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Basophil allergen threshold sensitivity and component-resolved diagnostics improve hazelnut allergy diagnosis
Karolinska Inst, Dept Clin Sci & Educ, Soder Sjukhuset, Stockholm, Sweden.;Soder Sjukhuset, Sachs Children & Youth Hosp, S-11883 Stockholm, Sweden..
Karolinska Inst, Dept Med, Clin Immunol & Allergy Unit, Stockholm, Sweden.;Karolinska Hosp, S-10401 Stockholm, Sweden..
Karolinska Inst, Dept Med, Clin Immunol & Allergy Unit, Stockholm, Sweden.;Karolinska Hosp, S-10401 Stockholm, Sweden..
Karolinska Inst, Dept Clin Sci & Educ, Soder Sjukhuset, Stockholm, Sweden.;Soder Sjukhuset, Sachs Children & Youth Hosp, S-11883 Stockholm, Sweden..
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2015 (English)In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 45, no 9, 1412-1418 p.Article in journal (Refereed) Published
Abstract [en]

BackgroundIgE sensitization to hazelnut is common, especially in birch endemic areas. However, its clinical significance often needs to be confirmed by a food challenge. ObjectiveTo evaluate the clinical significance of IgE antibodies to hazelnut components and basophil allergen threshold sensitivity (CD-sens) to hazelnut, in relation to double-blind placebo-controlled food challenge (DBPCFC) in children with a suspected hazelnut allergy. MethodsForty children underwent a DBPCFC. CD-sens to hazelnut as well as IgE antibodies to hazelnut and its components Cor a 1, Cor a 8, Cor a 9 and Cor a 14 were analysed. Serum tryptase was measured before, during and after DBPCFC. ResultsEight children had a positive DBPCFC, and all of them had a high CD-sens value to hazelnut. Of the 32 children that passed the DBPCFC, 31 were very low or negative in CD-sens. A positive DBPCFC corresponded with significantly higher CD-sens values (median 8.9, range 3.3-281) compared to children negative in challenge (median 0.05, range 0-34.7, P<0.0001). Children positive in challenge also had higher levels of IgE-ab to Cor a 9 and Cor a 14 (P<0.01 and P<0.001, respectively) compared with those with a negative challenge. In relation to the results from DBPCFC, the sensitivity of CD-sens and IgE-ab to Cor a 14 was excellent (100%) and the specificity was very high (>97% and >94%, respectively). Five of the eight patients positive at challenge showed an increase in tryptase >20% compared to tryptase baseline levels. Conclusions and Clinical RelevanceCD-sens and component-resolved diagnostics to hazelnut, used separately or in combination, may improve the diagnostic accuracy and safety and reduce overdiagnosis of hazelnut allergy.

Place, publisher, year, edition, pages
2015. Vol. 45, no 9, 1412-1418 p.
Keyword [en]
basophils, CD-sens, flow cytometry, IgE antibody, molecular allergology, oral food challenge, tryptase
National Category
Respiratory Medicine and Allergy
Identifiers
URN: urn:nbn:se:uu:diva-262955DOI: 10.1111/cea.12515ISI: 000360317200006PubMedID: 25707509OAI: oai:DiVA.org:uu-262955DiVA: diva2:857732
Available from: 2015-09-30 Created: 2015-09-23 Last updated: 2017-12-01Bibliographically approved

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Borres, Magnus P.

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