IgE binding to linear epitopes of Ara h 2 in peanut allergic preschool children undergoing oral Immunotherapy

Stephen C. Dreskin, Matthew Germinaro, Dominik Reinhold, Xueni Chen, Brian P. Vickery, Michael Kulis, A. Wesley Burks, Surendra S. Negi, Werner Braun, Jeffery M. Chambliss, Spodra Eglite, Caitlin M.G. McNulty

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Background: For patients with peanut allergy, there are currently no methods to predict who will develop sustained unresponsiveness (SU) after oral immunotherapy (OIT). Objective: Assess IgE binding to peanut (PN), Ara h 2, and specific linear epitopes of Ara h 2 as predictors of the important clinical parameters: eliciting dose threshold and attainment of SU following OIT. Methods: Samples and clinical data were collected from children undergoing OIT. PN- and Ara h 2-sIgE were quantified by ImmunoCAP®. IgE binding to linear peptides of Ara h 2 and Ara h 6 was measured with peptide microarrays. Results: Values of PN-sIgE correlated with eliciting dose (P =.001) and with a higher likelihood of achieving SU (P <.0001), but these relationships were lost at higher values for PN-sIgE (≥14 kIU for eliciting dose and ≥35 kIU/L for SU). In subjects with PN-sIgE ≥ 14 kIU/L, binding of IgE to epitopes 5 and 6 of Ara h 2 was associated with a lower eliciting dose at baseline challenge (P <.001; Pc <.02). In subjects with PN-sIgE ≥ 35 kIU/L, a combined model of IgE binding to epitopes 1, 5 and 6 with PN-sIgE was highly predictive of attainment of SU (AUC of 0.86; P =.0067). Conclusion: In young patients with peanut allergy, measurement of PN-sIgE and IgE binding to specific linear epitopes of Ara h 2 in baseline samples may allow stratification of patients regarding sensitivity to challenge and outcome of OIT.

Original languageEnglish (US)
Pages (from-to)817-823
Number of pages7
JournalPediatric Allergy and Immunology
Volume30
Issue number8
DOIs
StatePublished - Dec 1 2019

Keywords

  • IgE
  • allergens
  • food allergy
  • immunotherapy
  • oral immunotherapy
  • peanut allergy
  • tolerance induction

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Immunology and Allergy
  • Immunology

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    Dreskin, S. C., Germinaro, M., Reinhold, D., Chen, X., Vickery, B. P., Kulis, M., Burks, A. W., Negi, S. S., Braun, W., Chambliss, J. M., Eglite, S., & McNulty, C. M. G. (2019). IgE binding to linear epitopes of Ara h 2 in peanut allergic preschool children undergoing oral Immunotherapy. Pediatric Allergy and Immunology, 30(8), 817-823. https://doi.org/10.1111/pai.13117