Frontiers in Allergy (Jun 2021)
Estimating the Risk of Severe Peanut Allergy Using Clinical Background and IgE Sensitization Profiles
- Mareen R. Datema,
- Mareen R. Datema,
- Sarah A. Lyons,
- Montserrat Fernández-Rivas,
- Barbara Ballmer-Weber,
- Barbara Ballmer-Weber,
- Barbara Ballmer-Weber,
- André C. Knulst,
- Riccardo Asero,
- Laura Barreales,
- Simona Belohlavkova,
- Frédéric de Blay,
- Michael Clausen,
- Ruta Dubakiene,
- Cristina Fernández-Perez,
- Philipp Fritsche,
- David Gislason,
- Karin Hoffmann-Sommergruber,
- Monika Jedrzejczak-Czechowicz,
- Laurian Jongejan,
- Marek L. Kowalski,
- Tanya Z. Kralimarkova,
- Jonas Lidholm,
- Nikolaos G. Papadopoulos,
- Nikolaos G. Papadopoulos,
- Todor A. Popov,
- Nayade del Prado,
- Ashok Purohit,
- Isabel Reig,
- Suranjith L. Seneviratne,
- Athanassios Sinaniotis,
- Emilia Vassilopoulou,
- Serge A. Versteeg,
- Stefan Vieths,
- Paco M. J. Welsing,
- E. N. Clare Mills,
- Thuy-My Le,
- Aeilko H. Zwinderman,
- Ronald van Ree,
- Ronald van Ree
Affiliations
- Mareen R. Datema
- Department of Experimental Immunology, Amsterdam University Medical Center, Amsterdam, Netherlands
- Mareen R. Datema
- Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Amsterdam University Medical Center, Amsterdam, Netherlands
- Sarah A. Lyons
- Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
- Montserrat Fernández-Rivas
- Allergy Department, Hospital Clinico San Carlos, Instituto de Investigacion Sanitario San Carlos, Madrid, Spain
- Barbara Ballmer-Weber
- Allergy Unit, Department of Dermatology, University Hospital, Zurich, Switzerland
- Barbara Ballmer-Weber
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Barbara Ballmer-Weber
- Clinic for Dermatology and Allergology, Kantonsspital St. Gallen, St. Gallen, Switzerland
- André C. Knulst
- Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
- Riccardo Asero
- Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Italy
- Laura Barreales
- Clinical Epidemiology Unit, Preventive Medicine Department, Hospital Clinico San Carlos, Instituto de Investigacion Sanitario San Carlos, Madrid, Spain
- Simona Belohlavkova
- 0Department of Allergology and Immunology, Faculty of Medicine in Pilsen, Charles University, Prague, Czechia
- Frédéric de Blay
- 1Allergy Division, Chest Disease Department, Strasbourg University Hospital, Strasbourg, France
- Michael Clausen
- 2Faculty of Medicine, Landspitali University Hospital, University of Iceland, Reykjavik, Iceland
- Ruta Dubakiene
- 3Medical Faculty, Vilnius University, Vilnius, Lithuania
- Cristina Fernández-Perez
- Clinical Epidemiology Unit, Preventive Medicine Department, Hospital Clinico San Carlos, Instituto de Investigacion Sanitario San Carlos, Madrid, Spain
- Philipp Fritsche
- Allergy Unit, Department of Dermatology, University Hospital, Zurich, Switzerland
- David Gislason
- 2Faculty of Medicine, Landspitali University Hospital, University of Iceland, Reykjavik, Iceland
- Karin Hoffmann-Sommergruber
- 4Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
- Monika Jedrzejczak-Czechowicz
- 5Department of Immunology, Rheumatology and Allergy, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
- Laurian Jongejan
- Department of Experimental Immunology, Amsterdam University Medical Center, Amsterdam, Netherlands
- Marek L. Kowalski
- 5Department of Immunology, Rheumatology and Allergy, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
- Tanya Z. Kralimarkova
- 6Clinical Center of Allergology, Medical University of Sofia, Sofia, Bulgaria
- Jonas Lidholm
- 7Thermo Fisher Scientific, Uppsala, Sweden
- Nikolaos G. Papadopoulos
- 8Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
- Nikolaos G. Papadopoulos
- 9Division of Infection, Immunity & Respiratory Medicine, University of Manchester, Manchester, United Kingdom
- Todor A. Popov
- 0Clinic of Occupational Diseases, University Hospital Sv. Ivan Rilski, Sofia, Bulgaria
- Nayade del Prado
- Clinical Epidemiology Unit, Preventive Medicine Department, Hospital Clinico San Carlos, Instituto de Investigacion Sanitario San Carlos, Madrid, Spain
- Ashok Purohit
- 1Allergy Division, Chest Disease Department, Strasbourg University Hospital, Strasbourg, France
- Isabel Reig
- Allergy Department, Hospital Clinico San Carlos, Instituto de Investigacion Sanitario San Carlos, Madrid, Spain
- Suranjith L. Seneviratne
- 1Institute of Immunity and Transplantation, University College London, London, United Kingdom
- Athanassios Sinaniotis
- 8Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
- Emilia Vassilopoulou
- 2Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
- Serge A. Versteeg
- Department of Experimental Immunology, Amsterdam University Medical Center, Amsterdam, Netherlands
- Stefan Vieths
- 3Paul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines, Langen, Germany
- Paco M. J. Welsing
- 4Division of Internal Medicine and Dermatology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
- E. N. Clare Mills
- 5Division of Infection, Immunity and Respiratory Medicine, Manchester Institute of Biotechnology, University of Manchester, Manchester, United Kingdom
- Thuy-My Le
- Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
- Aeilko H. Zwinderman
- Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Amsterdam University Medical Center, Amsterdam, Netherlands
- Ronald van Ree
- Department of Experimental Immunology, Amsterdam University Medical Center, Amsterdam, Netherlands
- Ronald van Ree
- 6Department of Otorhinolaryngology, Amsterdam University Medical Center, Amsterdam, Netherlands
- DOI
- https://doi.org/10.3389/falgy.2021.670789
- Journal volume & issue
-
Vol. 2
Abstract
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.
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