Background

Peanut allergy is characterized by the development of IgE against peanut antigen.

Objective

We sought to evaluate the evolution of epitope-specific (es)IgE and esIgG₄ in a prospective cohort of high-risk infants to determine whether antibody profiles can predict peanut allergy after age 4 years.

Methods

The end point was allergy status at age 4⁺ years; samples from 293 children were collected at age 3 to 15 months and 2 to 3 and 4⁺ years. Levels of specific (s)IgE and sIgG₄ to peanut and component proteins, and 50 esIgE and esIgG₄ were quantified. Changes were analyzed with mixed-effects models. Machine learning algorithms were developed to identify a combination of antigen- and epitope-specific antibodies that using 3- to 15-month or 2- to 3-year samples can predict allergy status at age 4⁺ years.

Results

At age 4⁺ years, 38% of children were Tolerant or 14% had Possible, 8% Convincing, 24% Serologic, and 16% Confirmed allergy. At age 3 to 15 months, esIgE profiles were similar among groups, whereas marked increases were evident at age 2 and 4⁺ years only in Confirmed and Serologic groups. In contrast, peanut sIgE level was significantly lower in the Tolerant group at age 3 to 15 months, increased in Confirmed and Serologic groups but decreased in Convincing and Possibly Allergic groups over time. An algorithm combining esIgEs with peanut sIgE outperformed different clinically relevant IgE cutoffs, predicting allergy status on an “unseen” set of patients with area under the curves of 0.84 at age 3 to 15 months and 0.87 at age 2 to 3 years.

Conclusions

Early epitope-specific plus peanut-specific IgE is predictive of allergy status at age 4⁺ years.

中文翻译：

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早期表位特异性 IgE 抗体可预测儿童花生过敏。

背景

花生过敏的特征是产生针对花生抗原的 IgE。

客观的

我们试图在高危婴儿的前瞻性队列中评估表位特异性 (es)IgE 和 esIgG ₄的演变，以确定抗体谱是否可以预测 4 岁后的花生过敏。

方法

终点是在4岁过敏状态⁺年; 从293名儿童样本在3岁至15个月和2收集3和4 ⁺年。特定的电平（S）IgE和特异性IgG ₄至花生和组分蛋白，和50嵌入式硅锗和esIgG ₄进行定量。使用混合效应模型分析了变化。机器学习算法被开发，以确定使用3- 15个月或2至3年的样本可以在年龄预测过敏状态4抗原表位和特异性抗体的组合⁺年。

结果

4岁时⁺年，儿童的38％是宽容或14％有可能的，8％有说服力的，24％的血清学和16％确认过敏。在3岁至15个月，嵌入式硅锗曲线是组相似，而显着增加，在2岁和4是明显⁺年只在确认和血清学组。相反，花生 sIgE 水平在 3 至 15 个月大时在耐受组中显着降低，在确认组和血清学组中增加，但在令人信服和可能过敏组中随着时间的推移而下降。将 esIgE 与花生 sIgE 相结合的算法优于不同的临床相关 IgE 截止值，预测一组“看不见的”患者的过敏状态，其曲线下面积在 3 至 15 个月时为 0.84，在 2 至 3 岁时为 0.87。

结论

表位特异性早期加花生特异性IgE是年龄预测的过敏状态4 ⁺年。