Abstract:
Background: Various biomarkers are used to define peanut
allergy (PA). We aimed to observe changes in PA resolution and
persistence over time comparing biomarkers in PA and peanut sensitised
but tolerant (PS) children in a population-based cohort.
Methods: Participants were recruited from the EAT and EAT-On
studies, conducted across England and Wales and were generally well
exclusively breastfed babies recruited at 3 months old and followed up
until 11 years old. Clinical characteristics, skin prick test (SPT),
sIgE to peanut and peanut components and mast cell activation tests
(MAT) were assessed at 12m, 36m and 7-11y.
Results: The prevalence of PA was 2.1% with only 1 child
having PA resolution at 7-11y. PA children had larger SPT size, higher
peanut-sIgE, Ara h 2-sIgE and MAT (all p<0.001) compared to PS
children at 36m and 7-11y. SPT, peanut-sIgE, Ara h 2-sIgE and MAT
between children with persistent PA, new PA, outgrown PA and PS were
statistically significant at both 36m and 7-11y (p<0.001).
Those with persistent PA had SPT, peanut-sIgE and Ara h 2-sIgE that
increased over time and MAT which was highest at 36m. New PA children
had increased SPT and peanut-sIgE from 36m to 7-11y, but MAT remained
low. PS children had low biomarkers across time.
Conclusions: In this cohort, few children outgrow or develop
new PA between 36m and 7-11y. Children with PA have significantly higher
SPT, peanut-sIgE, Ara h 2-sIgE and MAT compared to PS children, evident
from 12-36m of age.
Abstract word count: 244
Keywords: biomarkers, food allergy, mast cell activation test,
peanut allergy, tolerance
Word count: 3337
Number of tables: 2
Number of figures: 4