Detect sensitizations to the whole peanut to create personalized management plans for your patients.

Peanut allergens by the numbers

Peanut allergen component testing

Ara

h8

Ara

h9

Ara

h3

Ara

h2

Ara

h1

Ara h8 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

Peanut allergen component testing Measurement of specific IgE by blood 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.

High levels of peanut IgE can predict the likelihood of peanut sensitivity, but may not be solely predictive of reactions or allergic response.1

LOWER RISK of systemic reaction2

• Risk of mild, localized symptoms, such as itching/tingling of the lips, mouth, and oropharynx3

• Cross-reactive with pollens (e.g., birch)3

Knowing to which protein your patient is sensitized can help you develop a management plan.1,2,8-10

Ara

h8

77.6% of peanut sensitive patients may not be at risk for a systemic reaction.1

Ara h8 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.

VARIABLE RISK of systemic reaction including anaphylaxis4

• Often accompanied by sensitization to other peanut proteins5

• Cross-reactive with fruits with pits (e.g., peaches)4

HIGHER RISK of systemic reaction including anaphylaxis6,7

• Sensitization to Ara h2 is nearly always associated with clinical peanut allergy2

Determine which proteins your patient is sensitized to.

Reduce patient anxiety with individualized management plans.

Ara

h9

Ara

h2

Ara

h1

Ara

h3

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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Childhood Allergy Profile - D. pteronyssinus (House mite), (NTC-2721) d1; D. farinae (House

mite), (NTC-2722) d2; Cat dander, (NTC-2601) e1; Dog dander, (NTC-2605) e5; Egg white, (NTC-2801) f1; Milk, (NTC-2802) f2; Codfish, (NTC-2803) f3; Wheat, (NTC-2804) f4; Peanut, (NTC-2813) f13; Soybean, (NTC-2814) f14; Shrimp, (NTC-2824) f24; Walnut, (NTC-3489) f256; Cockroach, (NTC-2736) i6; Cladosporium herbarum, (NTC-2702) m2; Alternaria alternata, (NTC-2706) m6; Total IgE

10659

Childhood Allergy Profile w/Reflexes - Contains all components of the Childhood Allergy Profile (NTC-

10659) with reflex to the following components, Egg Component Panel, (NTC-91372); Ovomucoid, (NTC-3046) f233; Ovalbumin, (NTC-2719) f232; Milk Component Panel, (NTC-91403); Casein, (NTC-2853) f78; Alpha-lactalbumin, (NTC-2851) f76; Beta-lactoglobulin, (NTC-2852) f77; Peanut Component Panel, (NTC-91681) Ara h1, f422; Ara h2, f423; Ara h3, f424; Ara h8, f352; Ara h9

91683

Food Allergy Panel - Milk, (NTC-2802) f2; IgE Egg white, (NTC-2801) f1; IgE Peanut,

(NTC-2813) f13; IgE Walnut, (NTC-3489) f256; IgE Corn, (NTC-2808) f8; IgE Wheat, (NTC-2804) f4; IgE Soybean, (NTC-2814) f14; IgE Codfish, (NTC-2803) f3; IgE Clam, (NTC-8929) f207; IgE Shrimp, (NTC-2824) f24; Total IgE

38767

Food Allergy Profile - Egg white, (NTC-2801) f1; Milk, (NTC-2802) f2; Codfish, (NCT-2803)

f3; Wheat, (NTC-2804) f4; Corn, (NTC-2808) f8; Sesame seed, (NTC-2810) f10; Peanut, (NTC-2813) f13; Soybean, (NTC-2814) f14; Shrimp, (NTC-2824) f24; Clam, (NTC-8929) f207; Walnut, (NTC-3489) f256; Scallop, (NTC-273) f338

10715

Food Allergy Profile w/Reflexes - Contains all components of the Food Allergy Profile (NTC-10715)

with reflex to the following components, with reflex to Egg Component Panel, (NTC-91372); Ovomucoid, (NTC-3046) f233; Ovalbumin, (NTC-2719) f232; Milk Component Panel, (NTC-91403); Casein, (NTC-2853) f78; Alpha-lactalbumin, (NTC-2851) f76; Beta-lactoglobulin, (NTC-2852) f77; Peanut Component Panel, (NTC-91681) Ara h1, f422; Ara h2, f423; Ara h3, f424; Ara h8, f352; Ara h9

91682

Nut Mix Group 18 - IgE allergy testing for: Almond, (NTC-2820) f20; Cashew nut, (NTC-

2608) f202; Coconut, (NTC-2836) f36; Hazelnut, (NTC-2817) f17; Peanut, (NTC-2813) f13; Pecan, (NTC-2864) f201; Sesame seed, (NTC-2810) f10

7918

Nut Panel - Macadamia nut, (NTC-38475); Pecan, (NTC-2864); Brazil nut,

(NTC-2818); Walnut, (NTC-3489); Cashew nut, (NTC-2608); Pistachio, (NTC-2726); Hazelnut, (NTC-2817); Almond, (NTC-2820); Peanut—no reflexes (NTC-2813)

94462

Nut Panel w/Reflexes - Macadamia nut, (NTC-38475); Pecan, (NTC-2864); Brazil nut (with

reflex), (NTC-94464); Walnut (with reflex), (NTC-94467); Cashew nut (with reflex), (NTC-94465); Pistachio, (NTC-2726); Hazelnut (with reflex), (NTC-94468); Almond, (NTC-2820); Peanut (with reflex), (NTC-91747)

94463

Peanut Component Panel - Ara h1, f422; Ara h2, f423; Ara h3, f424; Ara h8, f352; Ara h9

91681

Peanut (Total) w/Reflex - Peanut, f13; *Positive result reflexes to 91681—Peanut

Component Panel, (Ara h1, f422; Ara h2, f423; Ara h3, f424; Ara h8, f352; Ara h9)

91747

Diagnoseby the numbers.

Assess risks for systemic reactions and cross-reactivity.

Address anxiety with individualized management plans.

Enable confidence in dietary and lifestyle choices.

Test Name Test NameTest Code Test Code

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