Imperial College London
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Dr Paul Turner

Faculty of Medicine, National Heart & Lung Institute

Reader in Paediatric Allergy & Clinical Immunology
 
 
 
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Contact

 

+44 (0)20 3312 7754p.turner

 
 
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Location

 

Children's Clinical Research FacilityCambridge WingSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Suprun:2022:10.1111/all.15477,
author = {Suprun, M and Kearney, P and Butler, H and Getts, R and Sicherer, SH and Turner, P and Campbell, D and Sampson, HA},
doi = {10.1111/all.15477},
journal = {Allergy},
pages = {3061--3069},
title = {Predicting probability of tolerating discrete amounts of peanut protein in allergic children using epitope-specific IgE antibody profiling},
url = {http://dx.doi.org/10.1111/all.15477},
volume = {77},
year = {2022}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: IgE-epitope profiling can accurately diagnose clinical peanut allergy. Objective: We sought to determine whether sequential (linear) epitope-specific IgE (ses-IgE) profiling can provide probabilities of tolerating discrete doses of peanut protein in allergic subjects undergoing double-blind, placebo-controlled food challenges utilizing PRACTALL dosing.Methods: 64 ses-IgE antibodies were quantified in blood samples using a bead-based epitope assay. A pair of ses-IgEs that predicts Cumulative Tolerated Dose (CTD) was determined using regression in 75 subjects from the discovery cohort. This epitope-based predictor was validated on 331 subjects from five independent cohorts (ages 4-25 years). Subjects were grouped based on their predicted values and probabilities of reactions at each CTD threshold were calculated.  Results:  In discovery, an algorithm using two ses-IgE antibodies was correlated with CTDs (rho=0.61, p<0.05); this correlation was 0.51 (p<0.05) in validation. Using the ses-IgE-based predictor, subjects were assigned into “high”, “moderate”, or “low” dose reactivity groups. On average, subjects in the “high” group were 4 times more likely to tolerate a specific dose, compared to the “low” group. For example, predicted probabilities of tolerating 4, 14, 44 and 144 or 444mg in the “low” group were 92%, 77%, 53%, 29% and 10% compared to 98%, 95%, 94%, 88% and 73% in the “high” group. Conclusions: Accurate predictions of food challenge thresholds are complex due to factors including limited responder sample sizes at each dose and variations in study-specific challenge protocols. Despite these limitations, an epitope-based predictor was able to accurately identify CTDs and may provide a useful surrogate for peanut challenges.
AU  - Suprun,M
AU  - Kearney,P
AU  - Butler,H
AU  - Getts,R
AU  - Sicherer,SH
AU  - Turner,P
AU  - Campbell,D
AU  - Sampson,HA
DO  - 10.1111/all.15477
EP  - 3069
PY  - 2022///
SN  - 0105-4538
SP  - 3061
TI  - Predicting probability of tolerating discrete amounts of peanut protein in allergic children using epitope-specific IgE antibody profiling
T2  - Allergy
UR  - http://dx.doi.org/10.1111/all.15477
UR  - http://hdl.handle.net/10044/1/97693
VL  - 77
ER  -
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