Peanut-specific IgG subclasses as biomarkers of peanut allergy in LEAP study participants.

Antigen-specific IgG2 and IgG3 are rarely measured in food allergy clinical trials despite known function in preventing mast cell and basophil activation. Our objective was to determine whether measuring peanut-specific IgG2 and IgG3 levels would correlate with peanut allergy status. Peanut-specific IgG subclasses were measured via ELISA assays in Learning Early About Peanut allergy (LEAP) trial participants at 5 years of age and were correlated with peanut allergy vs peanut sensitization vs non-peanut allergic and peanut consumption vs peanut avoidance. Peanut-specific IgG1, IgG2, IgG3, and IgG4 levels were significantly different between participants with peanut allergy vs peanut sensitization vs non-peanut allergic, and a multivariate logistic regression model and stepwise selection found that IgG1 most closely associated with peanut allergy status. Similarly, all subclasses differentiated those consuming vs those avoiding peanut, but subsequent modeling found that IgG4 most closely associated with consumption status. Amongst the peanut-specific IgG subclasses, IgG1 was the best biomarker for peanut allergy, while IgG4 was the best biomarker for peanut antigen exposure in this highly atopic cohort. Our study did not find added value from evaluating peanut-specific IgG 2 and 3 as biomarkers of peanut allergy, although they did correlate with peanut allergy. Subsequent studies should assess the value of adding IgG subclasses to multivariate models predicting peanut allergy status.

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© 2024 The Authors.

Déclaration de conflit d'intérêts

Carolyn H. Baloh, MD: no conflicts of interest to report. Noha Lim, PhD: no conflicts of interest to report. Michelle F. Huffaker, MD: no conflicts of interest to report. Pooja Patel, MD: no conflicts of interest to report. Jody Tversky, MD: reports research funding from Regeneron and AstraZenica. George du Toit, MB BCh: reports grants from National Institute of Allergy and Infectious Diseases (NIAID, NIH), Food Allergy & Research Education (FARE), MRC & Asthma UK Centre, UK Dept of Health through NIHR, Action Medical Research and National Peanut Board. Scientific Advisory Board member Aimmune. Investigator on pharma-sponsored allergy studies (Aimmune, and DBV Technologies). Scientific advisor to Aimmune, DBV and Novartis. Gideon Lack, MB BCh: reports grants from National Institute of Allergy and Infectious Diseases (NIAID, NIH), other from Food Allergy & Research Education (FARE), other from MRC & Asthma UK Centre, other from UK Dept of Health through NIHR, other from National Peanut Board (NPB), other from The Davis Foundation, during the conduct of the study; shareholder in DBV Technologies, and Mighty Mission Me, personal fees from Novartis, personal fees from Sanofi-Genyzme, personal fees from Regeneron, personal fees from ALK-Abello, personal fees from Lurie Children's Hospital, outside the submitted work. Tanya M. Laidlaw, MD: reports grants from National Institute of Allergy and Infectious Diseases (NIAID, NIH), and has served on scientific advisory boards for GlaxoSmithKline, Sanofi-Genzyme, Novartis, Eli Lilly, and Regeneron. Donald W. MacGlashan Jr, MD, PhD: No conflicts of interest to report.