Ground Nut Monkey Nut Glycinin (h 1 and h 3) Conglutin (h 2) A bet v 1-homologous allergen (h 8) Group 1 Fagales-related protein (h 8) PR-10 Protein (h 8) Non-specific Lipid Transfer Protein (ns-LTP) (h 9) PR-14 Protein (h 9)
Bet v2 Profilin
Testing begins with analysis of peanut IgE. If peanut IgE is negative (<0.10 kU/L), testing is completed.
If peanut IgE is detectable (> or =0.10 kU/L), then the 7 peanut components (Ara h 2, Ara h 1, Ara h 3, Ara h 6, Ara h 8, and Ara h 9 and profilin Betv2) are performed at an additional charge.
The determination of the relative amount of IgE antibody to total peanut, and IgE antibodies to specific peanut components, can aid in assessment of the potential strength and type of allergenic response to peanuts.
IgE antibody to total peanut extract will be tested.
If detectable total peanut IgE antibody is present, additional specific peanut allergen antibody testing will be performed. This is comprised of testing for IgE antibodies to the potential allergens Ara h 2, Ara h 1, Ara h 3, Ara h 6, Ara h 8, Ara h 9, and profilin Bet v2.
Evaluation of patients with suspected peanut allergy
Evaluation of patients with possible peanut cross-reactivity
Results from peanut specific IgE antibody testing must be interpreted in the context of patient's clinical evaluation and history of allergen exposures.
Negative results for IgE to total peanut and any peanut components do not completely exclude the possibility of clinically relevant allergic responses upon exposure to peanut. Clinical correlation of results from in vitro IgE testing with patient history of allergic or anaphylactic responses to peanut is recommended.
Positive results for IgE to total peanut or any potential peanut allergenic components are not diagnostic for peanut allergy, and only indicate patient may be sensitized to peanut or a cross-reactive allergen. Clinical correlation of results from in vitro IgE testing with patient history of allergic or anaphylactic responses to peanut is recommended.
Testing for IgE antibodies may not useful in patients previously treated with immunotherapy to determine if residual clinical sensitivity exists, or in patients in whom the medical management does not depend upon identification of allergen specificity.
Some patients with significantly elevated concentrations of total peanut IgE antibodies do not have any reaction when administered a peanut oral food challenge. This may be due to the presence of an IgE antibody specific for a nonallergenic protein present within the peanut extract. Furthermore, some individuals with clinically insignificant or no sensitivity to allergens may have detectable levels of IgE antibodies in serum; therefore results must be interpreted in the clinical context.
False-positive results for IgE antibodies may occur in patients with markedly elevated serum IgE (>2500 kU/L) due to nonspecific binding to allergen solid phases.
Concentrations > or = 0.70 kU/L (Class 2 and above) will flag as abnormally high.
When detectable total peanut IgE antibody is present (> or =0.10 IgE kUa/L), additional specific component IgE antibody testing will be performed. If at least one potential specific allergenic peanut component IgE is detectable (> or =0.10 IgE kUa/L), an interpretative report will be provided.
When the sample is negative for total peanut IgE antibody (<0.10 IgE kUa/L), further testing for specific peanut component IgE antibodies will not be performed. Negative IgE results for total peanut antibody may indicate a lack of sensitization to potential peanut allergenic components.