Serological characteristics of peanut allergy in children

Background: Food challenge is considered an excellent clinical tool for the diagnosis of specific food allergy. However in the case of peanut allergy it may be difficult to perform because of the severity of the reactions. The quantitation of a specific immunoglobulin E (IgE) response to different peanut allergens could also contribute to the improvement of the diagnosis. We characterized the IgE response to a whole peanut protein extract and to Ara h 1 and Ara h 2 in different groups of patients classified according to the severity of their allergic reactions. Methods: Specific serum IgE were analyzed in 96 children by enzyme‐linked immunosorbent assay tests using a whole protein extract or purified peanut proteins and anti‐human IgE monoclonal antibodies labeled with acetylcholinesterase. Results: A parallel was observed between levels of peanut‐specific IgE and the classification in five groups and subgroups of patients upon increasing severity of symptoms, especially within the group of highest severity. Moreover, the highest frequency of positive response and the highest levels of specific IgE were observed with whole peanut protein extract. Conclusion: In a retrospective evaluation of peanut allergy in children, we have shown that quantitation of peanut‐specific IgE could be used to avoid a food challenge particularly in the case of severe reactions. When compared to Ara h 1 and Ara h 2, whole peanut protein extract appeared to be the most appropriate allergen to perform the test.