The NutCracker Study
Research type
Research Study
Full title
The NutCracker Study: A study of incidental sensitisation to peanut in egg allergic children, and the utility of component-resolved diagnostic testing to Ara h 2 in predicting clinical outcome. A Pilot Study.
IRAS ID
133448
Contact name
Deborah E Marriage
Contact email
Duration of Study in the UK
1 years, 3 months, 30 days
Research summary
Allergy to peanut affects 1% of UK children. Children with egg allergy are known to be at increased risk of having peanut allergy. The current diagnostic test looks for allergic antibodies (known as 'IgE antibodies') to whole peanut and is only useful in diagnosing peanut allergy if the child is seeking confirmation of peanut allergy following a clear history of a reaction. False positive results are common using this test, with only 10-20% of children with positive peanut-specific IgE actually being allergic (Tariq et al, 1996). The presence of positive IgE allergic antibodies is known as sensitisation. Recently, positive specific IgE antibody tests to specific individual peanut components, rather than to whole peanut, have been developed. This has been associated with improved prediction of allergy in children. Sensitisation to the component Ara h 2 has been proposed as the best predictor of peanut allergy (Nicolaou and Custovic, 2011).
All egg allergic children with a positive allergy skin prick test to peanut who have never eaten peanut attending the Paediatric Allergy Clinic at Bristol Children’s Hospital between October 2014 and December 2015 will be invited to participate. Permission to take an extra 0.5ml (tip of a teaspoon) of blood during routine venepuncture will be sought.
Children will then undergo a peanut oral provocation challenge (OPC) as part of their routine care. The child will subsequently be defined as peanut-allergic or peanut-tolerant depending upon the challenge outcome. Differences in mean Ara h 2 and whole peanut specific IgE levels will be compared between the two groups.
This will be a prospective study to investigate Ara h 2 levels in infants and young children attending a tertiary allergy clinic with egg. This aims to ultimately lead to patient benefit by clarifying a child's diagnosis without subjecting them to an oral peanut provocation challenge, which is the current gold standard for confirmation of peanut allergy.REC name
London - Camden & Kings Cross Research Ethics Committee
REC reference
14/LO/1894
Date of REC Opinion
16 Oct 2014
REC opinion
Favourable Opinion