Mareen R Datema1,2, Esben Eller3, Aeilko H Zwinderman2, Lars K Poulsen4, Serge A Versteeg1, Ronald van Ree1,5, Carsten Bindslev-Jensen3. 1. Department of Experimental Immunology, Academic Medical Center, Amsterdam, the Netherlands. 2. Department of Clinical Epidemiology, Academic Medical Centre, Biostatistics and Bioinformatics, Amsterdam, the Netherlands. 3. Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis (ORCA), Odense University Hospital, Odense, Denmark. 4. Allergy Clinic, Copenhagen University Hospital at Gentofte, Copenhagen, Denmark. 5. Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, the Netherlands.
Abstract
BACKGROUND: IgG4 antibodies have been suggested to play a protective role in the translation of peanut sensitization into peanut allergy. Whether they have added value as diagnostic read-out has not yet been reported. OBJECTIVE: To evaluate whether (a) peanut-specific IgG, IgG4 and/or IgA antibodies are associated with tolerance and/or less severe reactions and (b) they can improve IgE-based diagnostic tests. METHODS: Sera of 137 patients with challenge-proven peanut allergy and of 25 subjects that tolerated peanut, both with known IgE profiles to peanut extract and five individual peanut allergens, were analyzed for specific IgG and IgG4 . Antibody levels and ratios thereof were associated with challenge outcome including symptom severity grades. For comparison of the discriminative performance, receiver operating characteristic curve (ROC) analysis was used. RESULTS: IgE against Ara h 2 was significantly higher in allergic than in tolerant patients and associated with severity of reactions (P < 0.001) with substantial diagnostic capability (AUC 0.91, 95%CI 0.87-0.96 and 0.80, 95%CI 0.73-0.87, respectively). IgG and IgG4 were also positively associated albeit significantly weaker (AUCs from 0.65 to 0.72). On the other hand, ratios of IgG and IgG4 over IgE were greater in patients that were tolerant or had mild symptoms as compared to severe patients but they did not predict challenge outcomes better than IgE alone (AUCs from 0.54 to 0.89). CONCLUSION: IgE against Ara h 2 is the best biomarker for predicting peanut challenge outcomes including severity and IgG and IgG4 antibody ratios over IgE do not improve these outcomes.
BACKGROUND: IgG4 antibodies have been suggested to play a protective role in the translation of peanut sensitization into peanutallergy. Whether they have added value as diagnostic read-out has not yet been reported. OBJECTIVE: To evaluate whether (a) peanut-specific IgG, IgG4 and/or IgA antibodies are associated with tolerance and/or less severe reactions and (b) they can improve IgE-based diagnostic tests. METHODS: Sera of 137 patients with challenge-proven peanutallergy and of 25 subjects that tolerated peanut, both with known IgE profiles to peanut extract and five individual peanut allergens, were analyzed for specific IgG and IgG4 . Antibody levels and ratios thereof were associated with challenge outcome including symptom severity grades. For comparison of the discriminative performance, receiver operating characteristic curve (ROC) analysis was used. RESULTS:IgE against Ara h 2 was significantly higher in allergic than in tolerant patients and associated with severity of reactions (P < 0.001) with substantial diagnostic capability (AUC 0.91, 95%CI 0.87-0.96 and 0.80, 95%CI 0.73-0.87, respectively). IgG and IgG4 were also positively associated albeit significantly weaker (AUCs from 0.65 to 0.72). On the other hand, ratios of IgG and IgG4 over IgE were greater in patients that were tolerant or had mild symptoms as compared to severe patients but they did not predict challenge outcomes better than IgE alone (AUCs from 0.54 to 0.89). CONCLUSION:IgE against Ara h 2 is the best biomarker for predicting peanut challenge outcomes including severity and IgG and IgG4 antibody ratios over IgE do not improve these outcomes.
Authors: J H Akkerdaas; A Cianferoni; E Islamovic; J Kough; G S Ladics; S McClain; L K Poulsen; A Silvanovich; L Pereira Mouriès; R van Ree Journal: Front Allergy Date: 2022-05-31
Authors: Mariona Pascal; Carmen Moreno; Ignacio Dávila; Ana I Tabar; Joan Bartra; Moisés Labrador; Olga Luengo Journal: Clin Transl Allergy Date: 2021-08 Impact factor: 5.657
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Authors: Mareen R Datema; Sarah A Lyons; Montserrat Fernández-Rivas; Barbara Ballmer-Weber; André C Knulst; Riccardo Asero; Laura Barreales; Simona Belohlavkova; Frédéric de Blay; Michael Clausen; Ruta Dubakiene; Cristina Fernández-Perez; Philipp Fritsche; David Gislason; Karin Hoffmann-Sommergruber; Monika Jedrzejczak-Czechowicz; Laurian Jongejan; Marek L Kowalski; Tanya Z Kralimarkova; Jonas Lidholm; Nikolaos G Papadopoulos; Todor A Popov; Nayade Del Prado; Ashok Purohit; Isabel Reig; Suranjith L Seneviratne; Athanassios Sinaniotis; Emilia Vassilopoulou; Serge A Versteeg; Stefan Vieths; Paco M J Welsing; E N Clare Mills; Thuy-My Le; Aeilko H Zwinderman; Ronald van Ree Journal: Front Allergy Date: 2021-06-07