1
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Koppelman SJ, de Jong GAH, Marsh J, Johnson P, Dowell E, Perusko M, Westphal A, van Hage M, Baumert J, Apostolovic D. Novel post-translationally cleaved Ara h 2 proteoforms: Purification, characterization and IgE-binding properties. Int J Biol Macromol 2024; 264:130613. [PMID: 38447836 DOI: 10.1016/j.ijbiomac.2024.130613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/01/2024] [Accepted: 03/02/2024] [Indexed: 03/08/2024]
Abstract
The 2S albumins Ara h 2 and Ara h 6 have been shown to be the most important source of allergenicity in peanut. Several isoforms of these allergens have been described. Using extraction and liquid chromatography we isolated proteins with homology to Ara h 2 and characterized hitherto unknown Ara h 2 proteoforms with additional post-translational cleavage. High-resolution mass spectrometry located the cleavage site on the non-structured loop of Ara h 2 while far UV CD spectroscopy showed a comparable structure to Ara h 2. The cleaved forms of Ara h 2 were present in genotypes of peanut commonly consumed. Importantly, we revealed that newly identified Ara h 2 cleaved proteoforms showed comparable IgE-binding using sera from 28 peanut-sensitized individuals, possessed almost the same IgE binding potency and are likely similarly allergenic as intact Ara h 2. This makes these newly identified forms relevant proteoforms of peanut allergen Ara h 2.
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Affiliation(s)
- Stef J Koppelman
- Food Allergy Research and Resource Program, Department of Food Science & Technology, University of Nebraska, 279 Food Innovation Center, Lincoln, NE 68588-6207, USA
| | | | - Justin Marsh
- Food Allergy Research and Resource Program, Department of Food Science & Technology, University of Nebraska, 279 Food Innovation Center, Lincoln, NE 68588-6207, USA
| | - Phil Johnson
- Food Allergy Research and Resource Program, Department of Food Science & Technology, University of Nebraska, 279 Food Innovation Center, Lincoln, NE 68588-6207, USA
| | - Emily Dowell
- Food Allergy Research and Resource Program, Department of Food Science & Technology, University of Nebraska, 279 Food Innovation Center, Lincoln, NE 68588-6207, USA
| | - Marija Perusko
- Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden; Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Adrie Westphal
- Wageningen University and Research (WUR), Wageningen, the Netherlands
| | - Marianne van Hage
- Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden; Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Joseph Baumert
- Food Allergy Research and Resource Program, Department of Food Science & Technology, University of Nebraska, 279 Food Innovation Center, Lincoln, NE 68588-6207, USA
| | - Danijela Apostolovic
- Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden; Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.
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2
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Datema MR, Lyons SA, Fernández-Rivas M, Ballmer-Weber B, Knulst AC, Asero R, Barreales L, Belohlavkova S, de Blay F, Clausen M, Dubakiene R, Fernández-Perez C, Fritsche P, Gislason D, Hoffmann-Sommergruber K, Jedrzejczak-Czechowicz M, Jongejan L, Kowalski ML, Kralimarkova TZ, Lidholm J, Papadopoulos NG, Popov TA, Del Prado N, Purohit A, Reig I, Seneviratne SL, Sinaniotis A, Vassilopoulou E, Versteeg SA, Vieths S, Welsing PMJ, Mills ENC, Le TM, Zwinderman AH, van Ree R. Estimating the Risk of Severe Peanut Allergy Using Clinical Background and IgE Sensitization Profiles. FRONTIERS IN ALLERGY 2022; 2:670789. [PMID: 35386994 PMCID: PMC8974676 DOI: 10.3389/falgy.2021.670789] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/06/2021] [Indexed: 11/13/2022] Open
Abstract
Background: It is not well-understood why symptom severity varies between patients with peanut allergy (PA). Objective: To gain insight into the clinical profile of subjects with mild-to-moderate and severe PA, and investigate individual and collective predictive accuracy of clinical background and IgE to peanut extract and components for PA severity. Methods: Data on demographics, patient history and sensitization at extract and component level of 393 patients with probable PA (symptoms ≤ 2 h + IgE sensitization) from 12 EuroPrevall centers were analyzed. Univariable and penalized multivariable regression analyses were used to evaluate risk factors and biomarkers for severity. Results: Female sex, age at onset of PA, symptoms elicited by skin contact with peanut, family atopy, atopic dermatitis, house dust mite and latex allergy were independently associated with severe PA; birch pollen allergy with mild-to-moderate PA. The cross-validated AUC of all clinical background determinants combined (0.74) was significantly larger than the AUC of tests for sensitization to extract (0.63) or peanut components (0.54-0.64). Although larger skin prick test wheal size, and higher IgE to peanut extract, Ara h 1 and Ara h 2/6, were associated with severe PA, and higher IgE to Ara h 8 with mild-to-moderate PA, addition of these measurements of sensitization to the clinical background model did not significantly improve the AUC. Conclusions: Models combining clinical characteristics and IgE sensitization patterns can help establish the risk of severe reactions for peanut allergic patients, but clinical background determinants are most valuable for predicting severity of probable PA in an individual patient.
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Affiliation(s)
- Mareen R Datema
- Department of Experimental Immunology, Amsterdam University Medical Center, Amsterdam, Netherlands.,Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Sarah A Lyons
- Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Montserrat Fernández-Rivas
- Allergy Department, Hospital Clinico San Carlos, Instituto de Investigacion Sanitario San Carlos, Madrid, Spain
| | - Barbara Ballmer-Weber
- Allergy Unit, Department of Dermatology, University Hospital, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland.,Clinic for Dermatology and Allergology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - André C Knulst
- Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Riccardo Asero
- Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Italy
| | - Laura Barreales
- Clinical Epidemiology Unit, Preventive Medicine Department, Hospital Clinico San Carlos, Instituto de Investigacion Sanitario San Carlos, Madrid, Spain
| | - Simona Belohlavkova
- Department of Allergology and Immunology, Faculty of Medicine in Pilsen, Charles University, Prague, Czechia
| | - Frédéric de Blay
- Allergy Division, Chest Disease Department, Strasbourg University Hospital, Strasbourg, France
| | - Michael Clausen
- Faculty of Medicine, Landspitali University Hospital, University of Iceland, Reykjavik, Iceland
| | | | - Cristina Fernández-Perez
- Clinical Epidemiology Unit, Preventive Medicine Department, Hospital Clinico San Carlos, Instituto de Investigacion Sanitario San Carlos, Madrid, Spain
| | - Philipp Fritsche
- Allergy Unit, Department of Dermatology, University Hospital, Zurich, Switzerland
| | - David Gislason
- Faculty of Medicine, Landspitali University Hospital, University of Iceland, Reykjavik, Iceland
| | | | | | - Laurian Jongejan
- Department of Experimental Immunology, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Marek L Kowalski
- Department of Immunology, Rheumatology and Allergy, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | | | | | - Nikolaos G Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece.,Division of Infection, Immunity & Respiratory Medicine, University of Manchester, Manchester, United Kingdom
| | - Todor A Popov
- Clinic of Occupational Diseases, University Hospital Sv. Ivan Rilski, Sofia, Bulgaria
| | - Nayade Del Prado
- Clinical Epidemiology Unit, Preventive Medicine Department, Hospital Clinico San Carlos, Instituto de Investigacion Sanitario San Carlos, Madrid, Spain
| | - Ashok Purohit
- Allergy Division, Chest Disease Department, Strasbourg University Hospital, Strasbourg, France
| | - Isabel Reig
- Allergy Department, Hospital Clinico San Carlos, Instituto de Investigacion Sanitario San Carlos, Madrid, Spain
| | - Suranjith L Seneviratne
- Institute of Immunity and Transplantation, University College London, London, United Kingdom
| | | | - Emilia Vassilopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Serge A Versteeg
- Department of Experimental Immunology, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Stefan Vieths
- Paul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines, Langen, Germany
| | - Paco M J Welsing
- Division of Internal Medicine and Dermatology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - E N Clare Mills
- Division of Infection, Immunity and Respiratory Medicine, Manchester Institute of Biotechnology, University of Manchester, Manchester, United Kingdom
| | - Thuy-My Le
- Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Aeilko H Zwinderman
- Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Ronald van Ree
- Department of Experimental Immunology, Amsterdam University Medical Center, Amsterdam, Netherlands.,Department of Otorhinolaryngology, Amsterdam University Medical Center, Amsterdam, Netherlands
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3
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Blum LA, Ahrens B, Klimek L, Beyer K, Gerstlauer M, Hamelmann E, Lange L, Nemat K, Vogelberg C, Blümchen K. White Paper Erdnussallergie - Teil 2: Diagnostik der Erdnussallergie unter besonderer Berücksichtigung der molekularen Komponentendiagnostik. ALLERGO JOURNAL 2021. [DOI: 10.1007/s15007-021-4931-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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4
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Apostolovic D, Marsh JT, Baumert J, Taylor SL, Westphal A, de Jongh H, Johnson P, de Jong GAH, Koppelman SJ. Purification and Initial Characterization of Ara h 7, a Peanut Allergen from the 2S Albumin Protein Family. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2021; 69:6318-6329. [PMID: 34037388 DOI: 10.1021/acs.jafc.1c00618] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
2S albumins are important peanut allergens. Within this protein family, Ara h 2 and Ara h 6 have been described in detail, but Ara h 7 has received little attention. We now describe the first purification of Ara h 7 and its characterization. Two Ara h 7 isoforms were purified from peanuts. Mass spectrometry revealed that both the isoforms have a post-translation cleavage, a hydroxyproline modification near the N-terminus, and four disulfide bonds. The secondary structure of both Ara h 7 isoforms is highly comparable to those of Ara h 2 and Ara h 6. Both Ara h 7 isoforms bind IgE, and Ara h 7 is capable of inhibiting the binding between Ara h 2 and IgE, suggesting at least partially cross-reactive IgE epitopes. Ara h 7 was found in all main market types of peanut, at comparable levels. This suggests that Ara h 7 is a relevant allergen from the peanut 2S albumin protein family.
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Affiliation(s)
- Danijela Apostolovic
- Immunology and Allergy Division, Department of Medicine Solna, Karolinska Institutet, Solnavägen 1, 171 77 Solna, Sweden
| | - Justin T Marsh
- Food Allergy Research and Resource Program, Department of Food Science & Technology, University of Nebraska, 279 Food Innovation Center, Lincoln, Nebraska 68588-6207, United States
| | - Joe Baumert
- Food Allergy Research and Resource Program, Department of Food Science & Technology, University of Nebraska, 279 Food Innovation Center, Lincoln, Nebraska 68588-6207, United States
| | - Steve L Taylor
- Food Allergy Research and Resource Program, Department of Food Science & Technology, University of Nebraska, 279 Food Innovation Center, Lincoln, Nebraska 68588-6207, United States
| | - Adrie Westphal
- Biochemistry Dept., Wageningen University and Research, PO Box 17, 6700 AA Wageningen, The Netherlands
| | - Harmen de Jongh
- ProtinConsult, Rozenstraat 19, 3702 VL Zeist, The Netherlands
| | - Phil Johnson
- Food Allergy Research and Resource Program, Department of Food Science & Technology, University of Nebraska, 279 Food Innovation Center, Lincoln, Nebraska 68588-6207, United States
| | - Govardus A H de Jong
- Wageningen University and Research, Food and Biobased Research. PO Box 17, 6700 AA Wageningen, The Netherlands
| | - Stef J Koppelman
- Food Allergy Research and Resource Program, Department of Food Science & Technology, University of Nebraska, 279 Food Innovation Center, Lincoln, Nebraska 68588-6207, United States
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5
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Gomez-Casado C, Sanchez-Solares J, Izquierdo E, Díaz-Perales A, Barber D, Escribese MM. Oral Mucosa as a Potential Site for Diagnosis and Treatment of Allergic and Autoimmune Diseases. Foods 2021; 10:970. [PMID: 33925074 PMCID: PMC8146604 DOI: 10.3390/foods10050970] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 12/15/2022] Open
Abstract
Most prevalent food allergies during early childhood are caused by foods with a high allergenic protein content, such as milk, egg, nuts, or fish. In older subjects, some respiratory allergies progressively lead to food-induced allergic reactions, which can be severe, such as urticaria or asthma. Oral mucosa remodeling has been recently proven to be a feature of severe allergic phenotypes and autoimmune diseases. This remodeling process includes epithelial barrier disruption and the release of inflammatory signals. Although little is known about the immune processes taking place in the oral mucosa, there are a few reports describing the oral mucosa-associated immune system. In this review, we will provide an overview of the recent knowledge about the role of the oral mucosa in food-induced allergic reactions, as well as in severe respiratory allergies or food-induced autoimmune diseases, such as celiac disease.
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Affiliation(s)
- Cristina Gomez-Casado
- Institute of Applied Molecular Medicine, Department of Basic Medical Sciences, Faculty of Medicine, San Pablo CEU University, 28003 Madrid, Spain; (J.S.-S.); (E.I.); (D.B.); (M.M.E.)
| | - Javier Sanchez-Solares
- Institute of Applied Molecular Medicine, Department of Basic Medical Sciences, Faculty of Medicine, San Pablo CEU University, 28003 Madrid, Spain; (J.S.-S.); (E.I.); (D.B.); (M.M.E.)
| | - Elena Izquierdo
- Institute of Applied Molecular Medicine, Department of Basic Medical Sciences, Faculty of Medicine, San Pablo CEU University, 28003 Madrid, Spain; (J.S.-S.); (E.I.); (D.B.); (M.M.E.)
| | - Araceli Díaz-Perales
- Center of Plant Biotechnology and Genomics, Technical University of Madrid, 28040 Madrid, Spain;
| | - Domingo Barber
- Institute of Applied Molecular Medicine, Department of Basic Medical Sciences, Faculty of Medicine, San Pablo CEU University, 28003 Madrid, Spain; (J.S.-S.); (E.I.); (D.B.); (M.M.E.)
| | - María M. Escribese
- Institute of Applied Molecular Medicine, Department of Basic Medical Sciences, Faculty of Medicine, San Pablo CEU University, 28003 Madrid, Spain; (J.S.-S.); (E.I.); (D.B.); (M.M.E.)
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6
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Dreskin SC, Koppelman SJ, Andorf S, Nadeau KC, Kalra A, Braun W, Negi SS, Chen X, Schein CH. The importance of the 2S albumins for allergenicity and cross-reactivity of peanuts, tree nuts, and sesame seeds. J Allergy Clin Immunol 2021; 147:1154-1163. [PMID: 33217410 PMCID: PMC8035160 DOI: 10.1016/j.jaci.2020.11.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 11/06/2020] [Accepted: 11/10/2020] [Indexed: 12/17/2022]
Abstract
Allergies to peanuts, tree nuts, and sesame seeds are among the most important food-related causes of anaphylaxis. Important clinical questions include: Why is there a variable occurrence of coallergy among these foods and Is this immunologically mediated? The clinical and immunologic data summarized here suggest an immunologic basis for these coallergies that is based on similarities among the 2S albumins. Data from component resolved diagnostics have highlighted the relationship between IgE binding to these allergens and the presence of IgE-mediated food allergy. Furthermore, in vitro and in vivo experiments provide strong evidence that the 2S albumins are the most important allergens in peanuts for inducing an allergic effector response. Although the 2S albumins are diverse, they have a common disulfide-linked core with similar physicochemical properties that make them prime candidates to explain much of the observed coallergy among peanuts, tree nuts, and sesame seeds. The well-established frequency of cashew and pistachio nut coallergy (64%-100%) highlights how the structural similarities among their 2S albumins may account for observed clinical cross-reactivity. A complete understanding of the physicochemical properties of the 2S albumins in peanuts, tree nuts, and sesame seeds will enhance our ability to diagnose, treat, and ultimately prevent these allergies.
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Affiliation(s)
- Stephen C Dreskin
- Division of Allergy and Clinical Immunology, Department of Medicine, University of Colorado Denver, Aurora, Colo.
| | - Stef J Koppelman
- Food Allergy Research and Resource Program, Department of Food Science and Technology, University of Nebraska, Lincoln, Neb
| | - Sandra Andorf
- Division of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, Calif
| | - Kari C Nadeau
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, Calif
| | - Anjeli Kalra
- Division of Allergy and Clinical Immunology, Department of Medicine, University of Colorado Denver, Aurora, Colo
| | - Werner Braun
- Sealy Center for Structural Biology and Molecular Biophysics, The University of Texas Medical Branch, Galveston, Tex; Department of Biochemistry and Molecular Biology, The University of Texas Medical Branch, Galveston, Tex
| | - Surendra S Negi
- Sealy Center for Structural Biology and Molecular Biophysics, The University of Texas Medical Branch, Galveston, Tex; Department of Biochemistry and Molecular Biology, The University of Texas Medical Branch, Galveston, Tex
| | - Xueni Chen
- Division of Allergy and Clinical Immunology, Department of Medicine, University of Colorado Denver, Aurora, Colo
| | - Catherine H Schein
- Department of Biochemistry and Molecular Biology, The University of Texas Medical Branch, Galveston, Tex; Institute for Human Infection and Immunity, The University of Texas Medical Branch, Galveston, Tex.
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7
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Greenhawt M, Shaker M, Wang J, Oppenheimer JJ, Sicherer S, Keet C, Swaggart K, Rank M, Portnoy JM, Bernstein J, Chu DK, Dinakar C, Golden D, Horner C, Lang DM, Lang ES, Khan DA, Lieberman J, Stukus D, Wallace D. Peanut allergy diagnosis: A 2020 practice parameter update, systematic review, and GRADE analysis. J Allergy Clin Immunol 2020; 146:1302-1334. [PMID: 32810515 DOI: 10.1016/j.jaci.2020.07.031] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/14/2020] [Accepted: 07/17/2020] [Indexed: 12/14/2022]
Abstract
Given the burden of disease and the consequences of a diagnosis of peanut allergy, it is important that peanut allergy be accurately diagnosed so that an appropriate treatment plan can be developed. However, a test that indicates there is peanut sensitization present (eg, a "positive" test) is not always associated with clinical reactivity. This practice parameter addresses the diagnosis of IgE-mediated peanut allergy, both in children and adults, as pertaining to 3 fundamental questions, and based on the systematic reviews and meta-analyses, makes recommendations for the clinician who is evaluating a patient for peanut allergy. These questions relate to when diagnostic tests should be completed, which diagnostic tests to utilize, and the utility (or lack thereof) of diagnostic testing to predict the severity of a future allergic reaction to peanut.
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Affiliation(s)
- Matthew Greenhawt
- Section of Allergy and Immunology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colo.
| | - Marcus Shaker
- Section of Allergy and Immunology, Dartmouth-Hitchcock Medical Center, Dartmouth Geisel School of Medicine, Lebanon, NH
| | - Julie Wang
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai and the Jaffe Food Allergy Institute, New York, NY
| | - John J Oppenheimer
- Department of Internal Medicine, New Jersey Medical School, Morristown, NJ
| | - Scott Sicherer
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai and the Jaffe Food Allergy Institute, New York, NY
| | - Corinne Keet
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Md
| | - Keri Swaggart
- Library Services, Children's Mercy Hospital, Kansas City, Mo
| | - Matthew Rank
- Division of Allergy, Asthma, and Clinical Immunology, Mayo Clinic, Scottsdale, Ariz; Division of Pulmonology, Phoenix Children's Hospital, Phoenix, Ariz
| | - Jay M Portnoy
- Division of Allergy, Asthma & Immunology, Department of Pediatrics, Children's Mercy Hospital, Kansas City, Mo
| | - Jonathan Bernstein
- Division of Immunology, Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Derek K Chu
- Department of Health Research Methods, Evidence & Impact, Department of Medicine, McMaster University, Hamilton, Ontario, Canada; The Research Institute of St. Joe's Hamilton, Hamilton, Ontario, Canada
| | - Chitra Dinakar
- Division of Allergy and Asthma, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, Calif
| | - David Golden
- Department of Allergy-Clinical Immunology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Md
| | - Carolyn Horner
- Division of Allergy, Immunology, and Pulmonary Medicine, Washington University School of Medicine, St Louis, Mo
| | - David M Lang
- Department of Allergy and Clinical Immunology, Cleveland Clinic, Cleveland, Ohio
| | - Eddy S Lang
- Department of Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - David A Khan
- Division of Allergy & Immunology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Tex
| | - Jay Lieberman
- Division of Allergy and Immunology, Department of Pediatrics, The University of Tennessee, Memphis, Tenn
| | - David Stukus
- Division of Allergy and Immunology, Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio
| | - Dana Wallace
- Nova Southeastern University College of Allopathic Medicine, Fort Lauderdale, Fla
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8
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Kansen HM, van Erp FC, Knulst AC, Ehlers AM, Lyons SA, Knol EF, Meijer Y, Otten HG, van der Ent CK, Le TM. Accurate Prediction of Peanut Allergy in One-Third of Adults Using a Validated Ara h 2 Cutoff. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 9:1667-1674.e3. [PMID: 33248282 DOI: 10.1016/j.jaip.2020.11.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 11/02/2020] [Accepted: 11/09/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The diagnostic value of peanut components is extensively studied in children, but to a lesser extent in adults with suspected peanut allergy. The use of peanut components in daily practice may reduce the need for double-blind placebo-controlled food challenges (DBPCFCs); however, validation studies are currently lacking. OBJECTIVE To evaluate the diagnostic value of (combined) peanut components and validate a previously found Ara h 2 cutoff level with 100% positive predictive value (PPV) in adults with suspected peanut allergy. METHODS Adults who underwent a peanut DBPCFC were included: 84 patients from a previous study (2002-2012) and 70 new patients (2012-2019). Specific IgE (sIgE) to peanut extract, Ara h 1, 2, 3, 6, and 8 was measured using ImmunoCAP. Diagnostic value was assessed with an area under the curve (AUC) analysis. RESULTS In total, 95 (62%) patients were peanut allergic. sIgE to Ara h 2 and Ara h 6 were the best predictors with an AUC (95% confidence interval) of 0.85 (0.79-0.91) and 0.85 (0.79-0.92), respectively. The Ara h 2 cutoff level with 100% PPV (≥1.75 kUA/L) was validated in the 70 new patients. Thirty percent of all included patients could be classified correctly as peanut allergic using this validated cutoff level. CONCLUSION sIgE to Ara h 2 and Ara h 6 have equally high discriminative ability. Peanut allergy can be predicted accurately in one-third of adults using a validated cutoff level of sIgE to Ara h 2.
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Affiliation(s)
- Hannah M Kansen
- Department of Dermatology and Allergology, University Medical Center, Utrecht University, Utrecht, the Netherlands; Department of Pediatric Pulmonology and Allergology, Wilhelmina Children's Hospital, University Medical Center, Utrecht University, Utrecht, the Netherlands.
| | - Francine C van Erp
- Department of Dermatology and Allergology, University Medical Center, Utrecht University, Utrecht, the Netherlands
| | - André C Knulst
- Department of Dermatology and Allergology, University Medical Center, Utrecht University, Utrecht, the Netherlands; Center of Translational Immunology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Anna M Ehlers
- Department of Dermatology and Allergology, University Medical Center, Utrecht University, Utrecht, the Netherlands; Center of Translational Immunology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Sarah A Lyons
- Department of Dermatology and Allergology, University Medical Center, Utrecht University, Utrecht, the Netherlands
| | - Edward F Knol
- Department of Dermatology and Allergology, University Medical Center, Utrecht University, Utrecht, the Netherlands; Center of Translational Immunology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Yolanda Meijer
- Department of Pediatric Pulmonology and Allergology, Wilhelmina Children's Hospital, University Medical Center, Utrecht University, Utrecht, the Netherlands
| | - Henny G Otten
- Center of Translational Immunology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Cornelis K van der Ent
- Department of Pediatric Pulmonology and Allergology, Wilhelmina Children's Hospital, University Medical Center, Utrecht University, Utrecht, the Netherlands
| | - Thuy-My Le
- Department of Dermatology and Allergology, University Medical Center, Utrecht University, Utrecht, the Netherlands; Center of Translational Immunology, University Medical Center Utrecht, Utrecht, the Netherlands
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9
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Santos AF, Du Toit G, O'Rourke C, Becares N, Couto-Francisco N, Radulovic S, Khaleva E, Basting M, Harris KM, Larson D, Sayre P, Plaut M, Roberts G, Bahnson HT, Lack G. Biomarkers of severity and threshold of allergic reactions during oral peanut challenges. J Allergy Clin Immunol 2020; 146:344-355. [PMID: 32311390 PMCID: PMC7417812 DOI: 10.1016/j.jaci.2020.03.035] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 02/10/2020] [Accepted: 03/20/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Oral food challenge (OFC) is the criterion standard to assess peanut allergy (PA), but it involves a risk of allergic reactions of unpredictable severity. OBJECTIVE Our aim was to identify biomarkers for risk of severe reactions or low dose threshold during OFC to peanut. METHODS We assessed Learning Early about Peanut Allergy study, Persistance of Oral Tolerance to Peanut study, and Peanut Allergy Sensitization study participants by administering the basophil activation test (BAT) and the skin prick test (SPT) and measuring the levels of peanut-specific IgE, Arachis hypogaea 2-specific IgE, and peanut-specific IgG4, and we analyzed the utility of the different biomarkers in relation to PA status, severity, and threshold dose of allergic reactions to peanut during OFC. RESULTS When a previously defined optimal cutoff was used, the BAT diagnosed PA with 98% specificity and 75% sensitivity. The BAT identified severe reactions with 97% specificity and 100% sensitivity. The SPT, level of Arachis hypogaea 2-specific IgE, level of peanut-specific IgE, and IgG4/IgE ratio also had 100% sensitivity but slightly lower specificity (92%, 93%, 90%, and 88%, respectively) to predict severity. Participants with lower thresholds of reactivity had higher basophil activation to peanut in vitro. The SPT and the BAT were the best individual predictors of threshold. Multivariate models were superior to individual biomarkers and were used to generate nomograms to calculate the probability of serious adverse events during OFC for individual patients. CONCLUSIONS The BAT diagnosed PA with high specificity and identified severe reactors and low threshold with high specificity and high sensitivity. The BAT was the best biomarker for severity, surpassed only by the SPT in predicting threshold. Nomograms can help estimate the likelihood of severe reactions and reactions to a low dose of allergen in individual patients with PA.
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Affiliation(s)
- Alexandra F Santos
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, London, United Kingdom; Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, United Kingdom; Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, United Kingdom; Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom.
| | - George Du Toit
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, London, United Kingdom; Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, United Kingdom; Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, United Kingdom
| | - Colin O'Rourke
- Immune Tolerance Network, Benaroya Research Institute, Seattle, Wash
| | - Natalia Becares
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, 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
| | - Natália Couto-Francisco
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, 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
| | - Suzana Radulovic
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, London, United Kingdom; Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, United Kingdom; Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, United Kingdom
| | - Ekaterina Khaleva
- Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, United Kingdom
| | - Monica Basting
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, London, United Kingdom; Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, United Kingdom
| | | | | | - Peter Sayre
- Division of Hematology-Oncology, Department of Medicine, University of California, San Francisco, Calif
| | - Marshall Plaut
- National Institute of Allergy and Infectious Diseases, Bethesda, Md
| | - Graham Roberts
- David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, Southampton, United Kingdom; National Institute for Health Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and Clinical and Experimental Sciences Academic Unit, University of Southampton Faculty of Medicine, Southampton, United Kingdom
| | - Henry T Bahnson
- Immune Tolerance Network, Benaroya Research Institute, Seattle, Wash
| | - Gideon Lack
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, London, United Kingdom; Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, United Kingdom; Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, United Kingdom; Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom.
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10
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Buyuktiryaki B, Santos AF. Food allergy severity predictions based on cellular in vitro tests. Expert Rev Mol Diagn 2020; 20:679-692. [PMID: 32536279 DOI: 10.1080/14737159.2020.1782192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Food allergy is increasing in prevalence and the severity of allergic reactions is unpredictable. Identifying food-allergic patients at high risk of severe reactions would allow us to offer a personalized and improved management for these patients. AREAS COVERED We review the evidence for using the levels of specific IgE, the nature of the allergen, and cellular tests to identify patients at high risk of developing severe allergic reactions to foods. EXPERT OPINION The evidence about whether the quantity of allergen-specific IgE reflects the severity of allergic reactions to foods is conflicting, with some positive and some negative studies. For some foods, specific IgE to individual components (e.g. Ara h 2 in peanut) can provide additional information. However, more important than the quantity of IgE is possibly the quality of IgE, which can be captured by individual measurements of affinity/avidity, diversity, and specific activity, but is best measured overall using the basophil and mast cell activation tests, which assess the function of IgE in its ability to induce cell activation, degranulation, and mediator release. Biomarkers look at a single aspect of the allergic response and should be interpreted in the broader clinical context for each individual patient assessed.
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Affiliation(s)
- Betul Buyuktiryaki
- Division of Pediatric Allergy, Koc University Hospital , İstanbul, Turkey.,Department of Paediatric Allergy, Evelina London, Guy's and ST Thomas' Hospital NHS Foundation Trust , London, UK
| | - Alexandra F Santos
- Department of Paediatric Allergy, Evelina London, Guy's and ST Thomas' Hospital NHS Foundation Trust , London, UK.,Department of Women and Children's Health (Paediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London , London, UK.,Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London , London, UK.,Asthma UK Centre in Allergic Mechanisms of Asthma , London, UK
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11
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Affiliation(s)
- Alexandra F Santos
- Department of Women and Children's Health (Paediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London , London, UK.,Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London , London, UK.,Children's Allergy Service, Evelina London, Guy's and St Thomas' Hospital , London, UK.,Asthma UK Centre in Allergic Mechanisms of Asthma , London, UK
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12
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de Jongh HHJ, de Jong GAH, Apostolovic D, Taylor SL, Baumert JL, Koppelman SJ. Effect of heat treatment on the conformational stability of intact and cleaved forms ofthe peanut allergen Ara h 6 in relation to its IgE-binding potency. Food Chem 2020; 326:127027. [PMID: 32438232 DOI: 10.1016/j.foodchem.2020.127027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/16/2020] [Accepted: 05/08/2020] [Indexed: 01/14/2023]
Abstract
This work reports on theeffect of heat treatment on the protein conformational stabilityof intact and post-translationallycleaved peanut allergen Ara h 6 in relation to IgE-binding. Intact and post-translationallycleaved Ara h 6 are structurally similar and theirstrong resistance to denaturant-inducedunfolding is comparable. Only upon exposure toautoclave conditions the twoforms of Ara h 6 demonstrated susceptibility toirreversible denaturationresulting in a significant decrease in IgE-binding potency. Thisreduction isfor the intact protein more pronounced than for than for the cleaved form. This isattributed to less conformational constrains of the cleaved form comparedtointact, as suggested by the 2-fold lower activation energy for unfoldingfound for the cleavedform. Overall, harsh conditionsare required to denature Ara h 6 and to significantly reduce its IgE-bindingpotency. The cleavedform possesses more resistance to such denaturation than the intactform.
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Affiliation(s)
| | | | - Danijela Apostolovic
- Clinical Immunology and Allergy Unit, Department of Medicine Solna, Karolinska Institutet, Solnavägen 1, 171 77 Solna, Sweden
| | - Steve L Taylor
- Food Allergy Research and Resource Program, Department of Food Science & Technology, University of Nebraska, 279 Food Innovation Center, Lincoln, NE 68588-6207, USA
| | - Joseph L Baumert
- Food Allergy Research and Resource Program, Department of Food Science & Technology, University of Nebraska, 279 Food Innovation Center, Lincoln, NE 68588-6207, USA
| | - Stef J Koppelman
- Food Allergy Research and Resource Program, Department of Food Science & Technology, University of Nebraska, 279 Food Innovation Center, Lincoln, NE 68588-6207, USA.
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13
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Popp J, Trendelenburg V, Niggemann B, Randow S, Völker E, Vogel L, Reuter A, Spiric J, Schiller D, Beyer K, Holzhauser T. Pea (Pisum sativum) allergy in children: Pis s 1 is an immunodominant major pea allergen and presents IgE binding sites with potential diagnostic value. Clin Exp Allergy 2020; 50:625-635. [PMID: 32078204 DOI: 10.1111/cea.13590] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 02/07/2020] [Accepted: 02/15/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Food allergy to pea (Pisum sativum) has been rarely studied in children at the clinical and molecular levels. OBJECTIVE To elucidate the allergenic relevance and diagnostic value of pea 7S globulin Pis s 1, nsLTP, and 2S albumins PA1 and PA2 in children. METHODS Children with pea-specific IgE ≥ 0.35 kUA /L and clinical evidence of pea allergy or tolerance were included in the study. IgE binding against pea total protein extract, recombinant (r) rPis s 1, rPA1, rPA2, and natural nsLTP was analysed using IgE immunoblot/inhibition. Mediator release potency was investigated in passively sensitized rat basophil leukaemia (RBL) 2H3-cells. IgE binding to synthetic overlapping peptides of Pis s 1 was detected on multipeptide microarrays. RESULTS 19 pea-sensitized children were included, 14 with doctors' diagnosed allergy and 5 with tolerance to pea (median age 3.5 and 4.5 years, respectively). 11/14 (78%) pea-allergic and 1/5 (20%) tolerant children were sensitized to Pis s 1. Under the reducing conditions of immunoblot analysis, IgE binding to rPA1 was negligible, sensitization to rPA2 and nsLTP undetectable. Compared to pea total protein extract, rPis s 1 displayed on average 58% IgE binding capacity and a 20-fold higher mediator release potency. Selected Pis s 1-related peptides displayed IgE binding in pea-allergic but not in pea-tolerant children. CONCLUSIONS AND CLINICAL RELEVANCE In this study group, Pis s 1 is a major immunodominant allergen in pea-allergic children. Evidence for sensitization to nsLTP and 2S albumins was low but requires further verification with regard to conformational epitopes. Recombinant Pis s 1 and related peptides which were exclusively recognized by pea-allergic children may improve in vitro diagnosis of pea allergy once verified in prospective studies with larger study groups.
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Affiliation(s)
- Jasmin Popp
- Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - Valérie Trendelenburg
- Department of Pediatric Pulmonology, Immunology and Intensive Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Bodo Niggemann
- Department of Pediatric Pulmonology, Immunology and Intensive Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Stefanie Randow
- Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - Elke Völker
- Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - Lothar Vogel
- Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - Andreas Reuter
- Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - Jelena Spiric
- Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - Dirk Schiller
- Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - Kirsten Beyer
- Department of Pediatric Pulmonology, Immunology and Intensive Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
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Pandey AK, Sudini HK, Upadhyaya HD, Varshney RK, Pandey MK. Hypoallergen Peanut Lines Identified Through Large-Scale Phenotyping of Global Diversity Panel: Providing Hope Toward Addressing One of the Major Global Food Safety Concerns. Front Genet 2019; 10:1177. [PMID: 31827488 PMCID: PMC6890724 DOI: 10.3389/fgene.2019.01177] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 10/24/2019] [Indexed: 01/14/2023] Open
Abstract
Peanut allergy is one of the serious health concern and affects more than 1% of the world's population mainly in Americas, Australia, and Europe. Peanut allergy is sometimes life-threatening and adversely affect the life quality of allergic individuals and their families. Consumption of hypoallergen peanuts is the best solution, however, not much effort has been made in this direction for identifying or developing hypoallergen peanut varieties. A highly diverse peanut germplasm panel was phenotyped using a recently developed monoclonal antibody-based ELISA protocol to quantify five major allergens. Results revealed a wide phenotypic variation for all the five allergens studied i.e., Ara h 1 (4-36,833 µg/g), Ara h 2 (41-77,041 µg/g), Ara h 3 (22-106,765 µg/g), Ara h 6 (829-103,892 µg/g), and Ara h 8 (0.01-70.12 µg/g). The hypoallergen peanut genotypes with low levels of allergen proteins for Ara h 1 (4 µg/g), Ara h 2 (41 µg/g), Ara h 3 (22 µg/g), Ara h 6 (829 µg/g), and Ara h 8 (0.01 µg/g) have paved the way for their use in breeding and genomics studies. In addition, these hypoallergen peanut genotypes are available for use in cultivation and industry, thus opened up new vistas for fighting against peanut allergy problem across the world.
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Affiliation(s)
| | | | | | | | - Manish K. Pandey
- International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), Hyderabad, India
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15
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Comparison of recovery and immunochemical detection of peanut proteins from differentially roasted peanut flour using ELISA. Food Chem 2019; 292:32-38. [DOI: 10.1016/j.foodchem.2019.04.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 04/03/2019] [Accepted: 04/06/2019] [Indexed: 11/22/2022]
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16
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Pandey AK, Varshney RK, Sudini HK, Pandey MK. An Improved Enzyme-Linked Immunosorbent Assay (ELISA) Based Protocol Using Seeds for Detection of Five Major Peanut Allergens Ara h 1, Ara h 2, Ara h 3, Ara h 6, and Ara h 8. Front Nutr 2019; 6:68. [PMID: 31231654 PMCID: PMC6560202 DOI: 10.3389/fnut.2019.00068] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 04/25/2019] [Indexed: 02/05/2023] Open
Abstract
Peanut allergy is an important health concern among many individuals. As there is no effective treatment to peanut allergy, continuous monitoring of peanut-based products, and their sources is essential. Precise detection of peanut allergens is key for identification and development of improved peanut varieties with minimum or no allergens in addition to estimating the levels in peanut-based products available in food chain. The antibody based ELISA protocol along with sample preparation was standardized for Ara h 1, Ara h 2, Ara h 3, Ara h 6, and Ara h 8 to estimate their quantities in peanut seeds. Three different dilutions were optimized to precisely quantify target allergen proteins in peanut seeds such as Ara h 1 (1/1,000, 1/2,000, and 1/4,000), Ara h 2 and Ara h 3 (1/5,000, 1/10,000, and 1/20,000), Ara h 6 (1/40,000, 1/80,000, and 1/1,60,000), and Ara h 8 (1/10, 1/20, and 1/40). These dilutions were finalized for each allergen based on the accuracy of detection by achieving <20% coefficient of variation in three technical replicates. This protocol captured wide variation of allergen proteins in selected peanut genotypes for Ara h 1 (77-46,106 μg/g), Ara h 2 (265-5,426 μg/g), Ara h 3 (382-12,676 μg/g), Ara h 6 (949-43,375 μg/g), and Ara h 8 (0.385-6 μg/g). The assay is sensitive and reliable in precise detection of five major peanut allergens in seeds. Deployment of such protocol allows screening of large scale germplasm and breeding lines while developing peanut varieties with minimum allergenicity to ensure food safety.
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Affiliation(s)
| | | | - Hari K. Sudini
- International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), Hyderabad, India
| | - Manish K. Pandey
- International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), Hyderabad, India
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17
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Celakovská J, Bukac J, Ettler K, Vaneckova J, Krcmova I, Ettlerova K, Krejsek J. The occurrence of food hypersensitivity reactions and the relation to the sensitization to grass and trees in atopic dermatitis patients 14 years of age and older. Indian J Dermatol 2019; 64:346-354. [PMID: 31543527 PMCID: PMC6749770 DOI: 10.4103/ijd.ijd_164_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: Methods: Results: Conclusion:
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18
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Versluis A, van Os-Medendorp H, Blom WM, Michelsen-Huisman AD, Castenmiller JJM, Noteborn HPJM, Houben GF, Knulst AC. Potential cofactors in accidental food allergic reactions are frequently present but may not influence severity and occurrence. Clin Exp Allergy 2018; 49:207-215. [PMID: 30244525 DOI: 10.1111/cea.13282] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 09/06/2018] [Accepted: 09/19/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Cofactors, such as physical exercise and alcohol intake, might be associated with the severity or occurrence of food allergic reactions. OBJECTIVE To gain insight into the frequency of presence of potential cofactors in accidental food allergic reactions in adults and to what extent these factors influence the severity and occurrence of allergic reactions. METHODS A prospective cohort study was conducted, with a 1-year follow-up in adult patients with a physician-diagnosed food allergy. Patients were required to fill in a questionnaire after every accidental allergic reactions to food over a 1-year period. The primary outcome measure was the frequency that potential cofactors were present in these allergic reactions. RESULTS A total of 157 patients were included, of which 46% reported a total of 153 reactions during a 1-year follow-up period. In 74% of the reactions, ≥1 potential cofactor was reported to be present: tiredness (38%), alcohol intake (16%), stress (14%), symptoms of pollinosis (16%), symptoms of asthma (9%), sickness/flu (3%), physical exercise (3%) and use of analgesics (2%). More than one potential cofactor was reported in almost half of all reactions (47%). There was no significant difference in the presence of these factors between mild, moderate and severe reactions (P = 0.522). In the total study population, 9% of the patients used medication that might act as cofactor (antacids, angiotensin receptor blockers [ARBs], beta blockers and angiotensin-converting enzyme inhibitors [ACEIs]) on a daily basis, which however did not influence the occurrence of reactions. Furthermore, 38% daily used allergy-suppressing medication. CONCLUSIONS Although factors suggested to be cofactors were frequently present during accidental food allergic reactions, we found no evidence for an association between the potential cofactors examined and reaction severity, in a population where most reactions were of mild to moderate severity.
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Affiliation(s)
- Astrid Versluis
- Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - W Marty Blom
- TNO, Netherlands Organization for Applied Scientific Research, Zeist, The Netherlands
| | | | | | | | - Geert F Houben
- TNO, Netherlands Organization for Applied Scientific Research, Zeist, The Netherlands
| | - André C Knulst
- Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht, The Netherlands
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19
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de Jong GAH, Jayasena S, Johnson P, Marsh J, Apostolovic D, van Hage M, Nordlee J, Baumert J, Taylor SL, Roucairol C, de Jongh H, Koppelman SJ. Purification and Characterization of Naturally Occurring Post-Translationally Cleaved Ara h 6, an Allergen That Contributes Substantially to the Allergenic Potency of Peanut. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2018; 66:10855-10863. [PMID: 30284821 DOI: 10.1021/acs.jafc.8b03140] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The 2S albumin Ara h 6 is one of the most important peanut allergens. A post-translationally cleaved Ara h 6 (pAra h 6) was purified from Virginia type peanuts, and the cleavage site was mapped using high-resolution mass spectrometry. Compared to intact Ara h 6, pAra h 6 lacks a 5-amino acid stretch, resembling amino acids 43-47 (UniProt accession number Q647G9) in the nonstructured loop. Consequently, pAra h 6 consists of two chains: an N-terminal chain of approximately 5 kDa and a C-terminal chain of approximately 9 kDa, held together by disulfide bonds. Intermediate post-translationally cleaved products, in which this stretch is cleaved yet still attached to one of the subunits, are also present. The secondary structure and immunoglobulin E (IgE) binding of pAra h 6 resembles that of intact Ara h 6, indicating that the loss of the nonstructured loop is not critical for maintaining the protein structure. Commercially available monoclonal and polyclonal immunoglobulin G (IgG) antibodies directed to Ara h 6 react with both intact Ara h 6 and pAra h 6, suggesting that the involved epitopes are not located in the area that is post-translationally cleaved. No differences between intact Ara h 6 and pAra h 6 in terms of IgE binding were found, suggesting that the area that is post-translationally cleaved is not involved in IgE epitopes either. For all main cultivars Runner, Virginia, Valencia, and Spanish, intact Ara h 6 and pAra h 6 occur in peanut at similar levels, indicating that pAra h 6 is a consistent and important contributor to the allergenic potency of peanut.
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Affiliation(s)
| | - Shyamali Jayasena
- Food Allergy Research and Resource Program, Department of Food Science & Technology , University of Nebraska , 279 Food Innovation Center , Lincoln , Nebraska 68588-6207 , United States
| | - Phil Johnson
- Food Allergy Research and Resource Program, Department of Food Science & Technology , University of Nebraska , 279 Food Innovation Center , Lincoln , Nebraska 68588-6207 , United States
| | - Justin Marsh
- Food Allergy Research and Resource Program, Department of Food Science & Technology , University of Nebraska , 279 Food Innovation Center , Lincoln , Nebraska 68588-6207 , United States
| | - Danijela Apostolovic
- Immunology and Allergy Unit, Department of Medicine Solna , Karolinska Institutet , 171 77 Stockholm , Sweden
| | - Marianne van Hage
- Immunology and Allergy Unit, Department of Medicine Solna , Karolinska Institutet , 171 77 Stockholm , Sweden
| | - Julie Nordlee
- TNO , Utrechtseweg 48 , 3704 HE , Zeist , The Netherlands
| | - Joe Baumert
- TNO , Utrechtseweg 48 , 3704 HE , Zeist , The Netherlands
| | - Steve L Taylor
- TNO , Utrechtseweg 48 , 3704 HE , Zeist , The Netherlands
| | - Camille Roucairol
- DBV Technologies , Development Department , 92120 Montrouge , France
| | | | - Stef J Koppelman
- Food Allergy Research and Resource Program, Department of Food Science & Technology , University of Nebraska , 279 Food Innovation Center , Lincoln , Nebraska 68588-6207 , United States
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20
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Koppelman SJ, Smits M, Tomassen M, de Jong GAH, Baumert J, Taylor SL, Witkamp R, Veldman RJ, Pieters R, Wichers H. Release of Major Peanut Allergens from Their Matrix under Various pH and Simulated Saliva Conditions-Ara h2 and Ara h6 Are Readily Bio-Accessible. Nutrients 2018; 10:E1281. [PMID: 30208580 PMCID: PMC6165493 DOI: 10.3390/nu10091281] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 08/28/2018] [Accepted: 08/31/2018] [Indexed: 01/24/2023] Open
Abstract
The oral mucosa is the first immune tissue that encounters allergens upon ingestion of food. We hypothesized that the bio-accessibility of allergens at this stage may be a key determinant for sensitization. Light roasted peanut flour was suspended at various pH in buffers mimicking saliva. Protein concentrations and allergens profiles were determined in the supernatants. Peanut protein solubility was poor in the pH range between 3 and 6, while at a low pH (1.5) and at moderately high pHs (>8), it increased. In the pH range of saliva, between 6.5 and 8.5, the allergens Ara h2 and Ara h6 were readily released, whereas Ara h1 and Ara h3 were poorly released. Increasing the pH from 6.5 to 8.5 slightly increased the release of Ara h1 and Ara h3, but the recovery remained low (approximately 20%) compared to that of Ara h2 and Ara h6 (approximately 100% and 65%, respectively). This remarkable difference in the extraction kinetics suggests that Ara h2 and Ara h6 are the first allergens an individual is exposed to upon ingestion of peanut-containing food. We conclude that the peanut allergens Ara h2 and Ara h6 are quickly bio-accessible in the mouth, potentially explaining their extraordinary allergenicity.
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Affiliation(s)
- Stef J Koppelman
- Food Allergy Research and Resource Program, Department of Food Science & Technology, University of Nebraska, 279 Food Innovation Center, Lincoln, NE 68588-6207, USA.
| | - Mieke Smits
- Research Group Innovative Testing in Life Sciences and Chemistry, University of Applied Sciences, Heidelberglaan 7, 3584 CS Utrecht, The Netherlands.
| | - Monic Tomassen
- Food & Biobased Research, Wageningen University and Research, Bornse Weilanden 9, P.O. Box 17, 6700 AA Wageningen, The Netherlands.
| | | | - Joe Baumert
- Food Allergy Research and Resource Program, Department of Food Science & Technology, University of Nebraska, 279 Food Innovation Center, Lincoln, NE 68588-6207, USA.
| | - Steve L Taylor
- Food Allergy Research and Resource Program, Department of Food Science & Technology, University of Nebraska, 279 Food Innovation Center, Lincoln, NE 68588-6207, USA.
| | - Renger Witkamp
- Department of Human Nutrition, Wageningen University and Research, Stippeneng 4, 6708 WE Wageningen, The Netherlands.
| | - Robert Jan Veldman
- Research Group Innovative Testing in Life Sciences and Chemistry, University of Applied Sciences, Heidelberglaan 7, 3584 CS Utrecht, The Netherlands.
| | - Raymond Pieters
- Research Group Innovative Testing in Life Sciences and Chemistry, University of Applied Sciences, Heidelberglaan 7, 3584 CS Utrecht, The Netherlands.
- Institute for Risk Assessment Sciences, Faculty of Veterinary Medicines, Utrecht University, Yalelaan 1, 3584 CL, Utrecht, The Netherlands.
| | - Harry Wichers
- Food & Biobased Research, Wageningen University and Research, Bornse Weilanden 9, P.O. Box 17, 6700 AA Wageningen, The Netherlands.
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21
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Pettersson ME, Koppelman GH, Flokstra-de Blok BMJ, Kollen BJ, Dubois AEJ. Prediction of the severity of allergic reactions to foods. Allergy 2018; 73:1532-1540. [PMID: 29380392 PMCID: PMC6033096 DOI: 10.1111/all.13423] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2018] [Indexed: 12/14/2022]
Abstract
Background There is currently considerable uncertainty regarding what the predictors of the severity of diagnostic or accidental food allergic reactions are, and to what extent the severity of such reactions can be predicted. Objective To identify predictors for the severity of diagnostic and accidental food allergic reactions and to quantify their impact. Methods The study population consisted of children with a double‐blind, placebo‐controlled food challenge (DBPCFC)–confirmed food allergy to milk, egg, peanut, cashew nut, and/or hazelnut. The data were analyzed using multiple linear regression analysis. Missing values were imputed using multiple imputation techniques. Two scoring systems were used to determine the severity of the reactions. Results A total of 734 children were included. Independent predictors for the severity of the DBPCFC reaction were age (B = 0.04, P = .001), skin prick test ratio (B = 0.30, P < .001), eliciting dose (B = −0.09, P < .001), level of specific immunoglobulin E (B = 0.15, P < .001), reaction time during the DBPCFC (B = −0.01, P = .004), and severity of accidental reaction (B = 0.08, P = .015). The total explained variance of this model was 23.5%, and the eliciting dose only contributed 4.4% to the model. Independent predictors for more severe accidental reactions with an explained variance of 7.3% were age (B = 0.03, P = .014), milk as causative food (B = 0.77, P < .001), cashew as causative food (B = 0.54, P < .001), history of atopic dermatitis (B = −0.47, P = .006), and severity of DBPCFC reaction (B = 0.12, P = .003). Conclusions The severity of DBPCFCs and accidental reactions to food remains largely unpredictable. Clinicians should not use the eliciting dose obtained from a graded food challenge for the purposes of making risk‐related management decisions.
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Affiliation(s)
- M. E. Pettersson
- Department of Pediatric Pulmonology and Pediatric Allergy; University Medical Center Groningen, University of Groningen; Groningen The Netherlands
- GRIAC Research Institute; University Medical Center Groningen, University of Groningen; Groningen The Netherlands
| | - G. H. Koppelman
- Department of Pediatric Pulmonology and Pediatric Allergy; University Medical Center Groningen, University of Groningen; Groningen The Netherlands
- GRIAC Research Institute; University Medical Center Groningen, University of Groningen; Groningen The Netherlands
| | - B. M. J. Flokstra-de Blok
- GRIAC Research Institute; University Medical Center Groningen, University of Groningen; Groningen The Netherlands
- Department of General Practice; University Medical Center Groningen, University of Groningen; Groningen The Netherlands
| | - B. J. Kollen
- Department of General Practice; University Medical Center Groningen, University of Groningen; Groningen The Netherlands
| | - A. E. J. Dubois
- Department of Pediatric Pulmonology and Pediatric Allergy; University Medical Center Groningen, University of Groningen; Groningen The Netherlands
- GRIAC Research Institute; University Medical Center Groningen, University of Groningen; Groningen The Netherlands
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22
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Characterization of narrow-leaf lupin (Lupinus angustifolius L.) recombinant major allergen IgE-binding proteins and the natural β-conglutin counterparts in sweet lupin seed species. Food Chem 2018; 244:60-70. [DOI: 10.1016/j.foodchem.2017.10.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 09/14/2017] [Accepted: 10/05/2017] [Indexed: 11/22/2022]
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23
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Remington B, Broekman HCH, Blom WM, Capt A, Crevel RWR, Dimitrov I, Faeste CK, Fernandez-Canton R, Giavi S, Houben GF, Glenn KC, Madsen CB, Kruizinga AK, Constable A. Approaches to assess IgE mediated allergy risks (sensitization and cross-reactivity) from new or modified dietary proteins. Food Chem Toxicol 2017; 112:97-107. [PMID: 29258956 DOI: 10.1016/j.fct.2017.12.025] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 11/03/2017] [Accepted: 12/15/2017] [Indexed: 11/16/2022]
Abstract
The development and introduction of new dietary protein sources has the potential to improve food supply sustainability. Understanding the potential allergenicity of these new or modified proteins is crucial to ensure protection of public health. Exposure to new proteins may result in de novo sensitization, with or without clinical allergy, or clinical reactions through cross-reactivity. In this paper we review the potential of current methodologies (in silico, in vitro degradation, in vitro IgE binding, animal models and clinical studies) to address these outcomes for risk assessment purposes for new proteins, and especially to identify and characterise the risk of sensitization for IgE mediated allergy from oral exposure. Existing tools and tests are capable of assessing potential crossreactivity. However, there are few possibilities to assess the hazard due to de novo sensitization. The only methods available are in vivo models, but many limitations exist to use them for assessing risk. We conclude that there is a need to understand which criteria adequately define allergenicity for risk assessment purposes, and from these criteria develop a more suitable battery of tests to distinguish between proteins of high and low allergenicity, which can then be applied to assess new proteins with unknown risks.
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Affiliation(s)
| | - H C H Broekman
- Dep. Dermatology/Allergology, University Medical Centre Utrecht (UMCU), P.O. Box 85500, The Netherlands
| | | | - A Capt
- Bayer SAS, Sophia Antipolis, France
| | - R W R Crevel
- Safety & Environmental Assurance Centre, Unilever, Bedford, UK
| | - I Dimitrov
- Faculty of Pharmacy, Medical University of Sofia, Sofia, 1000 Bulgaria
| | - C K Faeste
- Norwegian Veterinary Institute, Oslo, Norway
| | - R Fernandez-Canton
- Monsanto Europe S.A., Avenue de Tervuren 270-272, B-1150 Brussels, Belgium
| | - S Giavi
- Allergy Department, 2nd Paediatric Clinic, University of Athens, Athens, Greece
| | | | - K C Glenn
- Monsanto Company, 800 N. Lindbergh Boulevard, St. Louis, MO 63017, USA
| | - C B Madsen
- National Food Institute, Technical University of Denmark, Søborg, Denmark
| | | | - A Constable
- Nestec Ltd, P.O. Box 44, CH-1000 Lausanne 26, Switzerland
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24
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Blankestijn MA, Otten HG, Suer W, Weimann A, Knol EF, Knulst AC. Specific IgE to peanut 2S albumin Ara h 7 has a discriminative ability comparable to Ara h 2 and 6. Clin Exp Allergy 2017; 48:60-65. [PMID: 28906044 DOI: 10.1111/cea.13030] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 08/15/2017] [Accepted: 09/04/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND Little is known on the clinical relevance of peanut 2S albumin Ara h 7. OBJECTIVE To investigate the discriminative ability of Ara h 7 in peanut allergy and assess the role of cross-reactivity between Ara h 2, 6 and Ara h 7 isoforms. METHODS Sensitization to recombinant peanut storage proteins Ara h 1, 2, 3, 6, and 7 was assessed using a line blot in sera from 40 peanut-tolerant and 40 peanut-allergic patients, based on food challenge outcome. A dose-dependent ELISA inhibition experiment was performed with recombinant Ara h 2, 6 and Ara h 7 isoforms. RESULTS For Ara h 7.0201, an area under the ROC curve was found of 0.83, comparable to Ara h 2 (AUC 0.81) and Ara h 6 (AUC 0.85). Ara h 7 intensity values strongly correlated with those from Ara h 2 and 6 (rs = 0.81). Of all patients sensitized to 2S albumins Ara h 2, 6, or 7, the majority was co-sensitized to all three (n = 24, 68%), although mono-sensitization to either 2S albumin was also observed in selected patients (Ara h 2: n = 6, 17%; Ara h 6: n = 2, 6%; Ara h 7: n = 2, 6%). Binding to Ara h 7.0101 could be strongly inhibited by Ara h 7.0201, but not the other way around. CONCLUSIONS AND CLINICAL RELEVANCE Specific IgE against Ara h 7.0201 has a predictive ability for peanut allergy similar to Ara h 2 and 6 and possesses unique IgE epitopes as well as epitopes shared between the other Ara h 7 isoform and Ara h 2 and 6. While co-sensitization to all three 2S albumins is most common, mono-sensitization to either Ara h 2, 6, or 7 occurs in selected patients, leading to a risk of misdiagnosis when testing for a single 2S albumin.
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Affiliation(s)
- M A Blankestijn
- Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - H G Otten
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - W Suer
- EUROIMMUN, Lübeck, Germany
| | | | - E F Knol
- Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - A C Knulst
- Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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25
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Schwager C, Kull S, Behrends J, Röckendorf N, Schocker F, Frey A, Homann A, Becker WM, Jappe U. Peanut oleosins associated with severe peanut allergy-importance of lipophilic allergens for comprehensive allergy diagnostics. J Allergy Clin Immunol 2017; 140:1331-1338.e8. [PMID: 28342912 DOI: 10.1016/j.jaci.2017.02.020] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 12/15/2016] [Accepted: 02/08/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Peanut allergy is one of the most common and most severe food allergies in Western countries and its accurate diagnosis to prevent potential life-threatening allergic reactions is crucial. However, aqueous extracts used for routine diagnostic measurements are devoid of lipophilic allergens such as oleosins. We have recently succeeded in the isolation and purification of these unique proteins, and the present study evaluates their allergenic potential and clinical relevance. OBJECTIVE We sought to assess allergenicity and sensitization prevalence of oleosins obtained from both raw and in-shell roasted peanuts. In addition, we tested the utilization of natural and recombinant oleosins for allergy diagnostic purposes. METHODS Oleosin sensitization, prevalence, and impact of thermal processing were analyzed by immunoblot with sera from 52 peanut-allergic individuals displaying different clinical phenotypes. The application of natural and recombinant oleosins for allergy diagnostics was investigated by basophil activation test (BAT). IgE-binding epitopes were identified by oligopeptide microarray. RESULTS Sensitization to oleosins was observed exclusively in peanut-allergic subjects suffering from severe systemic reactions. IgE-binding capacity of oleosins derived from in-shell roasted peanuts was increased as shown by immunoblot analysis and BAT. Both natural and recombinant molecules can be used to identify oleosin-sensitized patients by BAT. A linear epitope of Ara h 15 was determined that displays high similarity to other seed-derived oleosins. CONCLUSIONS Oleosins are clinically relevant peanut allergens and most likely associated with severe allergic symptoms. In-shell roasting increases their allergenicity, which is consistent with the observation that most allergic reactions are in connection with roasted peanuts.
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Affiliation(s)
- Christian Schwager
- Division of Clinical and Molecular Allergology, Research Center Borstel, Priority Research Area Asthma and Allergy, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Borstel, Germany
| | - Skadi Kull
- Division of Clinical and Molecular Allergology, Research Center Borstel, Priority Research Area Asthma and Allergy, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Borstel, Germany
| | - Jochen Behrends
- Core Facility Fluorescence Cytometry, Research Center Borstel, Borstel, Germany
| | - Niels Röckendorf
- Division of Mucosal Immunology and Diagnostics, Research Center Borstel, Priority Research Area Asthma and Allergy, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Borstel, Germany
| | - Frauke Schocker
- Division of Clinical and Molecular Allergology, Research Center Borstel, Priority Research Area Asthma and Allergy, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Borstel, Germany
| | - Andreas Frey
- Division of Mucosal Immunology and Diagnostics, Research Center Borstel, Priority Research Area Asthma and Allergy, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Borstel, Germany
| | - Arne Homann
- Division of Clinical and Molecular Allergology, Research Center Borstel, Priority Research Area Asthma and Allergy, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Borstel, Germany
| | - Wolf-Meinhard Becker
- Division of Clinical and Molecular Allergology, Research Center Borstel, Priority Research Area Asthma and Allergy, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Borstel, Germany
| | - Uta Jappe
- Division of Clinical and Molecular Allergology, Research Center Borstel, Priority Research Area Asthma and Allergy, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Borstel, Germany; Interdisciplinary Allergy Outpatient Clinic, Department of Internal Medicine, University of Luebeck, Luebeck, Germany.
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26
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Blankestijn MA, Remington BC, Houben GF, Baumert JL, Knulst AC, Blom WM, Klemans RJB, Taylor SL. Threshold Dose Distribution in Walnut Allergy. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2017; 5:376-380. [PMID: 28110058 DOI: 10.1016/j.jaip.2016.12.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 12/12/2016] [Accepted: 12/19/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND In food allergy, eliciting doses (EDs) of foods on a population level can improve risk management and labeling strategies for the food industry and regulatory authorities. Previously, data available for walnut were unsuitable to determine EDs. OBJECTIVE The objective of this study was to determine EDs for walnut allergic adults and to compare with previously established threshold data for peanut and tree nuts. METHODS Prospectively, adult subjects with a suspected walnut allergy underwent a low-dose double-blind, placebo-controlled food challenge. Individual no observed and lowest observed adverse effect levels were determined and log-normal, log-logistic, and Weibull models were fit to the data. Estimated ED values were calculated for the ED5, ED10, and ED50, the dose respectively predicted to provoke an allergic reaction in 5%, 10%, and 50% of the walnut allergic population. RESULTS Fifty-seven subjects were challenged and 33 subjects were confirmed to be walnut allergic. Objective symptoms occurred in 20 of the positive challenges (61%). The cumulative EDs in the distribution models ranged from 3.1 to 4.1 mg for the ED05, from 10.6 to 14.6 mg walnut protein for the ED10, and from 590 to 625 mg of walnut protein for the ED50. CONCLUSIONS Our data indicate that population EDs for walnut are slightly higher compared with those for peanut and hazelnut allergy. Currently available data indicate that the ED values for hazelnut could be used as a conservative temporary placeholder when implementing risk management strategies for other tree nuts where little or no food challenge data are available.
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Affiliation(s)
- Mark A Blankestijn
- Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Ben C Remington
- The Netherlands Organization for Applied Scientific Research (TNO), Zeist, The Netherlands
| | - Geert F Houben
- Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht, The Netherlands; The Netherlands Organization for Applied Scientific Research (TNO), Zeist, The Netherlands
| | - Joe L Baumert
- Food Allergy Research & Resource Program (FARRP), University of Nebraska, Lincoln, Neb
| | - André C Knulst
- Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - W Marty Blom
- The Netherlands Organization for Applied Scientific Research (TNO), Zeist, The Netherlands
| | - Rob J B Klemans
- Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Steve L Taylor
- Food Allergy Research & Resource Program (FARRP), University of Nebraska, Lincoln, Neb
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27
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Guillon B, Bernard H, Drumare MF, Hazebrouck S, Adel-Patient K. Heat processing of peanut seed enhances the sensitization potential of the major peanut allergen Ara h 6. Mol Nutr Food Res 2016; 60:2722-2735. [PMID: 27374416 PMCID: PMC5213772 DOI: 10.1002/mnfr.201500923] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 05/27/2016] [Accepted: 06/08/2016] [Indexed: 11/11/2022]
Abstract
SCOPE Processing of food has been shown to impact IgE binding and functionality of food allergens. In the present study, we investigated the impact of heat processing on the sensitization capacity of Ara h 6, a major peanut allergen and one of the most potent elicitors of the allergic reaction. METHODS AND RESULTS Peanut extracts obtained from raw or heat-processed peanut and some fractions thereof were biochemically and immunochemically characterized. These extracts/fractions, purified Ara h 6, or recombinant Ara h 6 including Ara h 6 mutants lacking disulfide bridges were used in in vitro digestion tests and mouse models of experimental sensitization. Peanut roasting led to the formation of complexes of high molecular weight, notably between Ara h 6 and Ara h 1, which supported the induction of IgE specific to native Ara h 6. On the contrary, a fraction containing free monomeric 2S albumins or purified native Ara h 6 displayed no intrinsic allergenicity. In addition to complex formation, heat denaturation and/or partial destabilization enhanced Ara h 6 immunogenicity and increased its sensitivity to digestion. CONCLUSION These results suggest that sensitization potency and IgE binding capacity can be supported by different structures, modified and/or produced during food processing in interaction with other food constituents.
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Affiliation(s)
- Blanche Guillon
- UMR CEA-INRA Service de Pharmacologie et d'Immunoanalyse, Université Paris-Saclay, Gif-sur-Yvette, France
| | - Hervé Bernard
- UMR CEA-INRA Service de Pharmacologie et d'Immunoanalyse, Université Paris-Saclay, Gif-sur-Yvette, France
| | - Marie-Françoise Drumare
- UMR CEA-INRA Service de Pharmacologie et d'Immunoanalyse, Université Paris-Saclay, Gif-sur-Yvette, France
| | - Stéphane Hazebrouck
- UMR CEA-INRA Service de Pharmacologie et d'Immunoanalyse, Université Paris-Saclay, Gif-sur-Yvette, France
| | - Karine Adel-Patient
- UMR CEA-INRA Service de Pharmacologie et d'Immunoanalyse, Université Paris-Saclay, Gif-sur-Yvette, France
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28
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Just J, Elegbede CF, Deschildre A, Bousquet J, Moneret-Vautrin DA, Crepet A. Three peanut-allergic/sensitized phenotypes with gender difference. Clin Exp Allergy 2016; 46:1596-1604. [PMID: 27512923 DOI: 10.1111/cea.12791] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 07/29/2016] [Accepted: 07/29/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Peanut-allergic reactions are heterogeneous ranging from mild symptoms to anaphylaxis. OBJECTIVE Identify peanut-allergic/sensitized phenotypes to personalize patient management. METHODS A combined factor and cluster analysis was used to study the phenotypes of 696 patients diagnosed with peanut sensitization and enrolled in the MIRABEL survey. The method was first applied to the 247 patients with an oral food challenge (OFC). It was then applied to the 449 patients without OFC to confirm the findings in an independent population. RESULTS Three independent clusters emerged from the OFC subgroup. Cluster 1, 'Severe peanut allergy with little allergic multi-morbidity' (123 subjects), had the highest proportion of patients with positive OFC (92%), a medium level of peanut protein inducing a positive OFC (235 mg), lower percentage of allergic multi-morbidity (2% asthma plus atopic dermatitis (A + AD), no cases of A + AD + multiple food allergies (MFA)). Cluster 2, 'Severe peanut allergy with frequent allergic multi-morbidity' (62 subjects), had a high proportion of patients with positive OFC (85%) with the lowest level of peanut protein inducing a positive OFC (112 mg), 89% allergic subjects, 100% with allergic multi-morbidity (A + AD) and 84% with A + AD + MFA. Cluster 3, 'Mild peanut-allergic/sensitized phenotype' (62 subjects), had the lowest mean age, the lowest proportion of patients with positive OFC (53%) with a high level of peanut protein inducing a positive OFC (770 mg), a low percentage of allergic multi-morbidity (48% A + AD + MFA). The two severe peanut-allergic phenotypes were more frequent in girls. The same clusters were found in the subgroup of patients without OFC. CONCLUSION & CLINICAL RELEVANCE Besides the classic markers associated with lower threshold doses of OFC (such as SPT and rAra h 2), allergic multi-morbidity and female gender should also be taken into account to better adapt the progressive dosage of provocation tests.
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Affiliation(s)
- J Just
- Allergology Department, Centre de l'Asthme et des Allergies. Hôpital d'Enfants Armand-Trousseau - 26, Paris Cedex 12, France.,INSERM, UMR_S 1136, Sorbonne Universités, UPMC Univ Paris 06 - Institut Pierre Louis d'Epidémiologie et de Santé Publique, Equipe EPAR, Paris, France
| | - C F Elegbede
- Risk Assessment Department (DER), French Agency for Food, Environmental and Occupational Health Safety (ANSES), Maisons-Alfort, France.,French National Institute for Agricultural Research (INRA), Paris Institute of Technology for Life, Food and Environmental Sciences (AgroParisTech), UMR Economie Publique INRA-AgroParisTech, Paris, France
| | - A Deschildre
- Pneumologie et allergologie pédiatriques, Pôle enfant, Hôpital Jeanne de Flandre, University Hospital, Université Lille Nord de France, Lille cedex, France
| | - J Bousquet
- CHRU de Montpellier, Montpellier, France
| | - D A Moneret-Vautrin
- Allergyvigilance Network, Vandoeuvre les Nancy, France.,Lorraine University, Nancy, France
| | - A Crepet
- Risk Assessment Department (DER), French Agency for Food, Environmental and Occupational Health Safety (ANSES), Maisons-Alfort, France
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29
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Versluis A, van Os-Medendorp H, Kruizinga AG, Blom WM, Houben GF, Knulst AC. Cofactors in allergic reactions to food: physical exercise and alcohol are the most important. IMMUNITY INFLAMMATION AND DISEASE 2016; 4:392-400. [PMID: 27980774 PMCID: PMC5134724 DOI: 10.1002/iid3.120] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 07/07/2016] [Accepted: 07/13/2016] [Indexed: 12/03/2022]
Abstract
Introduction Involvement of cofactors, like physical exercise, alcohol consumption and use of several types of medication, are associated with more severe food allergic symptoms. However, there is limited evidence on how often cofactors play a role in food allergic reactions. The study aimed to get more insight into the frequency of exposure to cofactors and how often cofactors are associated with more severe symptoms in food allergic patients. Methods A questionnaire was completed by patients visiting the Allergology outpatient clinic. Patients with food allergy were included. Outcome measures were the frequency of medication use of medication groups that might act as cofactor and the frequency that physical exercise, alcohol consumption and use of analgesics are associated with more severe food allergic symptoms. Results Four hundred ninety‐six patients were included in the study. The frequency with which patients used one or more types of medication that might act as cofactors was 7.7%: antacids/acid neutralizing medication (5%), NSAIDs (2%), beta blockers (0.6%), angiotensin‐converting enzyme inhibitors (0.6%), and angiotensin receptor blockers (0.2%). Of all patients, 13% reported more severe symptoms to food after involvement of one or more of the cofactors: physical exercise (10%), alcohol consumption (5%), and use of analgesics (0.6%). Sixty‐five percent did not know if these cofactors caused more severe symptoms; 22% reported that these cofactors had no effect. Conclusions Only a small percentage of patients (7.7%) used medication that might aggravate food allergic reactions. Physical exercise and alcohol consumption were the most frequently reported cofactors, but occurring still in only 10% or less.
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30
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Blankestijn MA, Blom WM, Otten HG, Baumert JL, Taylor SL, Bruijnzeel-Koomen CAFM, Houben GF, Knulst AC, Klemans RJB. Specific IgE to Jug r 1 has no additional value compared with extract-based testing in diagnosing walnut allergy in adults. J Allergy Clin Immunol 2016; 139:688-690.e4. [PMID: 27597723 DOI: 10.1016/j.jaci.2016.07.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 07/06/2016] [Accepted: 07/21/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Mark A Blankestijn
- Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - W Marty Blom
- The Netherlands Organization for Applied Scientific Research, Zeist, The Netherlands
| | - Henny G Otten
- Department of Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Joe L Baumert
- Food Allergy Research & Resource Program, University of Nebraska, Lincoln, Neb
| | - Steve L Taylor
- Food Allergy Research & Resource Program, University of Nebraska, Lincoln, Neb
| | | | - Geert F Houben
- Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht, The Netherlands; The Netherlands Organization for Applied Scientific Research, Zeist, The Netherlands
| | - André C Knulst
- Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Rob J B Klemans
- Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht, The Netherlands
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31
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van der Valk JPM, Schreurs MWJ, El Bouch R, Arends NJT, de Jong NW. Mono-sensitisation to peanut component Ara h 6: a case series of five children and literature review. Eur J Pediatr 2016; 175:1227-1234. [PMID: 27206507 PMCID: PMC5005383 DOI: 10.1007/s00431-016-2733-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 03/20/2016] [Accepted: 05/11/2016] [Indexed: 11/24/2022]
Abstract
UNLABELLED Here, we summarise the current clinical knowledge on Ara h 6 sensitisation and clinical relevance of this sensitisation pattern using five illustrative clinical cases. The literature search yielded a total of 166 papers, and an additional relevant article was found by 'snowballing'. A total of ten articles were considered relevant for this review. Most studies included patients with a sensitisation to Ara h 6 and cosensitisation to Ara h 2. Only three studies showed patients with a mono-sensitisation to Ara h 6. This illustrates that Ara h 6 mono-sensitisation has been neglected in literature. We present a case series of five children with sensitisation to peanut component Ara h 6. Only one of these five patients showed Ara h 8 cosensitivity. Three out of the five children had a positive double-blind placebo-controlled food challenge (DBPCFC), with moderate to strong reactions. CONCLUSION A mono-sensitisation to peanut component Ara h 6 is uncommon but can cause severe allergic reactions. Therefore, the determination of sIgE to Ara h 6 is warranted in patients with a suspected peanut allergy, especially in the absence of sensitisation to Ara h 1, 2, 3 and 9. WHAT IS KNOWN • Peanut allergy is common and can cause severe allergic reactions. • The diagnostics of peanut allergy has recently improved with the use of component resolved diagnosis What is new: • A mono-sensitisation to peanut component Ara h 6 is uncommon, but can cause severe allergic reactions • Determination of sIgE to Ara h 6 is warranted in patients with a suspected peanut allergy, especially in the absence of sensitisation to Ara h 1, 2, 3 and 9.
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Affiliation(s)
- J P M van der Valk
- Department of Internal Medicine, section of Allergology, Erasmus MC, Office Gk 323, P.O. box 2040, 3000CA, Rotterdam, The Netherlands.
| | - M W J Schreurs
- Department of Immunology, Laboratory Medical Immunology, Erasmus MC, Rotterdam, The Netherlands
| | - R El Bouch
- Department of Internal Medicine, section of Allergology, Erasmus MC, Office Gk 323, P.O. box 2040, 3000CA, Rotterdam, The Netherlands
| | - N J T Arends
- Department of Internal Medicine, section of Allergology, Erasmus MC, Office Gk 323, P.O. box 2040, 3000CA, Rotterdam, The Netherlands
- Department of Paediatric Allergology, Diaconessenhuis Voorburg, Reinier de Graaf Group, Delft, The Netherlands
| | - N W de Jong
- Department of Internal Medicine, section of Allergology, Erasmus MC, Office Gk 323, P.O. box 2040, 3000CA, Rotterdam, The Netherlands
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Turner PJ, Baumert JL, Beyer K, Boyle RJ, Chan CH, Clark AT, Crevel RWR, DunnGalvin A, Fernández-Rivas M, Gowland MH, Grabenhenrich L, Hardy S, Houben GF, O'B Hourihane J, Muraro A, Poulsen LK, Pyrz K, Remington BC, Schnadt S, van Ree R, Venter C, Worm M, Mills ENC, Roberts G, Ballmer-Weber BK. Can we identify patients at risk of life-threatening allergic reactions to food? Allergy 2016; 71:1241-55. [PMID: 27138061 DOI: 10.1111/all.12924] [Citation(s) in RCA: 150] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2016] [Indexed: 12/31/2022]
Abstract
Anaphylaxis has been defined as a 'severe, life-threatening generalized or systemic hypersensitivity reaction'. However, data indicate that the vast majority of food-triggered anaphylactic reactions are not life-threatening. Nonetheless, severe life-threatening reactions do occur and are unpredictable. We discuss the concepts surrounding perceptions of severe, life-threatening allergic reactions to food by different stakeholders, with particular reference to the inclusion of clinical severity as a factor in allergy and allergen risk management. We review the evidence regarding factors that might be used to identify those at most risk of severe allergic reactions to food, and the consequences of misinformation in this regard. For example, a significant proportion of food-allergic children also have asthma, yet almost none will experience a fatal food-allergic reaction; asthma is not, in itself, a strong predictor for fatal anaphylaxis. The relationship between dose of allergen exposure and symptom severity is unclear. While dose appears to be a risk factor in at least a subgroup of patients, studies report that individuals with prior anaphylaxis do not have a lower eliciting dose than those reporting previous mild reactions. It is therefore important to consider severity and sensitivity as separate factors, as a highly sensitive individual will not necessarily experience severe symptoms during an allergic reaction. We identify the knowledge gaps that need to be addressed to improve our ability to better identify those most at risk of severe food-induced allergic reactions.
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Affiliation(s)
- P. J. Turner
- Section of Paediatrics (Allergy and Infectious Diseases) & MRC and Asthma UK Centre in Allergic Mechanisms of Asthma; Imperial College London; London UK
| | - J. L. Baumert
- Food Allergy Research and Resource Program; Department of Food Science and Technology; University of Nebraska; Lincoln NE USA
| | - K. Beyer
- Department of Pediatric Pneumology and Immunology; Charité Universitätsmedizin; Berlin Germany
| | - R. J. Boyle
- Section of Paediatrics (Allergy and Infectious Diseases) & MRC and Asthma UK Centre in Allergic Mechanisms of Asthma; Imperial College London; London UK
| | | | - A. T. Clark
- Cambridge University Hospitals NHS Foundation Trust; Cambridge UK
| | - R. W. R. Crevel
- Safety and Environmental Assurance Centre; Unilever; Colworth Science Park; Sharnbrook Bedford UK
| | - A. DunnGalvin
- Applied Psychology and Paediatrics and Child Health; University College Cork; Cork Ireland
| | | | | | - L. Grabenhenrich
- Institute for Social Medicine; Epidemiology and Health Economics; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - S. Hardy
- Food Standards Agency; London UK
| | | | - J. O'B Hourihane
- Paediatrics and Child Health; University College Cork; Cork Ireland
| | - A. Muraro
- Department of Paediatrics; Centre for Food Allergy Diagnosis and Treatment; University of Padua; Veneto Italy
| | - L. K. Poulsen
- Allergy Clinic; Copenhagen University Hospital at Gentofte; Copenhagen Denmark
| | - K. Pyrz
- Applied Psychology and Paediatrics and Child Health; University College Cork; Cork Ireland
| | | | - S. Schnadt
- German Allergy and Asthma Association (Deutscher Allergie- und Asthmabund (DAAB)); Mönchengladbach Germany
| | - R. van Ree
- Departments of Experimental Immunology and of Otorhinolaryngology; Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
| | - C. Venter
- School of Health Sciences and Social Work; University of Portsmouth; Portsmouth UK
- The David Hide Asthma and Allergy Research Centre; St Mary's Hospital; Isle of Wight UK
| | - M. Worm
- Allergy-Center Charité; Department of Dermatology and Allergy; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - E. N. C. Mills
- Institute of Inflammation and Repair; Manchester Academic Health Science Centre; Manchester Institute of Biotechnology; The University of Manchester; Manchester UK
| | - G. Roberts
- The David Hide Asthma and Allergy Research Centre; St Mary's Hospital; Isle of Wight UK
- NIHR Respiratory Biomedical Research Unit; University Hospital Southampton NHS Foundation Trust and Human Development and Health Academic Unit; University of Southampton Faculty of Medicine; Southampton UK
| | - B. K. Ballmer-Weber
- Allergy Unit; Department of Dermatology; University Hospital; University Zürich; Zürich Switzerland
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Percival E, Bhatia R, Preece K, McElduff P, McEvoy M, Collison A, Mattes J. Reproducibility of serum IgE, Ara h2 skin prick testing and fraction of exhaled nitric oxide for predicting clinical peanut allergy in children. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2016; 12:35. [PMID: 27499764 PMCID: PMC4975907 DOI: 10.1186/s13223-016-0143-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Accepted: 07/13/2016] [Indexed: 01/27/2023]
Abstract
BACKGROUND Ara h2 sIgE serum levels improve the diagnostic accuracy for predicting peanut allergy, but the use of Ara h2 purified protein as a skin prick test (SPT), has not been substantially evaluated. The fraction of exhaled nitric oxide (FeNO) shows promise as a novel biomarker of peanut allergy. Reproducibility of these measures has not been determined. The aim was to assess the accuracy and reproducibility (over a time-period of at least 12 months) of SPT to Ara h2 in comparison with four predictors of clinical peanut allergy (Peanut SPT, Ara h2 specific Immunoglobulin E (sIgE), Peanut sIgE and FeNO). METHODS Twenty-seven children were recruited in a follow-up of a prospective cohort of fifty-six children at least 12 months after an open-labelled peanut food challenge. Their repeat assessment involved a questionnaire, SPT to peanut and Ara h2 purified protein, FeNO and sIgE to peanut and Ara h2 measurements. RESULTS Ara h2 SPT was no worse in accuracy when compared with peanut SPT, FeNO, Ara h2 sIgE and peanut sIgE (AUC 0.908 compared with 0.887, 0.889, 0.935 and 0.804 respectively) for predicting allergic reaction at previous food challenge. SPT for peanut and Ara h2 demonstrated limited reproducibility (ICC = 0.51 and 0.44); while FeNO demonstrated good reproducibility (ICC = 0.73) and sIgE for peanut and Ara h2 were highly reproducible (ICC = 0.81 and 0.85). CONCLUSIONS In this population, Ara h2 SPT was no worse in accuracy when compared with current testing for the evaluation of clinical peanut allergy, but had-like peanut SPT-poor reproducibility. FeNO, peanut sIgE and Ara h2 sIgE were consistently reproducible despite an interval of at least 12 months between the repeated measurements.
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Affiliation(s)
- Elizabeth Percival
- Experimental & Translational Respiratory Medicine Group, Hunter Medical Research Institute, University of Newcastle, Lookout Road, New Lambton, Newcastle, NSW 2305 Australia
- Department of Paediatric Medicine, John Hunter Children’s Hospital, Newcastle, NSW Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW Australia
| | - Rani Bhatia
- Department of Paediatric Allergy & Immunology, John Hunter Children’s Hospital, Newcastle, NSW Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW Australia
| | - Kahn Preece
- Experimental & Translational Respiratory Medicine Group, Hunter Medical Research Institute, University of Newcastle, Lookout Road, New Lambton, Newcastle, NSW 2305 Australia
- Department of Paediatric Immunology & Allergy, Starship Children’s Health, Auckland, New Zealand
| | - Patrick McElduff
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW Australia
| | - Mark McEvoy
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW Australia
| | - Adam Collison
- Experimental & Translational Respiratory Medicine Group, Hunter Medical Research Institute, University of Newcastle, Lookout Road, New Lambton, Newcastle, NSW 2305 Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW Australia
| | - Joerg Mattes
- Experimental & Translational Respiratory Medicine Group, Hunter Medical Research Institute, University of Newcastle, Lookout Road, New Lambton, Newcastle, NSW 2305 Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW Australia
- Department of Paediatric Respiratory & Sleep Medicine, John Hunter Children’s Hospital, Newcastle, NSW Australia
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Conformational stability of digestion-resistant peptides of peanut conglutins reveals the molecular basis of their allergenicity. Sci Rep 2016; 6:29249. [PMID: 27377129 PMCID: PMC4932508 DOI: 10.1038/srep29249] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 06/13/2016] [Indexed: 12/14/2022] Open
Abstract
Conglutins represent the major peanut allergens and are renowned for their resistance to gastro-intestinal digestion. Our aim was to characterize the digestion-resistant peptides (DRPs) of conglutins by biochemical and biophysical methods followed by a molecular dynamics simulation in order to better understand the molecular basis of food protein allergenicity. We have mapped proteolysis sites at the N- and C-termini and at a limited internal segment, while other potential proteolysis sites remained unaffected. Molecular dynamics simulation showed that proteolysis only occurred in the vibrant regions of the proteins. DRPs appeared to be conformationally stable as intact conglutins. Also, the overall secondary structure and IgE-binding potency of DRPs was comparable to that of intact conglutins. The stability of conglutins toward gastro-intestinal digestion, combined with the conformational stability of the resulting DRPs provide conditions for optimal exposure to the intestinal immune system, providing an explanation for the extraordinary allergenicity of peanut conglutins.
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35
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Allergenicity attributes of different peanut market types. Food Chem Toxicol 2016; 91:82-90. [DOI: 10.1016/j.fct.2016.02.016] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 01/28/2016] [Accepted: 02/19/2016] [Indexed: 11/20/2022]
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van Erp FC, Klemans RJB, Meijer Y, van der Ent CK, Knulst AC. Using Component-Resolved Diagnostics in the Management of Peanut-Allergic Patients. CURRENT TREATMENT OPTIONS IN ALLERGY 2016; 3:169-180. [PMID: 27330930 PMCID: PMC4891380 DOI: 10.1007/s40521-016-0080-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Instead of relying on crude peanut extract, component-resolved diagnostics (CRD) uses sensitization to allergenic proteins within peanut. In this review, we describe the recent advances and future perspectives of the use of CRD in the management of peanut-allergic patients. There is strong evidence that sensitization to Ara h 2 is the best predictor for clinically relevant peanut allergy in children and adults. Isolated sensitization to other peanut components is only rarely present in patients with systemic reactions to peanut. It is, however, important to remark that cut-off points of sIgE to Ara h 2 that predict tolerance or allergy vary between different study populations, different age groups and geographical regions, and validation studies performed in different settings are necessary to implement cut-offs in daily practice. Future studies should focus on the role of CRD in risk-assessment early in life, predicting long-term tolerance and monitoring treatment responses following immunotherapy.
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Affiliation(s)
- F C van Erp
- Department of Paediatric Pulmonology and Allergology, University Medical Centre Utrecht, Utrecht, The Netherlands ; Department of Paediatric Pulmonology and Allergology, University Medical Center Utrecht, Wilhelmina Children's Hospital, P O Box 85090, 3508 AB Utrecht, The Netherlands
| | - R J B Klemans
- Department of Dermatology and Allergology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Y Meijer
- Department of Paediatric Pulmonology and Allergology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - C K van der Ent
- Department of Paediatric Pulmonology and Allergology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - A C Knulst
- Department of Dermatology and Allergology, University Medical Centre Utrecht, Utrecht, The Netherlands
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Shamoon M, Sajid MW, Safdar W, Haider J, Omar M, Ammar A, Sharif HR, Khalid S, Randhawa MA. An update on hypoallergenicity of peanut and soybean: where are we now? RSC Adv 2016. [DOI: 10.1039/c6ra12515h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Legumes are one of the major sources of proteins and positively correlate with the development of modern society. At the same time, unfortunately, they significantly contribute to the rising prevalence of food allergy.
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Affiliation(s)
- Muhammad Shamoon
- State Key Laboratory of Food Science and Technology
- School of Food Science and Technology
- The Synergetic Innovation Center of Food Safety and Nutrition
- Jiangnan University
- Wuxi 214122
| | - Muhammad Wasim Sajid
- Department of Biosciences
- COMSATS Institute of Information Technology
- Sahiwal 57000
- Pakistan
| | - Waseem Safdar
- State Key Laboratory of Food Science and Technology
- School of Food Science and Technology
- The Synergetic Innovation Center of Food Safety and Nutrition
- Jiangnan University
- Wuxi 214122
| | - Junaid Haider
- Key Laboratory of Food Colloids and Biotechnology
- Ministry of Education
- School of Food Science and Technology
- Jiangnan University
- Wuxi 214122
| | - Mukama Omar
- Key Laboratory of Carbohydrate Chemistry and Biotechnology
- School of Biotechnology
- Jiangnan University
- Wuxi 214122
- P. R. China
| | - Alfarga Ammar
- State Key Laboratory of Food Science and Technology
- School of Food Science and Technology
- The Synergetic Innovation Center of Food Safety and Nutrition
- Jiangnan University
- Wuxi 214122
| | - Hafiz Rizwan Sharif
- Key Laboratory of Food Colloids and Biotechnology
- Ministry of Education
- School of Food Science and Technology
- Jiangnan University
- Wuxi 214122
| | - Saud Khalid
- Center for Polymer from Renewable Resources
- School of Food Science and Engineering
- South China University of Technology
- Guangzhou 510640
- P. R China
| | - Muhammad Atif Randhawa
- Faculty of Food
- Nutrition and Home Sciences
- National Institute of Food Science & Technology
- University of Agriculture
- Faisalabad 38040
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Versluis A, Knulst AC, Kruizinga AG, Michelsen A, Houben GF, Baumert JL, van Os-Medendorp H. Frequency, severity and causes of unexpected allergic reactions to food: a systematic literature review. Clin Exp Allergy 2015; 45:347-67. [PMID: 24766413 DOI: 10.1111/cea.12328] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Food allergic patients have to deal with an avoidance diet. Confusing labelling terms or precautionary labels can result in misinterpretation and risk-taking behaviour. Even those patients that strictly adhere to their diet experience (sometimes severe) unexpected allergic reactions to food. The frequency, severity and causes of such reactions are unknown. The objective of this review was to describe the frequency, severity and causes of unexpected allergic reactions to food in food allergic patients aged > 12 years, in order to develop improved strategies to deal with their allergy. A systematic review was carried out by two researchers, in six electronic databases (CINAHL, Cochrane, EMBASE, Medline, Psychinfo and Scopus). The search was performed with keywords relating to the frequency, severity and causes of unexpected allergic reactions to food. This resulted in 24 studies which met the inclusion criteria; 18 observational and six qualitative studies. This review shows that knowledge about the frequency of unexpected reactions is limited. Peanut, nuts, egg, fruit/vegetables and milk are the main causal foods. Severe reactions and even fatalities occur. Most reactions take place at home, but a significant number also take place when eating at friends' houses or in restaurants. Labelling issues, but also attitude and risky behaviour of patients can attribute to unexpected reactions. We conclude that prospective studies are needed to get more insight in the frequency, severity, quantity of unintended allergen ingested and causes of unexpected allergic reactions to food, to be able to optimize strategies to support patients in dealing with their food allergy. Although the exact frequency is not known, unexpected reactions to food occur in a significant number of patients and can be severe. For clinical practice, this means that patient education and dietary instructions are necessary.
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Siruguri V, Bharatraj DK, Vankudavath RN, Rao Mendu VV, Gupta V, Goodman RE. Evaluation of Bar, Barnase, and Barstar recombinant proteins expressed in genetically engineered Brassica juncea (Indian mustard) for potential risks of food allergy using bioinformatics and literature searches. Food Chem Toxicol 2015; 83:93-102. [DOI: 10.1016/j.fct.2015.06.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 06/02/2015] [Accepted: 06/03/2015] [Indexed: 11/26/2022]
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40
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Effect of thermal and electric field treatment on the conformation of Ara h 6 peanut protein allergen. INNOV FOOD SCI EMERG 2015. [DOI: 10.1016/j.ifset.2015.03.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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41
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A retrospective analysis of allergic reaction severities and minimal eliciting doses for peanut, milk, egg, and soy oral food challenges. Food Chem Toxicol 2015; 80:92-100. [DOI: 10.1016/j.fct.2015.02.023] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 02/24/2015] [Accepted: 02/26/2015] [Indexed: 11/23/2022]
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Santos AF, Du Toit G, Douiri A, Radulovic S, Stephens A, Turcanu V, Lack G. Distinct parameters of the basophil activation test reflect the severity and threshold of allergic reactions to peanut. J Allergy Clin Immunol 2015; 135:179-86. [PMID: 25567046 PMCID: PMC4282725 DOI: 10.1016/j.jaci.2014.09.001] [Citation(s) in RCA: 135] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 08/27/2014] [Accepted: 09/02/2014] [Indexed: 11/03/2022]
Abstract
Background The management of peanut allergy relies on allergen avoidance and epinephrine autoinjector for rescue treatment in patients at risk of anaphylaxis. Biomarkers of severity and threshold of allergic reactions to peanut could significantly improve the care for patients with peanut allergy. Objective We sought to assess the utility of the basophil activation test (BAT) to predict the severity and threshold of reactivity to peanut during oral food challenges (OFCs). Methods The severity of the allergic reaction and the threshold dose during OFCs to peanut were determined. Skin prick tests, measurements of specific IgE to peanut and its components, and BATs to peanut were performed on the day of the challenge. Results Of the 124 children submitted to OFCs to peanut, 52 (median age, 5 years) reacted with clinical symptoms that ranged from mild oral symptoms to anaphylaxis. Severe reactions occurred in 41% of cases, and 57% reacted to 0.1 g or less of peanut protein. The ratio of the percentage of CD63+ basophils after stimulation with peanut and after stimulation with anti-IgE (CD63 peanut/anti-IgE) was independently associated with severity (P = .001), whereas the basophil allergen threshold sensitivity CD-sens (1/EC50 × 100, where EC50 is half maximal effective concentration) value was independently associated with the threshold (P = .020) of allergic reactions to peanut during OFCs. Patients with CD63 peanut/anti-IgE levels of 1.3 or greater had an increased risk of severe reactions (relative risk, 3.4; 95% CI, 1.8-6.2). Patients with a CD-sens value of 84 or greater had an increased risk of reacting to 0.1 g or less of peanut protein (relative risk, 1.9; 95% CI, 1.3-2.8). Conclusions Basophil reactivity is associated with severity and basophil sensitivity is associated with the threshold of allergic reactions to peanut. CD63 peanut/anti-IgE and CD-sens values can be used to estimate the severity and threshold of allergic reactions during OFCs.
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Affiliation(s)
- Alexandra F Santos
- Department of Pediatric Allergy, Division of Asthma, Allergy & Lung Biology, King's College London, London, United Kingdom; MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom; Immunoallergology Department, Coimbra University Hospital, Coimbra, Portugal; Gulbenkian Programme for Advanced Medical Education, Lisbon, Portugal
| | - George Du Toit
- Department of Pediatric Allergy, Division of Asthma, Allergy & Lung Biology, King's College London, London, United Kingdom; MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom
| | - Abdel Douiri
- Department of Public Health Science, School of Medicine, King's College London, London, United Kingdom; National Institute for Health Research (NIHR), Biomedical Research Centre, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Suzana Radulovic
- Department of Pediatric Allergy, Division of Asthma, Allergy & Lung Biology, King's College London, London, United Kingdom; MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom
| | - Alick Stephens
- Department of Pediatric Allergy, Division of Asthma, Allergy & Lung Biology, King's College London, London, United Kingdom; MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom
| | - Victor Turcanu
- Department of Pediatric Allergy, Division of Asthma, Allergy & Lung Biology, King's College London, London, United Kingdom; MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom
| | - Gideon Lack
- Department of Pediatric Allergy, Division of Asthma, Allergy & Lung Biology, King's College London, London, United Kingdom; MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom.
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Jayasena S, Smits M, Fiechter D, de Jong A, Nordlee J, Baumert J, Taylor SL, Pieters RH, Koppelman SJ. Comparison of six commercial ELISA kits for their specificity and sensitivity in detecting different major peanut allergens. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2015; 63:1849-1855. [PMID: 25651402 DOI: 10.1021/jf504741t] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Six commercial peanut enzyme-linked immunosorbent assay kits were assessed for their ability to recover peanut from the standard reference material 2387 peanut butter and also for their specificity in detecting four major peanut allergens, Ara h 1, Ara h 2, Ara h 3, and Ara h 6. The percentage recovery of peanut from peanut butter differed across different kits as well as at different sample concentrations. The highest recovery was observed with the Romer and R-Biopharm kits, while four other kits were found to underestimate the protein content of the reference peanut butter samples. Five of the kits were most sensitive in detecting Ara h 3 followed by Ara h 1, while hardly recognizing Ara h 2 and Ara h 6. The other kit showed the highest sensitivity to Ara h 2 and Ara h 6, while Ara h 1 and Ara h 3 were poorly recognized. Although Ara h 2 and Ara h 6 are known to be heat stable and more potent allergens, antisera specific to any of these four peanut proteins/allergens may serve as good markers for the detection of peanut residues.
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Affiliation(s)
- Shyamali Jayasena
- Food Allergy Research and Resource Program, Department of Food Science & Technology, University of Nebraska , 143 Food Industry Complex, Lincoln, Nebraska 68583-0919, United States
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Abstract
Peanut allergy is an IgE-mediated, persisting immune disorder that is of major concern worldwide. Currently, no routine immunotherapy is available to treat this often severe and sometimes fatal food allergy. Traditional subcutaneous allergen immunotherapy with crude peanut extracts has proven not feasible due to the high risk of severe systemic side effects. The allergen-specific approaches under preclinical and clinical investigation comprise subcutaneous, oral, sublingual and epicutaneous immunotherapy with whole-peanut extracts as well as applications of hypoallergenic peanut allergens or T cell epitope peptides. Allergen-nonspecific approaches include monoclonal anti-IgE antibodies, TCM herbal formulations and Toll-like receptor 9-based immunotherapy. The potential of genetically engineered plants with reduced allergen levels is being explored as well as the beneficial influence of lactic acid bacteria and soybean isoflavones on peanut allergen-induced symptoms. Although the underlying mechanisms still need to be elucidated, several of these strategies hold great promise. It can be estimated that individual strategies or a combination thereof will result in a successful immunotherapy regime for peanut-allergic individuals within the next decade.
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Affiliation(s)
- Merima Bublin
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
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45
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Bernard H, Guillon B, Drumare MF, Paty E, Dreskin SC, Wal JM, Adel-Patient K, Hazebrouck S. Allergenicity of peanut component Ara h 2: Contribution of conformational versus linear hydroxyproline-containing epitopes. J Allergy Clin Immunol 2014; 135:1267-74.e1-8. [PMID: 25483599 DOI: 10.1016/j.jaci.2014.10.025] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 10/03/2014] [Accepted: 10/06/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND The 2S-albumin Ara h 2 is the most potent peanut allergen and a good predictor of clinical reactivity in allergic children. Posttranslational hydroxylation of proline residues occurs in DPYSP(OH)S motifs, which are repeated 2 or 3 times in different isoforms. OBJECTIVES We investigated the effect of proline hydroxylation on IgE binding and the relative contributions of linear and conformational epitopes to Ara h 2 allergenicity. METHODS Peptides containing DPYSP(OH)S motifs were synthesized. A recombinant variant of Ara h 2 without DPYSP(OH)S motifs was generated by means of deletion mutagenesis. IgE reactivity of 18 French and 5 American patients with peanut allergy toward synthetic peptides and recombinant allergens was assessed by using IgE-binding inhibition assays and degranulation tests of humanized rat basophilic leukemia cells. RESULTS Hydroxyproline-containing peptides exhibited an IgE-binding activity equivalent to that of the unfolded Ara h 2. In contrast, corresponding peptides without hydroxyprolines displayed a very weak IgE-binding capacity. Despite removal of the DPYSP(OH)S motifs, the deletion variant still displayed Ara h 2 conformational epitopes. The IgE-binding capacity of Ara h 2 was then recapitulated with an equimolar mixture of a hydroxylated peptide and the deletion variant. Hydroxylated peptides of 15 and 27 amino acid residues were also able to trigger cell degranulation. CONCLUSIONS Sensitization toward linear and conformational epitopes of Ara h 2 is variable among patients with peanut allergy. Optimal IgE binding to linear epitopes of Ara h 2 requires posttranslational hydroxylation of proline residues. The absence of hydroxyprolines could then affect the accuracy of component-resolved diagnostics by using rAra h 2.
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Affiliation(s)
- Hervé Bernard
- INRA, UR 496, Unité d'Immuno-Allergie Alimentaire, Jouy-en-Josas, France; CEA, iBiTecS/Service de Pharmacologie et d'Immunoanalyse, Gif-sur-Yvette, France
| | - Blanche Guillon
- INRA, UR 496, Unité d'Immuno-Allergie Alimentaire, Jouy-en-Josas, France; CEA, iBiTecS/Service de Pharmacologie et d'Immunoanalyse, Gif-sur-Yvette, France
| | - Marie-Françoise Drumare
- INRA, UR 496, Unité d'Immuno-Allergie Alimentaire, Jouy-en-Josas, France; CEA, iBiTecS/Service de Pharmacologie et d'Immunoanalyse, Gif-sur-Yvette, France
| | - Evelyne Paty
- Université Paris Descartes-Assistance Publique des Hôpitaux de Paris, Hôpital Necker Enfants Malades, Paris, France
| | - Stephen C Dreskin
- Division of Allergy and Clinical Immunology, Department of Medicine, University of Colorado Denver, Aurora, Colo
| | - Jean-Michel Wal
- INRA, UR 496, Unité d'Immuno-Allergie Alimentaire, Jouy-en-Josas, France; CEA, iBiTecS/Service de Pharmacologie et d'Immunoanalyse, Gif-sur-Yvette, France
| | - Karine Adel-Patient
- INRA, UR 496, Unité d'Immuno-Allergie Alimentaire, Jouy-en-Josas, France; CEA, iBiTecS/Service de Pharmacologie et d'Immunoanalyse, Gif-sur-Yvette, France
| | - Stéphane Hazebrouck
- INRA, UR 496, Unité d'Immuno-Allergie Alimentaire, Jouy-en-Josas, France; CEA, iBiTecS/Service de Pharmacologie et d'Immunoanalyse, Gif-sur-Yvette, France.
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46
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Blumchen K, Beder A, Beschorner J, Ahrens F, Gruebl A, Hamelmann E, Hansen G, Heinzmann A, Nemat K, Niggemann B, Wahn U, Beyer K. Modified oral food challenge used with sensitization biomarkers provides more real-life clinical thresholds for peanut allergy. J Allergy Clin Immunol 2014; 134:390-8. [DOI: 10.1016/j.jaci.2014.03.035] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 02/02/2014] [Accepted: 03/12/2014] [Indexed: 12/26/2022]
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Klemans RJB, Knol EF, Bruijnzeel-Koomen CAFM, Knulst AC. The diagnostic accuracy of specific IgE to Ara h 6 in adults is as good as Ara h 2. Allergy 2014; 69:1112-4. [PMID: 24813113 DOI: 10.1111/all.12424] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2014] [Indexed: 11/29/2022]
Abstract
Specific IgE (sIgE) to Ara h 2 is useful in diagnosing peanut allergy. Our aim was to assess the diagnostic value of sIgE to Ara h 6, another 2S albumin, in an adult population suspected of peanut allergy. Subjects with suspected peanut allergy between 2002 and 2013 were included if a diagnostic double-blind, placebo-controlled food challenge with peanut was performed. sIgE to Ara h 2 and Ara h 6 was measured by ImmunoCAP ISAC 112. Of 107 challenged subjects, 65 had a positive challenge (61%). The discriminative ability of sIgE to Ara h 2 and Ara h 6 was comparable: AUC 0.81 vs. 0.82. Positive predictive value for both tests was 95% using a cutoff value ≥1 ISU/l with poor corresponding sensitivity values (58% for Ara h 2, 62% for Ara h 6), but good specificity values (95% for both tests). In conclusion, the diagnostic value of sIgE to Ara h 6 on population level was as good as sIgE to Ara h 2. On individual level, however, 5% of the subjects showed contradicting results between both tests using a cutoff of 0.3 ISU/l, leading to a risk of misdiagnosis if only one of both tests is used.
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Affiliation(s)
- R. J. B. Klemans
- Department of Dermatology and Allergology; University Medical Center Utrecht; Utrecht the Netherlands
| | - E. F. Knol
- Department of Dermatology and Allergology; University Medical Center Utrecht; Utrecht the Netherlands
- Department of Immunology; University Medical Center Utrecht; Utrecht the Netherlands
| | | | - A. C. Knulst
- Department of Dermatology and Allergology; University Medical Center Utrecht; Utrecht the Netherlands
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Bernard H, Ah-Leung S, Drumare MF, Feraudet-Tarisse C, Verhasselt V, Wal JM, Créminon C, Adel-Patient K. Peanut allergens are rapidly transferred in human breast milk and can prevent sensitization in mice. Allergy 2014; 69:888-97. [PMID: 24773443 DOI: 10.1111/all.12411] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2014] [Indexed: 12/29/2022]
Abstract
BACKGROUND Food allergens have been evidenced in breast milk under physiological conditions, but the kinetic and the role of this passage in food allergies are still unclear. We then aimed to analyze the passage of peanut allergens in human breast milk and their allergenicity/immunomodulatory properties. METHODS Human breast milk was collected from two non-atopic peanut-tolerant mothers before and at different time points after ingestion of 30 g of commercial roasted peanut. Ara h 6, Ara h 6 immune complexes, and the IgE binding capacity of breast milk samples were measured using specific immunoassays. Their allergenic functionality was then assessed using cell-based assay. Finally, human breast milk obtained before or after peanut ingestion was administered intragastrically to BALB/c mice at different ages, and mice were further experimentally sensitized to peanut using cholera toxin. RESULTS Ara h 6 is detected as soon as 10 min after peanut ingestion, with peak values observed within the first hour after ingestion. The transfer is long-lasting, small quantities of peanut allergens being detected over a 24-h period. IgG-Ara h 6 and IgA-Ara h 6 immune complexes are evidenced, following a different kinetic of excretion than free allergens. Peanut allergens transferred in milk are IgE reactive and can induce an allergic reaction in vitro. However, administration of human breast milk to young mice, notably before weaning, does not lead to sensitization, but instead to partial oral tolerance. CONCLUSION The low quantities of immunologically active allergens transferred through breast milk may prevent instead of priming allergic sensitization to peanut.
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Affiliation(s)
- H. Bernard
- INRA; UR496 Unité d'Immuno-Allergie Alimentaire; Jouy-en-Josas France
- CEA; IBiTecS; Service de Pharmacologie et d'Immunoanalyse; Gif-sur-Yvette France
| | - S. Ah-Leung
- INRA; UR496 Unité d'Immuno-Allergie Alimentaire; Jouy-en-Josas France
- CEA; IBiTecS; Service de Pharmacologie et d'Immunoanalyse; Gif-sur-Yvette France
| | - M.-F. Drumare
- INRA; UR496 Unité d'Immuno-Allergie Alimentaire; Jouy-en-Josas France
- CEA; IBiTecS; Service de Pharmacologie et d'Immunoanalyse; Gif-sur-Yvette France
| | - C. Feraudet-Tarisse
- CEA; IBiTecS; Service de Pharmacologie et d'Immunoanalyse; Gif-sur-Yvette France
| | - V. Verhasselt
- EA 6302 Tolérance Immunitaire; Hôpital de l'Archet; Université de Nice Sophia-Antipolis; Nice France
| | - J.-M. Wal
- INRA; UR496 Unité d'Immuno-Allergie Alimentaire; Jouy-en-Josas France
- CEA; IBiTecS; Service de Pharmacologie et d'Immunoanalyse; Gif-sur-Yvette France
| | - C. Créminon
- CEA; IBiTecS; Service de Pharmacologie et d'Immunoanalyse; Gif-sur-Yvette France
| | - K. Adel-Patient
- INRA; UR496 Unité d'Immuno-Allergie Alimentaire; Jouy-en-Josas France
- CEA; IBiTecS; Service de Pharmacologie et d'Immunoanalyse; Gif-sur-Yvette France
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49
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Mayorga C, Gomez F, Aranda A, Koppelman SJ, Diaz-Perales A, Blanca-López N, Blazquez AB, Blanca M, Torres MJ. Basophil response to peanut allergens in Mediterranean peanut-allergic patients. Allergy 2014; 69:964-8. [PMID: 24816395 DOI: 10.1111/all.12421] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2014] [Indexed: 11/30/2022]
Abstract
Ara h 1, Ara h 2, and Ara h 3 are important sensitizers in peanut allergy. Ara h 9 has also been shown to be relevant in the Mediterranean area. We evaluated the basophil response to peanut allergens and Pru p 3 in Mediterranean patients: Group 1, peanut and peach allergy; Group 2, peanut allergy and tolerance to peach; Group 3, peach allergy and tolerance to peanut; Group 4, nonallergic subjects that tolerate both peanut and peach. Compared to controls (Group 4), there was an increased basophil activation with Ara h 2 (P = 0.031) and Pru p 3 (P = 0.009) in Group 1 and with Ara h 1 (P = 0.016), Ara h 2 (P = 0.001), and Ara h 9 (P = 0.016) in Group 2. Importantly, only Ara h 2 showed an increased activation (P = 0.009) in Group 2 compared to Group 3. Ara h 2 is the best discriminating allergen for peanut allergy diagnosis in a Mediterranean population showing two patterns: patients also allergic to peach, responding to Ara h 2 and Pru p 3, and patients allergic only to peanut, responding to Ara h 1, Ara h 2, and Ara h 9.
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Affiliation(s)
- C. Mayorga
- Research Laboratory; IBIMA; Regional University Hospital of Malaga; UMA; Malaga Spain
- UGC Allergy; IBIMA; Regional University Hospital of Malaga; UMA; Malaga Spain
| | - F. Gomez
- UGC Allergy; IBIMA; Regional University Hospital of Malaga; UMA; Malaga Spain
| | - A. Aranda
- Research Laboratory; IBIMA; Regional University Hospital of Malaga; UMA; Malaga Spain
| | - S. J. Koppelman
- University of Nebraska; Lincoln NE USA
- HAL Allergy; Leiden the Netherlands
| | - A. Diaz-Perales
- Centre for Plant Biotechnology and Genomics UPM-INIA; Pozuelo de Alarcón; Madrid Spain
| | | | - A. B. Blazquez
- Research Laboratory; IBIMA; Regional University Hospital of Malaga; UMA; Malaga Spain
| | - M. Blanca
- UGC Allergy; IBIMA; Regional University Hospital of Malaga; UMA; Malaga Spain
| | - M. J. Torres
- UGC Allergy; IBIMA; Regional University Hospital of Malaga; UMA; Malaga Spain
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50
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Abstract
Peanut seeds are currently widely used as source of human food ingredients in the United States of America and in European countries due to their high quality protein and oil content. This article describes the classification and molecular biology of peanut seed allergens with particular reference to their cross-reactivities. Currently, the IUIS allergen nomenclature subcommittee accepts 12 peanut allergens. Two allergens belong to the cupin and four to the prolamin superfamily, and six are distributed among profilins, Bet v 1-like proteins, oleosins, and defensins. Clinical observations frequently report an association of peanut allergy with allergies to legumes, tree nuts, seeds, fruits and pollen. Molecular cross-reactivity has been described between members of the Bet v 1-like proteins, the non-specific lipid transfer proteins, and the profilins. This review also addresses the less well-studied cross-reactivity between cupin and prolamin allergens of peanuts and of other plant food sources and the recently discovered cross-reactivity between peanut allergens of unrelated protein families.
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