TY - JOUR
T1 - Estimating the Risk of Severe Peanut Allergy Using Clinical Background and IgE Sensitization Profiles
AU - Datema, Mareen R.
AU - Lyons, Sarah A.
AU - Fernández-Rivas, Montserrat
AU - Ballmer-Weber, Barbara
AU - Knulst, André C.
AU - Asero, Riccardo
AU - Barreales, Laura
AU - Belohlavkova, Simona
AU - de Blay, Frédéric
AU - Clausen, Michael
AU - Dubakiene, Ruta
AU - Fernández-Perez, Cristina
AU - Fritsche, Philipp
AU - Gislason, David
AU - Hoffmann-Sommergruber, Karin
AU - Jedrzejczak-Czechowicz, Monika
AU - Jongejan, Laurian
AU - Kowalski, Marek L.
AU - Kralimarkova, Tanya Z.
AU - Lidholm, Jonas
AU - Papadopoulos, Nikolaos G.
AU - Popov, Todor A.
AU - Prado, Nayade del
AU - Purohit, Ashok
AU - Reig, Isabel
AU - Seneviratne, Suranjith L.
AU - Sinaniotis, Athanassios
AU - Vassilopoulou, Emilia
AU - Versteeg, Serge A.
AU - Vieths, Stefan
AU - Welsing, Paco M.J.
AU - Mills, E. N.Clare
AU - Le, Thuy My
AU - Zwinderman, Aeilko H.
AU - van Ree, Ronald
N1 - Funding Information: Funding. This work was funded by the European Commission under the 6th Framework Programme through EuroPrevall (FP6- FOOD-CT-2005-514000) and the 7th Framework Programme through iFAAM (Grant agreement no. 312147), respectively. Funding Information: We would like to thank all the patients for their participation in the study. We would like to thank ALK Abello (Madrid, Spain) for their generous gift of SPT reagents. We acknowledge the support by the 6th and 7th Framework Programmes of the EU, for EuroPrevall (FP6-FOOD-CT-2005-514000) and iFAAM (Grant agreement no. 312147), respectively. Publisher Copyright: Copyright © 2021 Datema, Lyons, Fernández-Rivas, Ballmer-Weber, Knulst, Asero, Barreales, Belohlavkova, de Blay, Clausen, Dubakiene, Fernández-Perez, Fritsche, Gislason, Hoffmann-Sommergruber, Jedrzejczak-Czechowicz, Jongejan, Kowalski, Kralimarkova, Lidholm, Papadopoulos, Popov, Prado, Purohit, Reig, Seneviratne, Sinaniotis, Vassilopoulou, Versteeg, Vieths, Welsing, Mills, Le, Zwinderman and van Ree.
PY - 2021
Y1 - 2021
N2 - 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.
AB - 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.
KW - EuroPrevall
KW - IgE
KW - clinical background
KW - component-resolved diagnostics
KW - iFAAM
KW - peanut allergy
KW - prediction
KW - severity
UR - http://www.scopus.com/inward/record.url?scp=85133614453&partnerID=8YFLogxK
U2 - https://doi.org/10.3389/falgy.2021.670789
DO - https://doi.org/10.3389/falgy.2021.670789
M3 - Article
SN - 2673-6101
VL - 2
JO - Frontiers in allergy
JF - Frontiers in allergy
M1 - 670789
ER -