D2.209 - Does component-based diagnostics help us to clarify a sesame allergy in children?

Sesame is becoming increasingly popular worldwide. In recent years, sensitisation or allergies to sesame seeds have been progressively observed in children. In order to rule out or confirm an allergy in the case of sensitisation, an oral food challenge is often carried out. This is time-consuming and poses a risk for the patient. 

In allergy diagnostics, the detection of specific IgE (sIgE) to 2S albumins has proven to be very helpful, particularly for peanut and nut allergies. This raises the question of whether the determination of Ses i 1-sIgE can also help in cases of suspected sesame allergy.

The aim of our research is therefore to determine the predictive value of sesame- and Ses i 1-sIgE in relation to the outcome of an oral food challenge.

Sera from 63 children and adolescents (age range 1 to 17 years, median 3 years) who had an oral food challenge with sesame were analysed for sIgE against sesame and the corresponding 2S albumin Ses i 1. A correlation analysis of the respective sIgE titres and the provocation results (allergic/tolerant) was then conducted.

Based on the ROC analyses performed, Ses i 1-sIgE demonstrated higher predictive power (AUC 0.884) compared to sesame-sIgE (AUC 0.759). In both cases, however, the sIgE titre levels were directly correlated with the provocation result: the higher the sIgE concentrations, the higher the risk of an allergic reaction. The probability of a clinically relevant sesame allergy was 80% with a Ses i 1-sIgE of 11.7 kU/l and 95% with 18.9 kU/l.

Component-based diagnostics may help avoid oral sesame challenges in some children.