TOPLINE:

Sensitization to the hazelnut storage proteins Cor a 9, Cor a 14, and Cor a 8 increased the odds of failing a hazelnut oral food challenge (OFC), and sensitization to the peanut lipid transfer protein Ara h 9 increased the odds of failing a peanut OFC in children with hazelnut and peanut allergies, respectively.

METHODOLOGY:

• Researchers analyzed 88 children with a tree nut or peanut allergy (56% boys) to identify biomarkers associated with a higher risk of failing an OFC.
• The allergenic molecules assessed via component-resolved diagnostics were Cor a 1, Cor a 8, Cor a 9, Cor a 14, Bet v 1, and Bet v 2 for hazelnut and Ara h 1, Ara h 2, Ara h 3, Ara h 8, and Ara h 9 for peanut.
• Children were considered sensitized if they had specific immunoglobulin E values ≥ 0.1 kUA/L to any of the allergenic molecules.
• All children underwent OFCs; the hazelnut challenge involved progressive and incremental dosing every 15-20 minutes (0.15-300 mg), and the peanut challenge involved progressive dosing (1.3-312 mg).

TAKEAWAY:

• Among 59 children who underwent a hazelnut OFC, 44.1% experienced failure, with Cor a 9, Cor a 14, and Cor a 8 emerging as significant predictors (P < .05 for all).
• Among 30 children who underwent a peanut OFC, 53% experienced OFC failure, with Ara h 9 emerging as a significant predictor (P = .042268).

IN PRACTICE:

"It is essential to underline that these markers can help stratify risk, guide decisions about whether or not to perform an OFC, and potentially reduce the number of challenges required, but they do not entirely replace the need of OFC in all cases, particularly when confirmation of allergy or assessment of its severity is needed," the authors wrote. 

SOURCE:

Giulia Brindisi, MD, PhD, with the Sapienza University of Rome, Rome, Italy, was the corresponding author of the study, which was published online on January 29, 2026, in Nutrients.

LIMITATIONS:

This study was limited by its small sample size, geographic variability, cross-reactivity between allergenic molecules, and the lack of universally applicable cutoff values for molecular components.

DISCLOSURES:

The authors reported having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.