Component resolved diagnosis of walnut allergy in young children: Jug r 1 as a major walnut allergen

Jeongmin Lee,² Kyunguk Jeong,¹ Se-ah Jeon, Sooyoung Lee¹

¹ Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea
² Department of Pediatrics, Yonsei University, Wonju College of Medicine, Wonju, Korea

Abstract

Background: Walnuts (WN) are one of the main causes of tree nut allergies. However, the potential value of component resolved diagnosis (CRD) for WN allergy is controversial.
Objective: We analyzed the clinical and immunological features of clinical WN allergy and the usefulness of CRD in young children.
Methods: Forty-one participants with a history of ingesting WN who were assessed for serum-specific IgE to WN (WN-sIgE) using CRD (ImmunoCAP ISAC 112) at the Department of Pediatrics in Ajou University Hospital were enrolled and their demographic profiles, clinical symptoms, and laboratory findings were evaluated.
Results: A total of 32 patients were diagnosed with clinical WN allergy, of which 31 had specific immunoglobulin E antibodies to Jug r 1 (Jug r1-sIgE). The Jug r 1-sIgE levels were higher in WN-allergic patients than in WN-tolerant patients and significantly higher in patients with anaphylaxis than in the WN-tolerant patients. Receiver-operating characteristic curves demonstrated that the Jug r 1-sIgE level was much better in discriminating between clinical WN allergy and WN tolerance in young children than the WN-sIgE level.
Conclusions: Jug r 1 is the major component allergen in young children with clinical WN allergy. To measure Jug r 1-sIgE appears to be a promising approach for both diagnosis and predicting severity in young children with a history of suspected WN allergy.
Key words: Jug r 1, walnut, allergy, children, ISAC, component resolved diagnosis,