期刊
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
卷 148, 期 3, 页码 835-842出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.jaci.2021.01.030
关键词
Peanut allergy; biomarkers; sequential epitope; antibody; IgE; IgG(4); bead-based epitope assay
资金
- National Institute of Allergy and Infectious Diseases of the National Institutes of Health [UM1AI109565, NO1-AI-15416, HHSN272200800029C, UM2AI117870]
- David H. and Julia Koch Research Program in Food Allergy Therapeutics
- AllerGenis LLC
- Integrated Pharmacological Sciences Training Program grant from the National Institute of General Medical Sciences [T32GM062754]
Early peanut consumption in high-risk infants may reduce the risk of peanut allergy. Children who consume peanut tend to generate a presumably protective antibody earlier and in greater quantities, while children who avoid peanut may produce more allergic antibodies.
Background: In the LEAP (Learning Early About Peanut Allergy) trial, early consumption of peanut in high-risk infants was found to decrease the rate of peanut allergy at 5 years of age. Sequential epitope-specific (ses-)IgE is a promising biomarker of clinical peanut reactivity. Objective: We sought to compare the evolution of ses-IgE and ses-IgG4 in children who developed (or not) peanut allergy and to evaluate the immunomodulatory effects of early peanut consumption on these antibodies. Methods: Sera from 341 children (LEAP cohort) were assayed at baseline, 1, 2.5, and 5 years of age, with allergy status determined by oral food challenge at 5 years. A bead-based epitope assay was used to quantitate ses-IgE and ses-IgG4 to 64 sequential epitopes fromAra h 1 to Ara h 3 and was analyzed using linear mixed-effect models. Results: In children avoiding peanut who became peanut allergic, the bulk of peanut ses-IgE did not develop until after 2.5 years. Minimal increases of ses-IgE occurred after 1 year in consumers, but not to the same epitopes as those in children developing peanut allergy. No major changes in ses-IgE were seen in nonallergic or sensitized children. IgE in sensitized consumers was detected against peanut proteins. ses-IgG4 increased over time in most children regardless of consumption or allergy status. Conclusions: Early peanut consumption in infants at high risk of developing peanut allergy appears to divert the immunologic response to a presumably protective'' effect. In general, consumers tend to generate ses-IgG4 earlier and in greater quantities than nonconsumers do, whereas only avoiders tend to generate significant quantities of ses-IgE.
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