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Estimating the Risk of Severe Peanut Allergy Using Clinical Background and IgE Sensitization Profiles
MR. Datema, SA. Lyons, M. Fernández-Rivas, B. Ballmer-Weber, AC. Knulst, R. Asero, L. Barreales, S. Belohlavkova, F. de Blay, M. Clausen, R. Dubakiene, C. Fernández-Perez, P. Fritsche, D. Gislason, K. Hoffmann-Sommergruber, M....
Jazyk angličtina Země Švýcarsko
Typ dokumentu časopisecké články
NLK
Directory of Open Access Journals
od 2020
PubMed Central
od 2020
ROAD: Directory of Open Access Scholarly Resources
od 2020
- Publikační typ
- časopisecké články MeSH
Background: It is not well-understood why symptom severity varies between patients with peanut allergy (PA). Objective: To gain insight into the clinical profile of subjects with mild-to-moderate and severe PA, and investigate individual and collective predictive accuracy of clinical background and IgE to peanut extract and components for PA severity. Methods: Data on demographics, patient history and sensitization at extract and component level of 393 patients with probable PA (symptoms ≤ 2 h + IgE sensitization) from 12 EuroPrevall centers were analyzed. Univariable and penalized multivariable regression analyses were used to evaluate risk factors and biomarkers for severity. Results: Female sex, age at onset of PA, symptoms elicited by skin contact with peanut, family atopy, atopic dermatitis, house dust mite and latex allergy were independently associated with severe PA; birch pollen allergy with mild-to-moderate PA. The cross-validated AUC of all clinical background determinants combined (0.74) was significantly larger than the AUC of tests for sensitization to extract (0.63) or peanut components (0.54-0.64). Although larger skin prick test wheal size, and higher IgE to peanut extract, Ara h 1 and Ara h 2/6, were associated with severe PA, and higher IgE to Ara h 8 with mild-to-moderate PA, addition of these measurements of sensitization to the clinical background model did not significantly improve the AUC. Conclusions: Models combining clinical characteristics and IgE sensitization patterns can help establish the risk of severe reactions for peanut allergic patients, but clinical background determinants are most valuable for predicting severity of probable PA in an individual patient.
Allergy Department 2nd Pediatric Clinic University of Athens Athens Greece
Allergy Division Chest Disease Department Strasbourg University Hospital Strasbourg France
Allergy Unit Department of Dermatology University Hospital Zurich Switzerland
Ambulatorio di Allergologia Clinica San Carlo Paderno Dugnano Italy
Clinic for Dermatology and Allergology Kantonsspital St Gallen St Gallen Switzerland
Clinic of Occupational Diseases University Hospital Sv Ivan Rilski Sofia Bulgaria
Clinical Center of Allergology Medical University of Sofia Sofia Bulgaria
Department of Experimental Immunology Amsterdam University Medical Center Amsterdam Netherlands
Department of Otorhinolaryngology Amsterdam University Medical Center Amsterdam Netherlands
Department of Pathophysiology and Allergy Research Medical University of Vienna Vienna Austria
Faculty of Medicine Landspitali University Hospital University of Iceland Reykjavik Iceland
Faculty of Medicine University of Zurich Zurich Switzerland
Institute of Immunity and Transplantation University College London London United Kingdom
Medical Faculty Vilnius University Vilnius Lithuania
Paul Ehrlich Institut Federal Institute for Vaccines and Biomedicines Langen Germany
Citace poskytuje Crossref.org
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