PDF(Pubmed)
Abstract：
(1) Peanut allergy is associated with high risk of anaphylaxis which could be prevented by oral immunotherapy. Patients eligible for immunotherapy are selected on the basis of a food challenge, although currently the assessment of antibodies against main peanut molecules (Ara h 1, 2, 3 and 6) is thought to be another option. (2) The current study assessed the relationship between the mentioned antibodies, challenge outcomes, skin tests and some other parameters in peanut-sensitized children. It involved 74 children, divided into two groups, based on their response to a food challenge. (3) Both groups differed in results of skin tests, levels of component-specific antibodies and peanut exposure history. The antibody levels were then used to calculate thresholds for prediction of challenge results or symptom severity. While the antibody-based challenge prediction revealed statistical significance, it failed in cases of severe symptoms. Furthermore, no significant correlation was observed between antibody levels, symptom-eliciting doses and the risk of severe anaphylaxis. Although in some patients it could result from interference with IgG4, the latter would not be a universal explanation of this phenomenon. (4) Despite some limitations, antibody-based screening may be an alternative to the food challenge, although its clinical relevance still requires further studies.
摘要：
（1）花生过敏与过敏反应的高风险相关，口服免疫疗法可以预防。符合免疫治疗条件的患者是根据食物挑战选择的。尽管目前评估针对主要花生分子（Arah1、2、3和6）的抗体被认为是另一种选择。(2)本研究评估了上述抗体之间的关系，挑战结果，花生致敏儿童的皮肤测试和其他一些参数。涉及74名儿童，分成两组,基于他们对食物挑战的反应。(3)两组皮肤试验结果不同,成分特异性抗体水平和花生接触史。然后使用抗体水平来计算预测攻击结果或症状严重程度的阈值。虽然基于抗体的攻击预测显示出统计学意义，在出现严重症状的情况下，它失败了。此外，抗体水平之间没有观察到显著的相关性，症状引发剂量和严重过敏反应的风险。尽管在某些患者中，它可能是由IgG4的干扰引起的，但后者并不是对这种现象的普遍解释。（4）尽管有一些限制，基于抗体的筛查可能是食物挑战的替代方案，尽管其临床相关性仍需进一步研究。
