ArticleThe Journal of allergy and clinical immunology2020
Biomarkers of severity and threshold of allergic reactions during oral peanut challenges.
Article in The Journal of allergy and clinical immunology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06554691 (Exploring the Immunological Basis in the Evolution of Tree Nut and Peanut Allergy During Treatment Care for Understanding Markers and Treatment Targets), which is not on this map. Cited by 76 papers, 4 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Exploring the Immunological Basis in the Evolution of Tree Nut and Peanut Allergy During Treatment Care for Understanding Markers and Treatment Targets
Who cites it
76 citing papers in PubMed, 4 syntheses or guidelines pooled it, 150 citations in OpenAlex.
- Precision Medicine in Plant Food Allergy: a Systematic Review of Biomarkers Under a Clinical Approach.Clinical reviews in allergy & immunology · 2026Pooled it
- Risk factors for severe reactions in food allergy: Rapid evidence review with meta-analysis.Allergy · 2022Pooled it
- Using data from food challenges to inform management of consumers with food allergy: A systematic review with individual participant data meta-analysis.The Journal of allergy and clinical immunology · 2021Pooled it
- Biomarkers associated with persistence and severity of IgE-mediated food allergies: a systematic review.Jornal de pediatriaPooled it
- Transepidermal Water Loss in Oral Food Challenges in Children With Peanut Allergy: A Randomized Clinical Trial.JAMA network open · 2025Trial
- Trial
- Efficacy and safety of oral immunotherapy in children aged 1-3 years with peanut allergy (the Immune Tolerance Network IMPACT trial): a randomised placebo-controlled study.Lancet (London, England) · 2022Trial
- Is age a critical factor for the diagnosis of peanut allergy in children?The World Allergy Organization journal · 2026Article
- Review
- Emerging Biomarkers in Pediatric Food Allergy: From Mechanistic Endotyping to Precision Diagnosis and Therapeutic Monitoring.Biomedicines · 2026Review
- The "Survivor Peptide" Hypothesis: Structural Resilience and Immunological Persistence of Food Allergens in the Gut-Mammary Axis.Nutrients · 2026Review
- Article
- Innovative diagnostic techniques and their clinical implications in food allergy: current clinical practice and future perspectives.Frontiers in allergy · 2026Review
- Clinical and immunological markers of peanut allergy severity and tolerance in children.Frontiers in allergy · 2026Article
- Observational
- Review
- A hand-operated microfluidic sample preparation-to-analysis workflow for simplifying the basophil activation test.Lab on a chip · 2025Article
- Epitope-Specific Antibodies in Allergic Disease and Clinical Tolerance.Immunological reviews · 2025Review
- AI-Driven Biomarker Discovery and Personalized Allergy Treatment: Utilizing Machine Learning and NGS.Current allergy and asthma reports · 2025Review
- Biomarker-driven drug development for allergic diseases and asthma: An FDA public workshop.The Journal of allergy and clinical immunology · 2025Article
16 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on byReply.2022
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Authors and funding
15 authors at 9 institutions in 2 countries.
Funding
Abstract
backgroundOral food challenge (OFC) is the criterion standard to assess peanut allergy (PA), but it involves a risk of allergic reactions of unpredictable severity.
objectiveOur aim was to identify biomarkers for risk of severe reactions or low dose threshold during OFC to peanut.
methodsWe assessed Learning Early about Peanut Allergy study, Persistance of Oral Tolerance to Peanut study, and Peanut Allergy Sensitization study participants by administering the basophil activation test (BAT) and the skin prick test (SPT) and measuring the levels of peanut-specific IgE, Arachis hypogaea 2-specific IgE, and peanut-specific IgG4, and we analyzed the utility of the different biomarkers in relation to PA status, severity, and threshold dose of allergic reactions to peanut during OFC.
resultsWhen a previously defined optimal cutoff was used, the BAT diagnosed PA with 98% specificity and 75% sensitivity. The BAT identified severe reactions with 97% specificity and 100% sensitivity. The SPT, level of Arachis hypogaea 2-specific IgE, level of peanut-specific IgE, and IgG4/IgE ratio also had 100% sensitivity but slightly lower specificity (92%, 93%, 90%, and 88%, respectively) to predict severity. Participants with lower thresholds of reactivity had higher basophil activation to peanut in vitro. The SPT and the BAT were the best individual predictors of threshold. Multivariate models were superior to individual biomarkers and were used to generate nomograms to calculate the probability of serious adverse events during OFC for individual patients.
conclusionsThe BAT diagnosed PA with high specificity and identified severe reactors and low threshold with high specificity and high sensitivity. The BAT was the best biomarker for severity, surpassed only by the SPT in predicting threshold. Nomograms can help estimate the likelihood of severe reactions and reactions to a low dose of allergen in individual patients with PA.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.