Diagnosis of Sesame Allergy: Analysis of Current Practice and Exploration of Sesame Component Ses i 1

Sarah Saf; Travis M. Sifers; Mary Grace Baker; Christopher M. Warren; Christopher Knight; Katrina Bakhl; Jacob D. Kattan; Hugh A. Sampson; Anna Nowak-Wegrzyn

doi:10.1016/j.jaip.2019.11.028

Diagnosis of Sesame Allergy: Analysis of Current Practice and Exploration of Sesame Component Ses i 1

Sarah Saf, Travis M. Sifers, Mary Grace Baker, Christopher M. Warren, Christopher Knight, Katrina Bakhl, Jacob D. Kattan, Hugh A. Sampson, Anna Nowak-Wegrzyn^*

^*Corresponding author for this work

Preventive Medicine

Research output: Contribution to journal › Article › peer-review

27 Scopus citations

Abstract

Background: Sesame is an allergen of increasing importance. Objective: We sought to characterize the outcomes of oral food challenges (OFCs) to sesame and evaluate the diagnostic accuracy of skin prick testing (SPT), sesame, and Ses i 1-specific IgE (sIgE). Methods: We reviewed sesame OFCs performed at the Mount Sinai pediatric allergy clinic between January 2010 and April 2018. We assessed the accuracy of diagnostic tests by calculating the area under the curve (AUC) of the receiver operating characteristic curves. The association between OFC outcome and sesame sensitization was analyzed using a logistic regression, which was then used to estimate the 95% positive predictive value (PPV) of these tests. Results: We identified 341 patients (69% male, mean age 7.7 years) who underwent sesame OFC. Among 106 (31%) positive OFCs, the median cumulative eliciting dose was 500 mg sesame protein (1/2 teaspoon tahini). Sesame SPT wheal ≥6 mm had sensitivity 54.1% and specificity 87.8%; AUC 0.756 (95% confidence interval [CI], 0.699-0.814). SPT wheal size ≥14 mm had 95% PPV. Sesame-sIgE level did not correlate with OFC outcome. Ses i-sIgE levels were analyzed in 30 patients using the Immuno Solid-phase Allergen Chip (ISAC) microarray and were significantly associated with OFC outcome (AUC: 0.715 [95% CI, 0.541-0.890]). Ses i 1-sIgE ≥0.3 ISAC Standardized Units had sensitivity 58.3% and specificity 83.3%. Conclusions: This is the largest study of sesame allergy to date. Sesame SPT is a more accurate predictor of sesame allergy compared with sesame sIgE. Ses i 1-sIgE appears promising but requires further study regarding diagnostic accuracy.

Original language	English (US)
Pages (from-to)	1681-1688.e3
Journal	Journal of Allergy and Clinical Immunology: In Practice
Volume	8
Issue number	5
DOIs	https://doi.org/10.1016/j.jaip.2019.11.028
State	Published - May 2020

Funding

Sarah Saf's scholarship was funded by ANAFORCAL French society grant.Conflicts of interest: H. A. Sampson is a part-time employee of DBV Technologies and the Icahn School of Medicine, New York, NY; receives grants from the National Institutes of Health, National Institute of Allergy and Infectious Diseases, and Food Allergy Research and Education; receives consultant fees from N-Fold LLC, UCB SA, and Hycor Biomedical; receives royalties from UpToDate and Elsevier; and holds stock options in DBV Technologies and N-FOLD. A. Nowak-Wegrzyn is employed by the NYU Langone Health, New York, NY; receives grants from DBV Technologies, Astellas Pharma, Nutricia, and Nestle; and receives royalties from UpToDate. She serves on the advisory boards for the Gerber Institute, Merck, ALK Abello, and Sanofi Aventis; and is the deputy editor for the Annals of Allergy, Asthma, and Immunology. The rest of the authors declare that they have no relevant conflicts of interest.

Keywords

Diagnosis
Food allergy
Oral food challenge
Predictive value
Serum-specific IgE
Ses i 1
Sesame
Sesame IgE
Skin prick test

ASJC Scopus subject areas

Immunology and Allergy

Access to Document

10.1016/j.jaip.2019.11.028

Cite this

@article{7f535168f9fb4f18b832b28bd89c89be,

title = "Diagnosis of Sesame Allergy: Analysis of Current Practice and Exploration of Sesame Component Ses i 1",

abstract = "Background: Sesame is an allergen of increasing importance. Objective: We sought to characterize the outcomes of oral food challenges (OFCs) to sesame and evaluate the diagnostic accuracy of skin prick testing (SPT), sesame, and Ses i 1-specific IgE (sIgE). Methods: We reviewed sesame OFCs performed at the Mount Sinai pediatric allergy clinic between January 2010 and April 2018. We assessed the accuracy of diagnostic tests by calculating the area under the curve (AUC) of the receiver operating characteristic curves. The association between OFC outcome and sesame sensitization was analyzed using a logistic regression, which was then used to estimate the 95% positive predictive value (PPV) of these tests. Results: We identified 341 patients (69% male, mean age 7.7 years) who underwent sesame OFC. Among 106 (31%) positive OFCs, the median cumulative eliciting dose was 500 mg sesame protein (1/2 teaspoon tahini). Sesame SPT wheal ≥6 mm had sensitivity 54.1% and specificity 87.8%; AUC 0.756 (95% confidence interval [CI], 0.699-0.814). SPT wheal size ≥14 mm had 95% PPV. Sesame-sIgE level did not correlate with OFC outcome. Ses i-sIgE levels were analyzed in 30 patients using the Immuno Solid-phase Allergen Chip (ISAC) microarray and were significantly associated with OFC outcome (AUC: 0.715 [95% CI, 0.541-0.890]). Ses i 1-sIgE ≥0.3 ISAC Standardized Units had sensitivity 58.3% and specificity 83.3%. Conclusions: This is the largest study of sesame allergy to date. Sesame SPT is a more accurate predictor of sesame allergy compared with sesame sIgE. Ses i 1-sIgE appears promising but requires further study regarding diagnostic accuracy.",

keywords = "Diagnosis, Food allergy, Oral food challenge, Predictive value, Serum-specific IgE, Ses i 1, Sesame, Sesame IgE, Skin prick test",

author = "Sarah Saf and Sifers, {Travis M.} and Baker, {Mary Grace} and Warren, {Christopher M.} and Christopher Knight and Katrina Bakhl and Kattan, {Jacob D.} and Sampson, {Hugh A.} and Anna Nowak-Wegrzyn",

note = "Publisher Copyright: {\textcopyright} 2019 American Academy of Allergy, Asthma & Immunology",

year = "2020",

month = may,

doi = "10.1016/j.jaip.2019.11.028",

language = "English (US)",

volume = "8",

pages = "1681--1688.e3",

journal = "Journal of Allergy and Clinical Immunology: In Practice",

issn = "2213-2198",

publisher = "Elsevier",

number = "5",

}

TY - JOUR

T1 - Diagnosis of Sesame Allergy

T2 - Analysis of Current Practice and Exploration of Sesame Component Ses i 1

AU - Saf, Sarah

AU - Sifers, Travis M.

AU - Baker, Mary Grace

AU - Warren, Christopher M.

AU - Knight, Christopher

AU - Bakhl, Katrina

AU - Kattan, Jacob D.

AU - Sampson, Hugh A.

AU - Nowak-Wegrzyn, Anna

PY - 2020/5

Y1 - 2020/5

N2 - Background: Sesame is an allergen of increasing importance. Objective: We sought to characterize the outcomes of oral food challenges (OFCs) to sesame and evaluate the diagnostic accuracy of skin prick testing (SPT), sesame, and Ses i 1-specific IgE (sIgE). Methods: We reviewed sesame OFCs performed at the Mount Sinai pediatric allergy clinic between January 2010 and April 2018. We assessed the accuracy of diagnostic tests by calculating the area under the curve (AUC) of the receiver operating characteristic curves. The association between OFC outcome and sesame sensitization was analyzed using a logistic regression, which was then used to estimate the 95% positive predictive value (PPV) of these tests. Results: We identified 341 patients (69% male, mean age 7.7 years) who underwent sesame OFC. Among 106 (31%) positive OFCs, the median cumulative eliciting dose was 500 mg sesame protein (1/2 teaspoon tahini). Sesame SPT wheal ≥6 mm had sensitivity 54.1% and specificity 87.8%; AUC 0.756 (95% confidence interval [CI], 0.699-0.814). SPT wheal size ≥14 mm had 95% PPV. Sesame-sIgE level did not correlate with OFC outcome. Ses i-sIgE levels were analyzed in 30 patients using the Immuno Solid-phase Allergen Chip (ISAC) microarray and were significantly associated with OFC outcome (AUC: 0.715 [95% CI, 0.541-0.890]). Ses i 1-sIgE ≥0.3 ISAC Standardized Units had sensitivity 58.3% and specificity 83.3%. Conclusions: This is the largest study of sesame allergy to date. Sesame SPT is a more accurate predictor of sesame allergy compared with sesame sIgE. Ses i 1-sIgE appears promising but requires further study regarding diagnostic accuracy.

AB - Background: Sesame is an allergen of increasing importance. Objective: We sought to characterize the outcomes of oral food challenges (OFCs) to sesame and evaluate the diagnostic accuracy of skin prick testing (SPT), sesame, and Ses i 1-specific IgE (sIgE). Methods: We reviewed sesame OFCs performed at the Mount Sinai pediatric allergy clinic between January 2010 and April 2018. We assessed the accuracy of diagnostic tests by calculating the area under the curve (AUC) of the receiver operating characteristic curves. The association between OFC outcome and sesame sensitization was analyzed using a logistic regression, which was then used to estimate the 95% positive predictive value (PPV) of these tests. Results: We identified 341 patients (69% male, mean age 7.7 years) who underwent sesame OFC. Among 106 (31%) positive OFCs, the median cumulative eliciting dose was 500 mg sesame protein (1/2 teaspoon tahini). Sesame SPT wheal ≥6 mm had sensitivity 54.1% and specificity 87.8%; AUC 0.756 (95% confidence interval [CI], 0.699-0.814). SPT wheal size ≥14 mm had 95% PPV. Sesame-sIgE level did not correlate with OFC outcome. Ses i-sIgE levels were analyzed in 30 patients using the Immuno Solid-phase Allergen Chip (ISAC) microarray and were significantly associated with OFC outcome (AUC: 0.715 [95% CI, 0.541-0.890]). Ses i 1-sIgE ≥0.3 ISAC Standardized Units had sensitivity 58.3% and specificity 83.3%. Conclusions: This is the largest study of sesame allergy to date. Sesame SPT is a more accurate predictor of sesame allergy compared with sesame sIgE. Ses i 1-sIgE appears promising but requires further study regarding diagnostic accuracy.

KW - Diagnosis

KW - Food allergy

KW - Oral food challenge

KW - Predictive value

KW - Serum-specific IgE

KW - Ses i 1

KW - Sesame

KW - Sesame IgE

KW - Skin prick test

UR - http://www.scopus.com/inward/record.url?scp=85076551213&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85076551213&partnerID=8YFLogxK

U2 - 10.1016/j.jaip.2019.11.028

DO - 10.1016/j.jaip.2019.11.028

M3 - Article

C2 - 31786253

AN - SCOPUS:85076551213

SN - 2213-2198

VL - 8

SP - 1681-1688.e3

JO - Journal of Allergy and Clinical Immunology: In Practice

JF - Journal of Allergy and Clinical Immunology: In Practice

IS - 5

ER -

Diagnosis of Sesame Allergy: Analysis of Current Practice and Exploration of Sesame Component Ses i 1

Abstract

Funding

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this