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Benefits and limitations of molecular diagnostics in peanut allergy

Part 14 of the series Molecular Allergology

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Abstract

Allergic reactions to peanut (Arachis hypogaea, Ara h) are caused by immunoglobulin E (IgE)-mediated sensitizations to various proteins. The stability and relative proportion of these proteins in peanut determine the risk of hazardous reactions. Hazardous sensitization to seed storage proteins [S2 albumins (Ara h 2, 6 and 7) > other seed storage proteins (Ara 1 and 3) > oleosins (Ara h 10 and 11)] are distinct from sensitizations to lipid transfer protein (Ara h 9) with moderate risk or cross-sensitizations to Bet v 1-homologous PR-10 protein (Ara h 8) and to profilin (Ara h 5) with low risk. A specific IgE test, e.g. to Ara h 2 in the case of suspected systemic reaction, or where this should be ruled out, can facilitate easier risk assessment. Results, however, are only relevant in the presence of corresponding clinical symptoms. IgE sensitization to peanut extract without hazardous reactions is often caused in this part of the world by Bet v 1-related cross reactions (in birch pollen allergy sufferers), cross-reactive carbohydrate determinants (CCD) or profilin sensitizations. In the case of doubt, clinical relevance can only be established by means of oral challenge, particularly since not all peanut allergens (e. g., oleosins) are available as yet for diagnostic purposes.

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Abbreviations

CCD:

cross-reactive carbohydrate determinants

IgE:

Immunglobulin E

nsLTP:

non-specific lipid transfer protein

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Author information

Authors and Affiliations

  1. Department of Pediatrics, St. Marien-Hospital, Robert-Koch-Str. 1, 53115, Bonn, Germany

    Lars Lange

  2. Department of Pediatric Pneumology and Immunology, Charité Universitätsmedizin Berlin, Berlin, Germany

    Kirsten Beyer

  3. Allergy and Asthma Center Westend, Berlin, Germany

    Jörg Kleine-Tebbe

Authors
  1. Lars Lange
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  2. Kirsten Beyer
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  3. Jörg Kleine-Tebbe
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Corresponding author

Correspondence to Lars Lange.

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The authors declare that no conflicts of interests exist.

Acknowledgements

We would like to thank Bodo Niggemann (Pediatric, Pneumology and Immunology, Charité University Medicine, Berlin) for his valuable advice in the preparation of the flow diagrams.

Cite this as Lange L, Beyer K, Kleine-Tebbe J. Benefits and limitations of molecular diagnostics in peanut allergy. Allergo J Int 2014;23:158–63 DOI: 10.1007/s40629-014-0019-z

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Lange, L., Beyer, K. & Kleine-Tebbe, J. Benefits and limitations of molecular diagnostics in peanut allergy. Allergo J Int 23, 158–163 (2014). https://doi.org/10.1007/s40629-014-0019-z

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  • DOI: https://doi.org/10.1007/s40629-014-0019-z

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