Evaluating clinical importance of sensitization to Ara h 6 quantitively in Japanese children

Background: The clinical importance of sensitization to Arachis hypogaea 6 (Ara h 6) in Japanese children remains unelucidated. We aimed to quantitatively evaluate the clinical importance of sensitization to Ara h 6 in managing peanut allergy in Japanese children. Methods: We retrospectively analyze...

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Main Authors: Sakura Sato, MD, Noriyuki Yanagida, MD, PhD, Ken-ichi Nagakura, MD, PhD, Kyohei Takahashi, MD, PhD, MPH, Magnus P. Borres, MD, PhD, Motohiro Ebisawa, MD, PhD
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:World Allergy Organization Journal
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Online Access:http://www.sciencedirect.com/science/article/pii/S1939455124001339
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Summary:Background: The clinical importance of sensitization to Arachis hypogaea 6 (Ara h 6) in Japanese children remains unelucidated. We aimed to quantitatively evaluate the clinical importance of sensitization to Ara h 6 in managing peanut allergy in Japanese children. Methods: We retrospectively analyzed the data of children with or without symptoms induced by an oral food challenge or home dosing of up to 3 g of peanuts. The specific immunoglobulin E (sIgE) levels against peanuts, Ara h 2, and Ara h 6 were quantified using an ImmunoCAP assay. Results: We examined 273 patients aged 4.6–9.8 years (median 6.3); 189 (69%) were male, 187 (68%) had allergies to peanuts, and 43 (16%) had anaphylactic reactions to peanuts. Ara h 6 and Ara h 2 co-sensitization was observed in 224 patients (82%). Ara h 6-sIgE levels were significantly associated with the probability of allergic reactions and anaphylaxis. The 95% probability of allergic reactions to peanuts was obtained at 44.5 kUA/L of Ara h 6-sIgE, but the 95% probability of anaphylaxis could not be calculated. A combination of Ara h 6 and Ara h 2 could not improve diagnostic accuracy for allergic reactions and anaphylaxis to peanuts. Conclusion: Sensitization to Ara h 6 played an important role in managing peanut allergy in Japanese children, and sIgE levels provided valuable predictive information for allergic reactions to peanuts. However, the measurement of Ara h 6 did not improve the diagnostic accuracy of anaphylaxis, and Ara h 2 alone might be sufficient for clinical evaluation in peanut allergy.
ISSN:1939-4551