Abstract
BackgroundFood allergies are a major component of the burden of allergic disease. Accurate risk assessment for prediction of future clinical reactivity or clinical tolerance is limited by currently available techniques. Recent studies suggest that constitutively elevated global serum levels of IL-10, a cytokine that down-regulates both Th1 and Th2 cytokine production, may be useful in identifying human clinical tolerance to foods.ObjectiveDetermine the usefulness of constitutive IL-10 levels as a marker of clinical tolerance to peanut in children and adults.Methodology/Principal Findings107 subjects who were clinically tolerant to peanut and 94 subjects who were clinically allergic to peanut participated. Plasma was analyzed via ELISA to quantify the frequency of individuals with constitutive IL-10 levels and the intensity of those responses. The data were then stratified by age, gender and clinical status to assess the utility of this putative biomarker in specific at-risk groups. All 201 subjects had readily quantified plasma IL-10. Levels were no higher in subjects who were clinically tolerant to peanut than those in individuals clinically allergic to peanut. Stratification by age, gender or both did not improve the capacity of IL-10 levels to identify clinical tolerance to peanut.Conclusions/SignificancePlasma IL-10 levels are neither a useful biomarker of clinical tolerance to peanut nor a potential tool for identification of clinical tolerance to peanut in humans.
Highlights
Peanut allergy is a leading cause of fatal anaphylaxis [1] and affects approximately 1.2 to 1.5% of people in North America and the United Kingdom [2,3]
To determine if plasma IL-10 differed significantly between populations who were clinically tolerant to peanut versus those exhibiting clear clinical histories of symptoms and signs after peanut ingestion, positive SPTs to peanut allergen, and elevated peanut specific IgE, the plasma from each group was analyzed to quantify constitutive IL-10 levels using a high sensitivity ELISA
No difference was evident in the frequency of constitutive IL-10 producers between clinically tolerant and peanut allergic populations
Summary
Peanut allergy is a leading cause of fatal anaphylaxis [1] and affects approximately 1.2 to 1.5% of people in North America and the United Kingdom [2,3]. The methods most commonly used for risk assessment include a detailed medical history of symptoms after peanut exposure, a skin prick test to peanut and quantification of peanut specific IgE in serum [4]. These tests are used in combination, as there is the potential for diagnostic error with reliance on any single method in isolation. Skin prick tests or peanut specific IgE levels are unable to differentiate reliably between sensitization to peanut, which is common, and risk of systemic allergic reaction to peanut, which is considerably less common [5,6,7]. Recent studies suggest that constitutively elevated global serum levels of IL-10, a cytokine that down-regulates both Th1 and Th2 cytokine production, may be useful in identifying human clinical tolerance to foods
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