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- Title
Utility of component analyses in subjects undergoing sublingual immunotherapy for peanut allergy.
- Authors
Burk, C. M.; Kulis, M.; Leung, N.; Kim, E. H.; Burks, A. W.; Vickery, B. P.
- Abstract
Background Sublingual immunotherapy (SLIT) with peanut changes clinical and immune responses in most peanut-allergic individuals, but the response is highly variable. Objective We sought to examine the component-specific effects of peanut SLIT and determine whether peanut component testing could predict the outcome of a double-blind, placebo-controlled food challenge (DBPCFC) after 12 months of peanut SLIT. Methods We included 33 subjects who underwent peanut SLIT with a DBPCFC of 2500 mg of peanut protein performed after 12 months of therapy. Plasma samples from baseline and after 12 months of peanut SLIT were assayed using ImmunoCAP for IgE and IgG4 against whole peanut, Ara h 1, Ara h 2, Ara h 3, Ara h 8, and Ara h 9. Results Following 12 months of SLIT, 10 subjects (30%) passed the DBPCFC without symptoms and were considered desensitized. Subjects that failed the DBPCFC tolerated a median of 460 mg peanut protein (range: 10-1710 mg). The desensitized group had significantly lower baseline levels of IgE against peanut (median 40.8 vs. 231 kUA/L, P = 0.0082), Ara h 2 (median 17 vs. 113 kUA/L, P = 0.0082), and Ara h 3 (median 0.3 vs. 8.5 kUA/L, P = 0.0396). ROC curves indicated that baseline IgE against peanut and Ara h 2 were equally effective at discriminating between the two groups (AUC = 0.7957, P = 0.007752 for both). Conclusion and Clinical Relevance In this cohort of subjects undergoing SLIT for peanut allergy, lower baseline levels of IgE against Ara h 2, Ara h 3, and peanut were associated with successful desensitization.
- Subjects
SUBLINGUAL immunotherapy; PEANUT allergy; TREATMENT effectiveness; IMMUNOGLOBULIN E; ALLERGY desensitization; ALLERGY treatment
- Publication
Clinical & Experimental Allergy, 2016, Vol 46, Issue 2, p347
- ISSN
0954-7894
- Publication type
Article
- DOI
10.1111/cea.12635