Peanut allergen component testing

Ara
h8
Peanut Ara
h9
allergens Ara

by the h1

numbers Ara
h2
Ara
h3

Detect sensitizations to the whole peanut to create

personalized management plans for your patients.
High levels of peanut IgE
can predict the likelihood
of peanut sensitivity, Ara
but may not be solely h8
predictive of reactions
or allergic response.1
LOWER RISK of
systemic reaction2
•R
 isk of mild, localized
symptoms, such as
itching/tingling of the lips,

Peanut allergen
mouth, and oropharynx3
•C
 ross-reactive with
pollens (e.g., birch)3

component testing
Measurement of specific IgE by blood Ara h8
test that provides objective assessment
of sensitization to the whole peanut is the
first step in discovering the likelihood of

+
a systemic reaction and the necessary
precautions that may be prescribed.

Knowing to which protein your

patient is sensitized can help you
develop a management plan.1,2,8-10

+/-
77.6% of peanut sensitive patients

+/-
may not be at risk for a
systemic reaction.1
 Ara
h1 Ara Determine which
h2 proteins your patient
Ara Ara
is sensitized to.
h9 h3

VARIABLE RISK
of systemic reaction
HIGHER RISK
of systemic reaction Reduce patient
including anaphylaxis4 including anaphylaxis6,7 anxiety with
• Often accompanied by
sensitization to other
• Sensitization to Ara h2 is
nearly always associated individualized
peanut proteins5 with clinical peanut allergy2
management plans.
• Cross-reactive with fruits
with pits (e.g., peaches)4

Ara h9 Ara h1, 2, 3 Test interpretations and next steps

Oral food challenge (OFC) with a specialist
may be recommended. High likelihood that
patient may pass OFC.

- -
If patient passes an OFC:
• Foods prepared with or around peanuts
may be consumed
• Patient not restricted to
peanut-free zones

5 If there is no clinical history of

+ -
symptoms, please see considerations
above
6 If there is a clinical history of symptoms,
please see considerations below

• Choose peanut-free zones

+/- +
for patient’s safety
• Prescribe epinephrine auto-injector
• Family, colleagues, and teachers should
be made aware of allergy and have a plan

As in all diagnostic testing, a diagnosis must be made by the physician based on test results, individual
patient history, the physician’s knowledge of the patient, and the physician’s clinical judgement.
 Diagnose Assess Address Enable
by the risks anxiety confidence
numbers. for systemic with individualized in dietary and
reactions and management plans. lifestyle choices.
cross-reactivity.

Test Name Test Code Test Name Test Code

Childhood Allergy Profile Food Allergy Profile w/Reflexes
-D
 . pteronyssinus (House mite), (NTC-2721) d1; D. farinae (House -C
 ontains all components of the Food Allergy Profile (NTC-10715)
mite), (NTC-2722) d2; Cat dander, (NTC-2601) e1; Dog dander, with reflex to the following components, with reflex to Egg
(NTC-2605) e5; Egg white, (NTC-2801) f1; Milk, (NTC-2802) f2; Component Panel, (NTC-91372); Ovomucoid, (NTC-3046) f233;
Codfish, (NTC-2803) f3; Wheat, (NTC-2804) f4; Peanut, (NTC-2813) 10659 91682
Ovalbumin, (NTC-2719) f232; Milk Component Panel, (NTC-91403);
f13; Soybean, (NTC-2814) f14; Shrimp, (NTC-2824) f24; Walnut, Casein, (NTC-2853) f78; Alpha-lactalbumin, (NTC-2851) f76; Beta-
(NTC-3489) f256; Cockroach, (NTC-2736) i6; Cladosporium lactoglobulin, (NTC-2852) f77; Peanut Component Panel, (NTC-
herbarum, (NTC-2702) m2; Alternaria alternata, (NTC-2706) m6; 91681) Ara h1, f422; Ara h2, f423; Ara h3, f424; Ara h8, f352; Ara h9
Total IgE
Nut Mix Group 18
Childhood Allergy Profile w/Reflexes
- I gE allergy testing for: Almond, (NTC-2820) f20; Cashew nut, (NTC-
-C
 ontains all components of the Childhood Allergy Profile (NTC-
2608) f202; Coconut, (NTC-2836) f36; Hazelnut, (NTC-2817) f17; 7918
10659) with reflex to the following components, Egg Component
Peanut, (NTC-2813) f13; Pecan, (NTC-2864) f201; Sesame seed,
Panel, (NTC-91372); Ovomucoid, (NTC-3046) f233; Ovalbumin,
91683 (NTC-2810) f10
(NTC-2719) f232; Milk Component Panel, (NTC-91403); Casein,
(NTC-2853) f78; Alpha-lactalbumin, (NTC-2851) f76; Beta- Nut Panel
lactoglobulin, (NTC-2852) f77; Peanut Component Panel, (NTC- -M
 acadamia nut, (NTC-38475); Pecan, (NTC-2864); Brazil nut,
91681) Ara h1, f422; Ara h2, f423; Ara h3, f424; Ara h8, f352; Ara h9 (NTC-2818); Walnut, (NTC-3489); Cashew nut, (NTC-2608); 94462
Pistachio, (NTC-2726); Hazelnut, (NTC-2817); Almond, (NTC-2820);
Food Allergy Panel
Peanut—no reflexes (NTC-2813)
-M
 ilk, (NTC-2802) f2; IgE Egg white, (NTC-2801) f1; IgE Peanut,
(NTC-2813) f13; IgE Walnut, (NTC-3489) f256; IgE Corn, (NTC-2808) Nut Panel w/Reflexes
38767
f8; IgE Wheat, (NTC-2804) f4; IgE Soybean, (NTC-2814) f14; IgE -M
 acadamia nut, (NTC-38475); Pecan, (NTC-2864); Brazil nut (with
Codfish, (NTC-2803) f3; IgE Clam, (NTC-8929) f207; IgE Shrimp, reflex), (NTC-94464); Walnut (with reflex), (NTC-94467); Cashew
(NTC-2824) f24; Total IgE 94463
nut (with reflex), (NTC-94465); Pistachio, (NTC-2726); Hazelnut
(with reflex), (NTC-94468); Almond, (NTC-2820); Peanut (with
Food Allergy Profile
reflex), (NTC-91747)
-E
 gg white, (NTC-2801) f1; Milk, (NTC-2802) f2; Codfish, (NCT-2803)
f3; Wheat, (NTC-2804) f4; Corn, (NTC-2808) f8; Sesame seed, Peanut Component Panel
10715 91681
(NTC-2810) f10; Peanut, (NTC-2813) f13; Soybean, (NTC-2814) f14; -A
 ra h1, f422; Ara h2, f423; Ara h3, f424; Ara h8, f352; Ara h9
Shrimp, (NTC-2824) f24; Clam, (NTC-8929) f207; Walnut, (NTC-
3489) f256; Scallop, (NTC-273) f338 Peanut (Total) w/Reflex
-P
 eanut, f13; *Positive result reflexes to 91681—Peanut
91747
Component Panel, (Ara h1, f422; Ara h2, f423; Ara h3, f424; Ara h8,
f352; Ara h9)
Multiple test codes are available. Refer to the Quest Diagnostics Directory of Services or the online Test Center (QuestDiagnostics.com /testcenter)
for test information.
NTC = National test code

For more information about peanut component testing, contact your local sales representative.
References

1. Nicolaou N, Poorafshar M, Murray C, et al. Allergy or tolerance in children sensitized to peanut: prevalence and differentiation using component-resolved diagnostics.
J Allergy Clin Immunol. 2010;125(1):191-197.
2. Asarnoj A, Nilsson C, Lidholm J, et al. Peanut component Ara h 8 sensitization and tolerance to peanut. J Allergy Clin Immunol. 2012;130(2):468-472.
3. Mittag D, Akkerdaas J, Ballmer-Weber BK, et al. Ara h 8, a Bet v 1-homologous allergen from peanut, is a major allergen in patients with combined birch pollen and peanut allergy.
J Allergy Clin Immunol. 2004;114(6):1410-1417.
4. Lauer I, Dueringer N, Pokoj S, et al. The non-specific lipid transfer protein, Ara h 9, is an important allergen in peanut. Clin Exp Allergy. 2009;39(9):1427-1437.
5. Movérare R, Ahlstedt S, Bengtsson U, et al. Evaluation of IgE antibodies to recombinant peanut allergens in patients with reported reactions to peanut. Int Arch Allergy Immunol.
2011;156(3):282-290.
6. Peeters KA, Koppelman SJ, van Hoffen E, et al. Does skin prick test reactivity to purified allergens correlate with clinical severity of peanut allergy? Clin Exp Allergy. 2007;37(1):108-115.
7. Asarnoj A, Movérare R, Östblom E, et al. IgE to peanut allergen components: relation to peanut symptoms and pollen sensitization in 8-year-olds. Allergy. 2010;65(9):1189-1195.
8. Dang TD, et al. Increasing the accuracy of peanut allergy diagnosis by using Ara h 2. J Allergy Clin Immunol. 2012;129(4):1056-1063.
9. Nicolaou N, et al. Quantification of specific IgE to whole peanut extract and peanut components in prediction of peanut allergy. J Allergy Clin Immunol. 2011:1-2.
10. Vereda A, et al. Peanut allergy: Clinical and immunologic differences among patients from 3 different geographic regions. J Allergy Clin Immunol. 2010;3(2):1-5.

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