A novel approach to diagnose cashew and pistachio allergy using peptide microarray technology

2022 AIFA Food Allergy Research Grant (supported by DBV Technologies)

Dr Brynn Wainstein

Other investigators: A/Prof Alice Lee, Dr Mahila Namasivayam and Dr Kylie-Ann Mallitt (UNSW); Dr Katie Frith, Dr Paul Gray and Ms Betina Altavilla (Sydney Children's Hospital) 

Cashew allergy affects almost 3 in every 100 children in Australia, the same as the proportion of children affected by peanut allergy in our country. Cashew allergy causes more severe reactions than peanut including life threatening severe allergic reactions termed anaphylaxis, potentially resulting in death. Cashew nut allergy is typically life-long. Despite this, much is still not known about it, compared to peanut allergy which has been reported extensively.

Currently available tests used to diagnose cashew allergy have significant limitations and have not changed in over three decades.

The “gold standard” for diagnosing cashew allergy, the oral food challenge (OFC), has the potential to cause a life-threatening allergic reaction. It is a costly, time consuming and labour intensive test that needs to be conducted in specialised medical clinics, leading to limited access and long waiting lists across Australia.  

Skin prick testing is more accessible but has an unacceptably high false positive rate when the history is unclear or is used as a screening tool.

The scarcity of information on cashew allergy and limitations with diagnosis causes considerable anxiety for affected families and places a burden on health care resources.  This underscores the urgent need to develop accurate diagnostic methods for cashew allergy.

Peptide microarray technology can be applied innovatively to diagnose food allergy.  It is minimally invasive and has diagnosed peanut allergy and severity almost as accurately as an OFC without the risk of a life-threatening reaction.

Peptide microarray technology hasn’t been studied in Australia for diagnosing cashew nut or other clinical food allergy. Cashew and pistachio nuts are from the same botanical family. This study plans to be the first to use peptide microarray testing in Australian children to study immediate allergy to cashew and pistachio nuts.

 

AIFA Food Allergy Research Grant of $15,000 (supported by DBV Technologies)