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Measurement of IgE to hazelnut allergen components cannot replace hazelnut challenge in Dutch adults
BACKGROUND: Component‐resolved diagnostics (CRD) help predict hazelnut allergy (HA) in children, but are of unknown diagnostic value in adults. This study aimed to evaluate the diagnostic accuracy of IgE to hazelnut extract and components in adults. METHODS: A Dutch population of consecutively prese...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9298907/ https://www.ncbi.nlm.nih.gov/pubmed/34731517 http://dx.doi.org/10.1111/all.15166 |
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author | Lyons, Sarah A. Welsing, Paco M. J. Hakobyan, Mariam Kansen, Hannah M. Knol, Edward F. Otten, Henny G. van Ree, Ronald Knulst, André C. Le, Thuy‐My |
author_facet | Lyons, Sarah A. Welsing, Paco M. J. Hakobyan, Mariam Kansen, Hannah M. Knol, Edward F. Otten, Henny G. van Ree, Ronald Knulst, André C. Le, Thuy‐My |
author_sort | Lyons, Sarah A. |
collection | PubMed |
description | BACKGROUND: Component‐resolved diagnostics (CRD) help predict hazelnut allergy (HA) in children, but are of unknown diagnostic value in adults. This study aimed to evaluate the diagnostic accuracy of IgE to hazelnut extract and components in adults. METHODS: A Dutch population of consecutively presenting adults suspected of HA, who underwent a double‐blind placebo‐controlled food challenge, were included. Serum IgE to hazelnut extract and Cor a 1, 8, 9, and 14 was measured on ImmunoCAP. Diagnostic accuracy was assessed by area under the curve (AUC) analysis. RESULTS: Of 89 patients undergoing challenge, 46 had challenge‐confirmed HA: 17 based on objective and 29 based on subjective symptoms. At commonly applied cutoffs 0.1 and 0.35 kU(A)/L, high sensitivity was observed for IgE to hazelnut extract and Cor a 1 (range 85–91%), and high specificity for IgE to Cor a 8, 9 and 14 (range 77–95%). However, the AUCs for hazelnut extract and components were too low for accurate prediction of HA (range 0.50–0.56). Combining hazelnut extract and component IgE measurements did not significantly improve accuracy. Higher IgE levels to Cor a 9 and 14 were tentatively associated with HA with objective symptoms, but the corresponding AUCs still only reached 0.68 and 0.63, respectively. CONCLUSIONS: Although hazelnut allergic adults are generally sensitized to hazelnut extract and Cor a 1, and hazelnut tolerant adults are usually not sensitized to Cor a 8, 9, or 14, challenge testing is still needed to accurately discriminate between presence and absence of HA in adults from a birch‐endemic country. |
format | Online Article Text |
id | pubmed-9298907 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-92989072022-07-21 Measurement of IgE to hazelnut allergen components cannot replace hazelnut challenge in Dutch adults Lyons, Sarah A. Welsing, Paco M. J. Hakobyan, Mariam Kansen, Hannah M. Knol, Edward F. Otten, Henny G. van Ree, Ronald Knulst, André C. Le, Thuy‐My Allergy ORIGINAL ARTICLES BACKGROUND: Component‐resolved diagnostics (CRD) help predict hazelnut allergy (HA) in children, but are of unknown diagnostic value in adults. This study aimed to evaluate the diagnostic accuracy of IgE to hazelnut extract and components in adults. METHODS: A Dutch population of consecutively presenting adults suspected of HA, who underwent a double‐blind placebo‐controlled food challenge, were included. Serum IgE to hazelnut extract and Cor a 1, 8, 9, and 14 was measured on ImmunoCAP. Diagnostic accuracy was assessed by area under the curve (AUC) analysis. RESULTS: Of 89 patients undergoing challenge, 46 had challenge‐confirmed HA: 17 based on objective and 29 based on subjective symptoms. At commonly applied cutoffs 0.1 and 0.35 kU(A)/L, high sensitivity was observed for IgE to hazelnut extract and Cor a 1 (range 85–91%), and high specificity for IgE to Cor a 8, 9 and 14 (range 77–95%). However, the AUCs for hazelnut extract and components were too low for accurate prediction of HA (range 0.50–0.56). Combining hazelnut extract and component IgE measurements did not significantly improve accuracy. Higher IgE levels to Cor a 9 and 14 were tentatively associated with HA with objective symptoms, but the corresponding AUCs still only reached 0.68 and 0.63, respectively. CONCLUSIONS: Although hazelnut allergic adults are generally sensitized to hazelnut extract and Cor a 1, and hazelnut tolerant adults are usually not sensitized to Cor a 8, 9, or 14, challenge testing is still needed to accurately discriminate between presence and absence of HA in adults from a birch‐endemic country. John Wiley and Sons Inc. 2021-11-16 2022-05 /pmc/articles/PMC9298907/ /pubmed/34731517 http://dx.doi.org/10.1111/all.15166 Text en © 2021 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | ORIGINAL ARTICLES Lyons, Sarah A. Welsing, Paco M. J. Hakobyan, Mariam Kansen, Hannah M. Knol, Edward F. Otten, Henny G. van Ree, Ronald Knulst, André C. Le, Thuy‐My Measurement of IgE to hazelnut allergen components cannot replace hazelnut challenge in Dutch adults |
title | Measurement of IgE to hazelnut allergen components cannot replace hazelnut challenge in Dutch adults |
title_full | Measurement of IgE to hazelnut allergen components cannot replace hazelnut challenge in Dutch adults |
title_fullStr | Measurement of IgE to hazelnut allergen components cannot replace hazelnut challenge in Dutch adults |
title_full_unstemmed | Measurement of IgE to hazelnut allergen components cannot replace hazelnut challenge in Dutch adults |
title_short | Measurement of IgE to hazelnut allergen components cannot replace hazelnut challenge in Dutch adults |
title_sort | measurement of ige to hazelnut allergen components cannot replace hazelnut challenge in dutch adults |
topic | ORIGINAL ARTICLES |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9298907/ https://www.ncbi.nlm.nih.gov/pubmed/34731517 http://dx.doi.org/10.1111/all.15166 |
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