IgE Profiles May Help Predict Which Peanut-allergic Children May Benefit Most from Oral Immunotherapy
February 3, 2023
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Peanut allergy patients who achieved sustained unresponsiveness during oral immunotherapy appear to have different baseline protein and epitope-specific IgE profiles, according to research to be presented at the 2023 AAAAI Annual Meeting.
Milwaukee, WI –Research being presented during the 2023 Annual Meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI) indicates that baseline epitope-specific IgE profiles may be predictive of achieving sustained unresponsiveness (SU) after completion of peanut oral immunotherapy.
The peanut Bead-Based Epitope Assay (BBEA) is a molecular diagnostic test that quantifies antibody binding to peanut epitopes, which are specific regions of the peanut proteins that are recognized by human antibodies. Peanut epitopes can help distinguish different types of peanut allergy, which is not possible with currently available testing methods, such as skin testing or whole-protein peanut IgE. A patient who is truly allergic to peanut has an IgE epitope binding profile that differs from a patient who may be sensitized but is not clinically reactive. In addition to having a sensitivity of 92% and a specificity of 94%, this test has a 93% concordance to results of a peanut oral food challenge, which is the gold standard for diagnosing food allergy.
Researchers examined patients from the POISED trial, who were randomized to peanut or a placebo for 24 months. Following this, desensitized patients either consumed no peanut or 300mg of peanut over the next 12 months. Researchers then determined SU by assessing which patients could pass a four-gram peanut oral food challenge.
Researchers measured IgE to peanut and peanut component proteins, IgG4 to peanut, and IgE and IgG4 to 64 allergenic peanut epitopes. Machine learning models were used to predict SU. Researchers observed that those who achieved SU despite stopping oral immunotherapy had different baseline peanut protein and epitope IgE profiles than those who achieved transient desensitization (i.e. those who passed their food challenges at the end of desensitization but did not pass the “final” food challenge at 156 weeks).
The machine learning model developed by researchers predicted SU with an 87% accuracy rate. Due to the limited sample size, resampling was used to predict SU rather than traditional training and testing sets.
Visit aaaai.org to learn more about OIT. Research presented at the AAAAI Annual Meeting, February 24-27 in San Antonio, Texas, is published in an online supplement to The Journal of Allergy and Clinical Immunology.
The American Academy of Allergy, Asthma & Immunology (AAAAI) is the leading membership organization of more than 7,100 allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic and immunologic diseases. The AAAAI is the go-to resource for patients living with allergies, asthma and immune deficiency disorders. Established in 1943, the AAAAI has more than 7,100 members in the United States, Canada and 72 other countries. The AAAAI’s Find an Allergist/Immunologist service is a trusted resource to help you find a specialist close to home.