Current and Emerging Immunotherapeutic Approaches to Treat and Prevent Peanut Allergy

Darren S Miller; Michael P Brown; Paul M Howley; John D Hayball


Expert Rev Vaccines. 2012;11(12):1471-1481. 

In This Article

Diagnosis of Peanut Allergy

A previous clinical history combined with open food challenge has been reported to provide a good predictive value; however, the primary clinical tool used to evaluate the food-allergic patient is skin-prick testing with different food sources, which can result in an immediate wheal and flare reaction. When skin-prick testing showing a wheal ≥16 mm was combined with peanut-specific IgE antibody levels ≥57 kU of antibody/l, a diagnosis of peanut allergy could be made with specificity and positive predictive values both of 100%.[44] Despite the utility of this approach, in the rare instances where patients reach this very high cut-off level serum of peanut-specific IgE antibody, it remains that the placebo-controlled, double-blind food challenge is still considered the 'gold standard' for the diagnosis of peanut-related allergy,[45] despite the obvious potential risks associated with its use, which naturally limits its application in the clinic.