D2.97 - Overall Prevalence and Particular Importance of Studying Sensitization to Peanut Molecules

Peanut allergy is a common IgE-mediated condition that attracts significant research attention due to the severity of its clinical manifestations and the increasing incidence of anaphylaxis. Peanut (family Fabaceae) contains 13 allergenic components. Since peanut-containing products are traditionally popular in Uzbekistan, determining the structure and prevalence of sensitization to these components is of critical importance.

The introduction of component-resolved diagnostics (CRD) has fundamentally changed the assessment of systemic reaction risk. Currently, specific IgE to the storage protein Ara h 2 (2S albumin) is considered the “gold standard” for predicting severe anaphylaxis. A high risk of systemic reactions is also associated with the lipid transfer protein Ara h 9 (LTP).

Based on data from the International Center of Molecular Allergology (ALEX, 2020–2025), 5,151 positive test results were analyzed. The prevalence of sensitization to peanut molecules was 9.9%. Among these, specific IgE to Ara h 9 was detected most frequently (52.9%).

Due to structural similarity between the storage proteins Ara h 2 and Ara h 6, co-sensitization is common. The study assessed the age-related prevalence of sensitization to these proteins (children under 18 years / adults):

• Ara h 6: 2.0% / 1.6%

• Ara h 2: 1.9% / 0.7%

A similar age-related decrease in sensitization frequency was observed for 2S albumins from other sources: sesame (14.0% in children vs 4.2% in adults), walnut (10.5% vs 1.5%), mustard (6.8% vs 3.0%), as well as cashew, pistachio, hazelnut, and soy.

Cross-sensitization to various 2S albumins necessitates a personalized dietary approach. Considering the age-related decline in sensitization frequency, it is important to monitor the sensitization profile over time. This approach allows timely expansion of the patient’s diet and improvement of quality of life.