Getting Specific with Molecular Peanut Testing

Usually, every summer we make our pilgrimage to our favorite allergist at the Allergy and Asthma Group of the Bay Area, Inc.  Even though we have many lovely allergists in Reno now, my kids pretty much consider our allergist a family member!  Yes, they’ve visited him more times than some cousins.  This summer was painfully hot and full of family travel, so we decided to postpone our visit to fall,  when the kids will be back into a routine, not overheated, battling pollen and tired from travel.  Taking them off Zyrtec for any sort of allergy testing is tricky, so we have learned to thoughtfully time our visits.  Alas, this fall we have a serious item on our annual agenda to discuss:  Uknow Peanut™ImmunoCAP™ Molecular Testing.

This term was news to me until this summer when I participated in an online webinar about this testing.  Then, I had the pleasure of speaking to Dr. Rob Reinhardt, who is a family and academic physician (he was wonderful on making sure I understood his background).  He us the US medical director for Thermo Fisher Scientific (formerly Phadia) and spends much of his time educating allergists, pediatricians and family physicians about component testing.

photo courtesy of graphicshunt.com

What I understand, is that Molecular Peanut Testing to be is another type of food allergy test that is specific to the peanut that is designed to give a better picture of peanut allergy and if tolerance is approaching.  The test is FDA cleared, by the way.  Basically, when a traditional peanut blood test is used, the test is based on a the whole peanut–all the components rolled into one test.  Molecular Peanut Testing breaks out each component (think skin, shell, nut meat, etc.).  Here is a fabulous brochure that seems to do a good job explaining this concept entitled: Uknow Peanut™ ImmunoCAP Molecular Testing.  Also, here are a few links to forums that Dr. Reinhardt and other experts use to connect with patients that I think you might find helpful:
·         www.isitallergyblog.com
·         www.facebook.com/IsItAllergy
·         http://twitter.com/isitallergy
So what’s the big deal about being able to break it down?  A person might be allergic to a component in a peanut that is not a high anaphylaxis risk.  OR…it is the other way around, a person is highly allergic to a high risk component and is not managing their peanut allergy appropriately.

I asked Dr. Reinhardt why would any of us be interested in this testing and who are the patients that are currently using this testing?  He gave me four basic scenarios…
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• Folks who are living in life stopping fear from their peanut allergy.  Understanding more details of their food allergy might help them  put their disease in better perspective.
• A person with a peanut allergy “label” without proper diagnosis, i.e., someone who had testing several years previously or someone who believes they have an allergy but has not been evaluated by a physician.
• Someone seeking information about their tolerance levels. This could be a patient who doesn’t believe they have a severe peanut allergy who could discover that indeed, they have a very severe allergy and should change their risk taking behavior.
• A patient who has tested positive for a peanut allergy but has no clinical history or history of reactions.

[/unordered_list] One overall outcome could be having enough detailed information that might help an allergist decide that a food challenge test is warranted or that the patient could be placed in a dangerous situation if they did participate in a challenge test.  It seems that this may be a new tool for physicians who need specific answers.  One of my friends is looking into her child participating in a peanut immunotherapy study said this test was used to determine if her child was a candidate for the study.  So, clearly this test is respected and being used.

The Uknow Peanut™ ImmunoCAP™ Molecular Testing process seems fairly simple…

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• Visit your physician and ask them to download the UKnow Peanut™ImmunoCAP Molecular Test forms. Your doctor needs to fill out these forms and you need to pay up front with credit card.  The cost is $300 and Dr. Reinhardt explained that since this test is new some insurance companies won’t cover it until you ask.  So, do ask them to cover it as you explain that the test is fresh on the market.  He explained financial aid is available too via a link on their website and that approval could take from to two to four weeks.
• Receive your kit, which will include resources and lab information that you’ll take to the lab along with your physician completed forms.  The test draws one vial of blood.
• Give blood sample at lab.
• Receive information that you and your doctor will review together.  Dr. Reinhardt explained that free consultation is provided to all physicians.
• Create your food allergy management plan.

[/unordered_list] I am curious about this testing since my son has tested positive for peanut, but has had no clinical history of peanut reactions in all 11 years since diagnosis.  I can trace a line to sesame seed, dairy and other seed reactions but not peanut or tree nut.  Dr. Reinhardt explained that other food and environmental molecular tests are coming as they are waiting for FDA clearance right now, but you can see the tests, which are available from PiRl lab. These are not FDA cleared yet-which means the FDA has not given their blessing that the tests will perform as Thermo Fisher says they will.    For our medically savvy Gratefulfoodie readers, here is an article from Advance for NP’s and PA’s (for the rest of us that means Nurse Practioners and Physician Assistants), “Diagnosing Peanut Allergy, Molecular Testing Provides a More Complete Picture”.   Medical types would probably enjoy this article since you will actually understand what they are saying!

UKnow Peanut™ ImmunoCAP™ Molecular Testing is new to me and I am very curious if anyone has had any experiences with this testing and if so, what was the value to you?  Can you share your experience in the comment section below?

I can’t give too much opinion since I have not experienced this first hand…yet!
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