Exploration of severity-associated peanut allergens via proteomic analysis

Background: The relationship between the severity of peanut allergy and component-specific immunoglobulin E (IgE) remains partially analyzed. We aimed to explore this relationship using a proteomic analysis of pediatric patients with peanut allergy. Methods: Immunoblotting and mass spectrometry were used to identify candidate peanut allergen components, which were confirmed via enzyme-linked immunosorbent assay using sera from pediatric patients with peanut allergy confirmed through a positive oral food challenge test (OFC). The association between each protein-specific IgE level and the severity of peanut allergy was compared. The severity of peanut allergy was quantified as TS/Pro, which is the total score (TS) of Anaphylaxis Scoring Aichi divided by the cumulative protein dose of peanuts at the OFC (Pro). Results: This study comprised 52 patients with peanut allergy. In addition to the known peanut allergen components, we discovered seven allergens in more than five participants. Among the participants, 24 (46.2%) had Annexin Gh1-specific IgE. Ara h 2 (rs = 0.67, p <.001) and Ara h 6 (rs = 0.66, p <.001) specific IgEs and the sum of the absorbance of all seven candidates (rs = 0.64, p <.001) were strongly correlated with TS/Pro. Ara h 1 (rs = 0.30, p <.05), Ara h 3 (rs = 0.37, p <.01), Ara h 7 (rs = 0.34, p <.05), and the seed biotin-containing protein SBP65 (rs = 0.35, p <.05) specific IgEs were correlated with TS/Pro. Conclusion: Ara h 2- and 6-specific IgEs and sensitization diversity were the most significant factors that correlated with peanut allergy severity. We identified SBP65 (Ara h 20) as a potential novel allergen component related to peanut allergy severity.