{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T15:41:32Z","timestamp":1758814892162},"reference-count":51,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,2,22]],"date-time":"2014-02-22T00:00:00Z","timestamp":1393027200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clin Experimental Allergy"],"published-print":{"date-parts":[[2014,3]]},"abstract":"Summary<\/jats:title>Background<\/jats:title>Retrospective studies of childhood peanut allergy demonstrate serum\u2010specific IgE (I<\/jats:styled-content>gE<\/jats:styled-content>) levels against the peanut allergen A<\/jats:styled-content>ra h2 may help predict a clinical reaction at food challenge. Fraction of exhaled nitric oxide (F<\/jats:styled-content>eNO<\/jats:styled-content>) is a non\u2010invasive tool correlating to allergic airways inflammation and has been independently associated with increased food\u2010specific I<\/jats:styled-content>gE<\/jats:styled-content>.<\/jats:p><\/jats:sec>Objective<\/jats:title>To assess the validity of serum\u2010specific A<\/jats:styled-content>ra h2 I<\/jats:styled-content>gE<\/jats:styled-content> measured prospectively to diagnose peanut allergy and explore the utility of FeNO<\/jats:styled-content> as a non\u2010invasive screening tool for childhood food challenge.<\/jats:p><\/jats:sec>Methods<\/jats:title>We recruited 53 participants from a cohort of consecutive children scheduled for an open\u2010labelled peanut food challenge (OFC<\/jats:styled-content>) by their paediatric allergist. Participants underwent skin prick test (SPT<\/jats:styled-content>) measurement for sensitization to whole peanut extract, and serum was collected for A<\/jats:styled-content>ra h2\u2010specific I<\/jats:styled-content>gE<\/jats:styled-content>. FeNO<\/jats:styled-content> was also measured in all cooperative children before the challenge. OFC<\/jats:styled-content> and assessment of reaction were undertaken by clinicians blinded to test results.<\/jats:p><\/jats:sec>Results<\/jats:title>A<\/jats:styled-content>ra h2\u2010specific I<\/jats:styled-content>gE<\/jats:styled-content> and F<\/jats:styled-content>eNO<\/jats:styled-content> each showed improved diagnostic accuracy when compared to SPT<\/jats:styled-content>. Receiver operator characteristic curve analysis gave an area under the curve (AUC<\/jats:styled-content>) for A<\/jats:styled-content>ra h2 sI<\/jats:styled-content>gE<\/jats:styled-content> of 0.84 (95% CI, 0.72\u20130.96). The AUC<\/jats:styled-content> for F<\/jats:styled-content>eNO<\/jats:styled-content>, 0.83 (95% CI, 0.71\u20130.95), was equivalent to that of A<\/jats:styled-content>ra h2. Combined AUC<\/jats:styled-content> for SPT<\/jats:styled-content>, sI<\/jats:styled-content>gE<\/jats:styled-content> to A<\/jats:styled-content>ra h2 and F<\/jats:styled-content>eNO<\/jats:styled-content> was 0.96 (95% CI 0.90\u20131.00). There was no correlation between F<\/jats:styled-content>eNO<\/jats:styled-content> and serum nitrite levels (rs\u00a0=\u00a0\u22120.13, P<\/jats:italic>\u00a0=\u00a00.6, n<\/jats:italic>\u00a0=\u00a018).<\/jats:p><\/jats:sec>Conclusion and clinical relevance<\/jats:title>Prospectively measured A<\/jats:styled-content>ra h2\u2010specific I<\/jats:styled-content>gE<\/jats:styled-content> improves diagnostic accuracy and reduces unsuccessful challenge to peanut. F<\/jats:styled-content>eNO<\/jats:styled-content> levels may provide improved diagnostic accuracy in a paediatric population undergoing OFC<\/jats:styled-content>. The proposed FeNO\u2010based diagnostic algorithm requires further validation studies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cea.12258","type":"journal-article","created":{"date-parts":[[2013,12,17]],"date-time":"2013-12-17T16:20:45Z","timestamp":1387297245000},"page":"371-380","source":"Crossref","is-referenced-by-count":12,"title":["The fraction of exhaled nitric oxide improves prediction of clinical allergic reaction to peanut challenge in children"],"prefix":"10.1111","volume":"44","author":[{"given":"K.","family":"Preece","sequence":"first","affiliation":[{"name":"Experimental & Translational Respiratory Medicine Group University of Newcastle and Hunter Medical Research Institute Newcastle NSW Australia"},{"name":"Department of Paediatric Allergy & Immunology Newcastle Children's Hospital Newcastle NSW Australia"},{"name":"School of Medicine and Public Health University of Newcastle Newcastle NSW 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