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Biomarkers to predict changes in peanut allergy in children over time
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  • Ru-Xin Foong,
  • George Du Toit,
  • Ronald Van Ree,
  • Tee Bahnson H,
  • Suzana Radulovic,
  • Jo Craven,
  • Matthew Kwok,
  • Zainab Jama,
  • Versteeg S.A.,
  • Helen A. Brough,
  • Kirsty Logan,
  • Michael Perkin,
  • Carsten Flohr,
  • Gideon Lack,
  • Alexandra Santos
Ru-Xin Foong
King's College London Faculty of Life Sciences & Medicine
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George Du Toit
King's College London Faculty of Life Sciences & Medicine
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Ronald Van Ree
Amsterdam UMC Locatie AMC Afdeling Klinische Immunologie en Reumatologie
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Tee Bahnson H
Immune Tolerance Network
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Suzana Radulovic
King's College London Faculty of Life Sciences & Medicine
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Jo Craven
King's College London Faculty of Life Sciences & Medicine
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Matthew Kwok
King's College London Faculty of Life Sciences & Medicine
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Zainab Jama
King's College London Faculty of Life Sciences & Medicine
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Versteeg S.A.
Amsterdam UMC Locatie AMC Afdeling Klinische Immunologie en Reumatologie
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Helen A. Brough
King's College London Faculty of Life Sciences & Medicine
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Kirsty Logan
King's College London School of Life Course & Population Sciences
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Michael Perkin
St George's University of London Population Health Research Institute
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Carsten Flohr
St John's Institute of Dermatology
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Gideon Lack
King's College London Faculty of Life Sciences & Medicine
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Alexandra Santos
King's College London Faculty of Life Sciences & Medicine

Corresponding Author:[email protected]

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Abstract

Background: Various biomarkers are used to define peanut allergy (PA). We aimed to observe changes in PA resolution and persistence over time comparing biomarkers in PA and peanut sensitised but tolerant (PS) children in a population-based cohort. Methods: Participants were recruited from the EAT and EAT-On studies, conducted across England and Wales and were generally well exclusively breastfed babies recruited at 3 months old and followed up until 11 years old. Clinical characteristics, skin prick test (SPT), sIgE to peanut and peanut components and mast cell activation tests (MAT) were assessed at 12m, 36m and 7-11y. Results: The prevalence of PA was 2.1% with only 1 child having PA resolution at 7-11y. PA children had larger SPT size, higher peanut-sIgE, Ara h 2-sIgE and MAT (all p<0.001) compared to PS children at 36m and 7-11y. SPT, peanut-sIgE, Ara h 2-sIgE and MAT between children with persistent PA, new PA, outgrown PA and PS were statistically significant at both 36m and 7-11y (p<0.001). Those with persistent PA had SPT, peanut-sIgE and Ara h 2-sIgE that increased over time and MAT which was highest at 36m. New PA children had increased SPT and peanut-sIgE from 36m to 7-11y, but MAT remained low. PS children had low biomarkers across time. Conclusions: In this cohort, few children outgrow or develop new PA between 36m and 7-11y. Children with PA have significantly higher SPT, peanut-sIgE, Ara h 2-sIgE and MAT compared to PS children, evident from 12-36m of age.
11 Nov 2023Submitted to Allergy
11 Nov 2023Submission Checks Completed
11 Nov 2023Assigned to Editor
11 Nov 2023Review(s) Completed, Editorial Evaluation Pending
15 Nov 2023Reviewer(s) Assigned
03 Apr 20241st Revision Received