Abstract
Background: Various biomarkers are used to define peanut
allergy (PA). We aimed to observe changes in PA resolution and
persistence over time comparing biomarkers in PA and peanut sensitised
but tolerant (PS) children in a population-based cohort.
Methods: Participants were recruited from the EAT and EAT-On
studies, conducted across England and Wales and were generally well
exclusively breastfed babies recruited at 3 months old and followed up
until 11 years old. Clinical characteristics, skin prick test (SPT),
sIgE to peanut and peanut components and mast cell activation tests
(MAT) were assessed at 12m, 36m and 7-11y. Results: The
prevalence of PA was 2.1% with only 1 child having PA resolution at
7-11y. PA children had larger SPT size, higher peanut-sIgE, Ara h 2-sIgE
and MAT (all p<0.001) compared to PS children at 36m and
7-11y. SPT, peanut-sIgE, Ara h 2-sIgE and MAT between children with
persistent PA, new PA, outgrown PA and PS were statistically significant
at both 36m and 7-11y (p<0.001). Those with persistent PA had
SPT, peanut-sIgE and Ara h 2-sIgE that increased over time and MAT which
was highest at 36m. New PA children had increased SPT and peanut-sIgE
from 36m to 7-11y, but MAT remained low. PS children had low biomarkers
across time. Conclusions: In this cohort, few children outgrow
or develop new PA between 36m and 7-11y. Children with PA have
significantly higher SPT, peanut-sIgE, Ara h 2-sIgE and MAT compared to
PS children, evident from 12-36m of age.