Food, drug, insect sting allergy, and anaphylaxis
Peanut-specific IgE antibodies in asymptomatic Ghanaian children possibly caused by carbohydrate determinant cross-reactivity

https://doi.org/10.1016/j.jaci.2013.04.023Get rights and content
Under a Creative Commons license
open access

Background

The prevalence of peanut allergy has increased in developed countries, but little is known about developing countries with high peanut consumption and widespread parasitic infections.

Objective

We sought to investigate peanut allergy in Ghana.

Methods

In a cross-sectional survey among Ghanaian schoolchildren (n = 1604), data were collected on reported adverse reactions to peanut, peanut sensitization (serum specific IgE and skin reactivity), consumption patterns, and parasitic infections. In a subset (n = 43) IgE against Ara h 1, 2, 3, and 9 as well as cross-reactive carbohydrate determinants (CCDs) was measured by using ImmunoCAP. Cross-reactivity and biological activity were investigated by means of ImmunoCAP inhibition and basophil histamine release, respectively.

Results

Adverse reactions to peanut were reported in 1.5%, skin prick test reactivity in 2.0%, and IgE sensitization (≥0.35 kU/L) in 17.5% of participants. Moreover, 92.4% of those IgE sensitized to peanut (≥0.35 kU/L) had negative peanut skin prick test responses. Schistosoma haematobium infection was positively associated with IgE sensitization (adjusted odds ratio, 2.29; 95% CI, 1.37-3.86). In the subset IgE titers to Ara h 1, 2, 3, and 9 were low (<1.3 kU/L), except for 6 moderately strong reactions to Ara h 9. IgE against peanut was strongly correlated with IgE against CCDs (r = 0.89, P < .0001) and could be almost completely inhibited by CCDs, as well as S haematobium soluble egg antigen. Moreover, IgE to peanut showed poor biological activity.

Conclusions

Parasite-induced IgE against CCDs might account largely for high IgE levels to peanut in our study population of Ghanaian schoolchildren. No evidence of IgE-mediated peanut allergy was found.

Key words

Peanut allergy
skin prick testing
IgE
Sub-Saharan Africa
IgE cross-reactivity
cross-reactive carbohydrate determinants
helminth infections
basophil histamine release
EuroPrevall

Abbreviations used

aOR
Adjusted odds ratio
BHR
Basophil histamine release
CCD
Cross-reactive carbohydrate determinant
CRD
Component-resolved diagnostics
SEA
Soluble egg antigen
SPT
Skin prick test

Cited by (0)

Supported by EuroPrevall (FOOD-CT-2005-514000), GLOFAL (FOOD-CT-2005-517812), and the Wellcome Trust (075791/Z/04/Z).

Disclosure of potential conflict of interest: A. S. Amoah has received grants from the European Union and the Wellcome Trust. B. B. Obeng, I. A. Larbi, S. A. Versteeg, Y. Aryeetey, J. Akkerdaas, L. Zuidmeer, F. C. Hartgers, D. A. Boakye, and M. Yazdanbakhsh have received grants from the European Union. J. Lidholm is employed by Thermo Fisher Scientific. M. Fernández-Rivas has received a grant and travel support from the European Commission, is employed by the Hospital Clinico San Carlos, has received grants from the European Commission and Instituto de Salud Carlos III, has received payment for lectures from ALK-Abelló, and has received travel support from the European Academy of Allergology and Clinical Immunology and the American Academy of Allergy, Asthma & Immunology. R. van Ree has received grants from the European Union and has consultant arrangements with HAL Allergy BV.