure. It is important to note that the Ara h 6 component is not found on routine component testing.…”

Section: Discussionmentioning

confidence: 99%

A case report of mono-sensitization to peanut component Ara h6

Bartellino

Barisciano

2019

Int J Contemp Pediatr

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Peanut is the most common food allergen in the US, affecting 1-2 % of the population and studies show that it is still on the rise. Component testing has offered better insight into the likelihood of reactivity with exposure. Extensive literature shows Arachis hypogea (Ara h) 2 as being the most clinically significant component identified to correlate with reactivity with exposure to the peanut protein, however there is minimal research on the reactivity of Ara h6. This case report describes a patient with a clinical reaction to peanut as a toddler and subsequent positivity on annual skin testing with commercial peanut extract, likely confounded by positive birch with advancing age. Immuno CAP testing revealed a negative Ara h2 and positive Ara h6, describing mono-sensitization to Ara h 6 and high probability of clinical reactivity. The importance of this case is to raise awareness of other highly allergenic components in patients with peanut allergy.

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“…Increased levels of IgE against 2S albumins in cashew (Ana o 3), walnut (Jug r 1) and hazelnut (Cor a 14) were correlated with patients experiencing GI reactions, which correspond well with the digestion‐resistant characteristics of 2S albumins . Additionally, component‐resolved diagnostics for peanut‐allergic subjects recently showed that sensitization to seed storage proteins in tree nuts was uncommon, suggesting that many peanut‐allergic patients could tolerate tree nuts without reactions …”

Section: Allergen Biochemistrymentioning

confidence: 99%

“…29 Additionally, component-resolved diagnostics for peanut-allergic subjects recently showed that sensitization to seed storage proteins in tree nuts was uncommon, suggesting that many peanut-allergic patients could tolerate tree nuts without reactions. 30…”

Section: Allergen Biochemistrymentioning

confidence: 99%

Tree nut allergies: Allergen homology, cross‐reactivity, and implications for therapy

Smeekens

Bagley

Kulis

2018

Clin Experimental Allergy

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Tree nut allergy is a potentially life-threatening disease that is increasing in prevalence, now affecting 1% of the general population in the United States. While other food allergies often resolve spontaneously, tree nut allergies are outgrown in less than 10% of cases. Due to the likelihood of cross-sensitization to multiple tree nut allergens, the current treatment guideline is strict avoidance of all nuts once one tree nut allergy has been diagnosed. For example, walnut and pecan are highly cross-reactive, along with cashew and pistachio, but the extent of clinical, IgE-mediated cross-reactivity among other tree nuts remains unclear, therefore making avoidance of all tree nuts a safe approach. There have been recent advances in immunotherapy for food allergies. For instance, there are investigational immunotherapies for milk, egg and peanut allergies, specifically oral immunotherapy, sublingual immunotherapy and epicutaneous immunotherapy. However, there are no large randomized controlled clinical trials for tree nut allergies. Even though there has been less research into tree nut allergy immunotherapies, the evidence of T-cell cross-reactivity among tree nuts exists in animal models and in T cells from allergic patients indicates that immunotherapeutic interventions may be possible. Here, we review the literature regarding epidemiology, allergen homology and cross-reactivity among tree nuts, and explore how current findings can be employed for effective therapy.

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Component‐resolved diagnostics demonstrates that most peanut‐allergic individuals could potentially introduce tree nuts to their diet

Cited by 33 publications

References 36 publications

Sensitization profiles to hazelnut allergens across the United States

Sensitization profiles to hazelnut allergens across the United States

A case report of mono-sensitization to peanut component Ara h6

Tree nut allergies: Allergen homology, cross‐reactivity, and implications for therapy

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