Peanut Allergen Component Testing

Test code 2813

High levels of peanut IgE can predict the likelihood of peanut sensitivity, but may not be solely predictive of reactions or allergic response.1

77.6% of peanut sensitive patients may not be at risk for a systemic reaction.1

Determine which of these proteins your patient has high levels of IgE to

Ara h8

LOWER RISK of systemic reaction2

  • Risk of mild, localized symptoms, such as itching/tingling of the lips, mouth, and oropharynx3
  • Cross-reactive with pollens (e.g., birch)3
 

Ara h9

VARIABLE RISK of systemic reaction including anaphylaxis4

  • Often accompanied by sensitization to other peanut proteins5
  • Cross-reactive with fruits with pits (e.g., peaches)4
 

Ara h1,h2,h3

HIGHER RISK of systemic reaction including anaphylaxis6,7

  • Sensitization to Ara h2 is nearly always associated with
    clinical peanut allergy2

Risk assessment and test interpretations

If antibodies are + for Ara h8 but - for Ara h9, h1, h2, h3

Oral food challenge (OFC) with a specialist may be recommended. High likelihood that patient may pass OFC.

If patient passes an OFC:

  • Foods prepared with or around peanuts may be consumed
  • Patient not restricted to peanut-free zones
 
 
  +   Ara h8
 
  -   Ara h9
 
  -   Ara h1, h2, h3
 
 

If antibodies are +/- for Ara h8 and + for a9
and - for Ara h1, h2, h3

  • If there is no clinical history of symptoms, please see considerations above
  • If there is a clinical history of symptoms, please see considerations below
 
 
  +/-   Ara h8
 
  +   Ara h9
 
  -   Ara h1, h2, h3
 

If antibodies are +/- for Ara h8, h9 and + for Ara h1, h2, h3

  • Choose peanut-free zones for patient’s safety
  • Prescribe epinephrine auto-injector
  • Family, colleagues, and teachers should be made aware of allergy and have a plan
 
 
  +/-   Ara h8
 
  +/-   Ara h9
 
  +   Ara h1, h2, h3
 

As in all diagnostic testing, a diagnosis must be made by the physician based on test results, individual patient history, the physician’s knowledge of the patient, and the physician’s clinical judgement.

Get more information

For more information, contact your local Sales Representative.

 

For clinical information and specimen requirements,
visit the test center.

 

Download the Peanut Allergen Component Testing brochure.

References

1. Nicolaou N, Poorafshar M, Murray C, et al. Allergy or tolerance in children sensitized to peanut: prevalence and differentiation using component-resolved diagnostics. J Allergy Clin Immunol. 2010;125(1):191-197.

2. Asarnoj A, Nilsson C, Lidholm J, et al. Peanut component Ara h 8 sensitization and tolerance to peanut. J Allergy Clin Immunol. 2012;130(2):468-472.

3. Mittag D, Akkerdaas J, Ballmer-Weber BK, et al. Ara h 8, a Bet v 1-homologous allergen from peanut, is a major allergen in patients with combined birch pollen and peanut allergy. J Allergy Clin Immunol. 2004;114(6):1410-1417.

4. Lauer I, Dueringer N, Pokoj S, et al. The non-specific lipid transfer protein, Ara h 9, is an important allergen in peanut. Clin Exp Allergy. 2009;39(9):1427-1437.

5. Movérare R, Ahlstedt S, Bengtsson U, et al. Evaluation of IgE antibodies to recombinant peanut allergens in patients with reported reactions to peanut. Int Arch Allergy Immunol. 2011;156(3):282-290.

6. Peeters KA, Koppelman SJ, van Hoffen E, et al. Does skin prick test reactivity to purified allergens correlate with clinical severity of peanut allergy? Clin Exp Allergy. 2007;37(1):108-115.

7. Asarnoj A, Movérare R, Östblom E, et al. IgE to peanut allergen components: relation to peanut symptoms and pollen sensitization in 8-year-olds. Allergy. 2010;65(9):1189-1195.