BackgroundThere are no studies of longitudinal immunoglobulin measurements in a population‐based cohort alongside challenge‐confirmed peanut allergy outcomes. Little is known about biomarkers for identifying naturally resolving peanut allergy during childhood.ObjectivesTo measure longitudinal trends in whole peanut and component Ara h 2 sIgE and sIgG4 in the first 10 years of life, in a population cohort of children with challenge‐confirmed peanut allergy, and to determine whether peanut‐specific immunoglobulin levels or trends are associated with peanut allergy persistence or resolution by 10 years of age.MethodsOne‐year‐old infants with challenge‐confirmed peanut allergy (n = 156) from the HealthNuts study (n = 5276) were prospectively followed at ages 4, 6, and 10 years with questionnaires, skin prick tests, oral food challenges, and plasma total‐IgE, sIgE and sIgG4 to peanut and Ara h 2.ResultsPeanut allergy resolved in 33.9% (95% CI = 25.3%, 43.3%) of children by 10 years old with most resolving (97.4%, 95% CI = 86.5%, 99.9%) by 6 years old. Decreasing Ara h 2 sIgE (p = .01) and increasing peanut sIgG4 (p < .001), Ara h 2 sIgG4 (p = .01), peanut sIgG4/sIgE (p < .001) and Ara h 2 sIgG4/sIgE (p < .001) from 1 to 10 years of age were associated with peanut allergy resolution. Peanut sIgE measured at 1 year old had the greatest prognostic value (AUC = 0.75 [95% CI = 0.66, 0.82]); however, no single threshold produced both high sensitivity and specificity.ConclusionOne third of infant peanut allergy resolved by 10 years of age. Decreasing sIgE and sIgG4 to peanut and Ara h 2 over time were associated with natural resolution of peanut allergy. However, biomarker levels at diagnosis were not strongly associated with the natural history of peanut allergy.

中文翻译：

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纵向花生和 Ara h 2 特异性-IgE、-IgG4 和-IgG4/-IgE 比率与儿童花生过敏的自然消退相关


背景目前还没有在基于人群的队列中进行纵向免疫球蛋白测量以及挑战确认的花生过敏结果的研究。对于识别儿童时期自然解决花生过敏的生物标志物知之甚少。目的测量在患有挑战确认花生过敏的儿童群体中，在生命的前 10 年中整个花生及其成分 Ara h 2 sIgE 和 sIgG4 的纵向趋势，并确定花生特异性免疫球蛋白水平或趋势是否与 10 岁时花生过敏的持续或缓解相关。 方法 来自 HealthNuts 研究 (n = 5276) 的一岁婴儿经挑战确认花生过敏 (n = 156) ）在 4、6 和 10 岁时进行了前瞻性随访，包括问卷调查、皮肤点刺试验、口服食物挑战以及血浆对花生和 Ara h 的总 IgE、sIgE 和 sIgG4 2。结果花生过敏的解决率为 33.9%（95% CI） = 25.3%, 43.3%）的儿童在 10 岁时解决问题（97.4%, 95% CI = 86.5%, 99.9%）在 6 岁时。减少 Ara h 2 sIgE (p = .01) 并增加花生 sIgG4 (p < .001)、Ara h 2 sIgG4 (p = .01)、花生 sIgG4/sIgE (p < .001) 和 Ara h 2 sIgG4/sIgE (p < .001) 1 至 10 岁与花生过敏的缓解相关。 1岁时测量的花生sIgE具有最大的预后价值（AUC = 0.75 [95% CI = 0.66, 0.82]）；然而，没有一个单一的阈值能够同时产生高敏感性和特异性。 结论 三分之一的婴儿花生过敏在 10 岁时得到了缓解。随着时间的推移，花生和 Ara h 2 的 sIgE 和 sIgG4 减少与花生过敏的自然消退相关。然而，诊断时的生物标志物水平与花生过敏的自然史并没有很强的相关性。