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. 2023 Feb;78(2):488-499.
doi: 10.1111/all.15568. Epub 2022 Nov 14.

Development of sensitization to peanut and storage proteins and relation to markers of airway and systemic inflammation: A 24-year follow-up

Sandra G Tedner  1   2 , Susanna Klevebro  3   4 , Anna Bergström  5   6 , Inger Kull  3   4 , Niklas Andersson  5 , Magnus P Borres  7 , Natalia Ballardini  3   4   5 , Marit Westman  8   9 , Jon R Konradsen  1   2 , Marianne van Hage  8 , Caroline Nilsson  3   4 , Erik Melén  3   4 , Anna Asarnoj  1   2
Affiliations

Development of sensitization to peanut and storage proteins and relation to markers of airway and systemic inflammation: A 24-year follow-up

Sandra G Tedner et al. Allergy. 2023 Feb.

Abstract

Background: Long-time data of peanut allergy over time is sparse. We aimed to study the longitudinal development of sensitization to peanut extract and storage protein allergen molecules and associations with asthma status, airway and systemic inflammation markers.

Methods: The Swedish birth cohort BAMSE followed 4089 participants with questionnaires, clinical investigations and blood sampling between 0 and 24 years. Information on (i) background factors at 2 months, (ii) peanut allergy symptoms and IgE data (ImmunoCAP) at 4, 8, 16, and 24 years, and (iii) IgE to storage proteins, lung function data including exhaled nitric oxide (FENO) as well as systemic inflammatory markers at 24 years of age were collected.

Results: The prevalence of peanut extract sensitization, defined as IgE ≥ 0.35 kUA /L, was 5.4%, 8.0%, 7.5%, and 6.2% at 4, 8, 16, and 24 years of age, respectively. Between 8 and 24 years of age, (33/1565) participants developed IgE-ab to peanut extract (median 1,4, range 0.7-2.6 kUA /L), and among those 85% were also sensitized to birch. Only six individuals developed sensitization to Ara h 2 (≥0.1 kUA /L) between 8 and 24 years of age, of whom three had an IgE-ab level between 0.1-0.12 kUA /L. Storage protein sensitization was associated with elevated FENO, blood eosinophils and type 2 inflammation-related systemic proteins.

Conclusion: Sensitization to peanut extract after 4 years of age is mainly induced by birch cross-sensitization and IgE to Ara h 2 rarely emerges after eight years of age. Storage protein sensitization is associated with respiratory and systemic inflammation.

Keywords: FENO; OLINK; birth cohort; molecular allergology; peanut allergy; sensitization.

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Conflict of interest statement

EM reports Advisory board fees from ALK and AstraZeneca outside the submitted work. MvH has received lecture fees from Thermo Fisher Scientific outside the submitted work. CN reports Advisory board fee from Aimmune Therapeutics, a Nestlé Health Science company outside the submitted work. SK reports Advisory board fee from Novartis and payment for lecture from AstraZeneca outside the submitted work. AA reports Advisory board fees from Aimmune Therapeutics, Nestlé Health Science, Sanofi and Novartis and lecture fees from Orion Pharma, Nestlé and Semper outside the submitted work. ST reports Advisory board fees from ALK and Sanofi outside the submitted work. None of the authors has any conflict of interest in relation to the current study.

Figures

FIGURE 1
FIGURE 1
Prevalence of peanut extract sensitization (%), reported peanut intake symptoms and peanut extract IgE levels at 4, 8, 16 and 24 years of age in subgroup A. (Cut off peanut extract IgE ≥0.35 kUA/L). N = 1167.
FIGURE 2
FIGURE 2
Prevalence of peanut allergen molecules (%) and peanut allergen molecule IgE levels at 8 and 24 years of age in subgroup B. (Cut off ≥0.1 kUA/L). N = 1565.
FIGURE 3
FIGURE 3
Reported peanut intake symptoms at 24 years of age among Ara h 2 sensitized versus non‐Ara h 2 sensitized participants in subgroup C. N = 2217. *for all specified symptoms p < .01 for difference in proportion sensitized/not sensitized to Ara h 2.
FIGURE 4
FIGURE 4
Characteristics of participants in subgroup B with transient, persistent and de novo Ara h 2 sensitization. N = 1565.
FIGURE 5
FIGURE 5
(A, B) Plasma protein level (in NPX) by sensitization and asthma status.
See this image and copyright information in PMC

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