Journal
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
Volume 132, Issue 3, Pages 639-647Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.jaci.2013.04.023
Keywords
Peanut allergy; skin prick testing; IgE; Sub-Saharan Africa; IgE cross-reactivity; cross-reactive carbohydrate determinants; helminth infections; basophil histamine release; EuroPrevall
Categories
Funding
- EuroPrevall [FOOD-CT-2005-514000]
- GLOFAL [FOOD-CT-2005-517812]
- Wellcome Trust [075791/Z/04/Z]
- European Union
- Wellcome Trust
- European Commission
- Instituto de Salud Carlos III
- ALK-Abello
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Background: The prevalence of peanut allergy has increased in developed countries, but little is known about developing countries with high peanut consumption and widespread parasitic infections. Objective: We sought to investigate peanut allergy in Ghana. Methods: In a cross-sectional survey among Ghanaian schoolchildren (n = 1604), data were collected on reported adverse reactions to peanut, peanut sensitization (serum specific IgE and skin reactivity), consumption patterns, and parasitic infections. In a subset (n = 43) IgE against Ara h 1, 2, 3, and 9 as well as cross-reactive carbohydrate determinants (CCDs) was measured by using ImmunoCAP. Cross-reactivity and biological activity were investigated by means of ImmunoCAP inhibition and basophil histamine release, respectively. Results: Adverse reactions to peanut were reported in 1.5%, skin prick test reactivity in 2.0%, and IgE sensitization (>= 0.35 kU/L) in 17.5% of participants. Moreover, 92.4% of those IgE sensitized to peanut (>= 0.35 kU/L) had negative peanut skin prick test responses. Schistosoma haematobium infection was positively associated with IgE sensitization (adjusted odds ratio, 2.29; 95% CI, 1.37-3.86). In the subset IgE titers to Ara h 1, 2, 3, and 9 were low (<1.3 kU/L), except for 6 moderately strong reactions to Ara h 9. IgE against peanut was strongly correlated with IgE against CCDs (r = 0.89, P < .0001) and could be almost completely inhibited by CCDs, as well as S haematobium soluble egg antigen. Moreover, IgE to peanut showed poor biological activity. Conclusions: Parasite-induced IgE against CCDs might account largely for high IgE levels to peanut in our study population of Ghanaian schoolchildren. No evidence of IgE-mediated peanut allergy was found.
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