Clinical Information

Peanut allergy is one of the most common food allergies in the United States, with an estimated prevalence of approximately 1% to 2%.(1) The clinical symptoms of peanut allergy may range from relatively mild, such as rhinorrhea, pruritus, or nausea, to a systemic and potentially life-threatening anaphylactic reaction. The diagnosis of peanut allergy is based upon the presence of compatible clinical symptoms in the context of peanut exposure, with support from identification of potential peanut-specific IgE allergen antibodies, either by skin testing or in vitro serology testing.

In vitro serology testing has generally focused on assessing for the presence of total peanut IgE antibodies. These antibodies are identified by immunoassay in which the capture allergen is an extract prepared from natural peanut raw material. Most studies have demonstrated a correlation between the amount of total peanut IgE allergen antibody present and an increased likelihood of a clinical allergic response.

Clinical manifestations of immediate hypersensitivity (allergic) diseases are caused by the release of proinflammatory mediators (histamine, leukotrienes, and prostaglandins) from IgE-sensitized effector cells (mast cells and basophils) when cell-bound IgE antibodies interact with allergen.

Once an elevated antibody response to total peanut IgE extract is established, assessment for the presence of specific IgE antibodies to the most common individual peanut allergenic components may be considered.