Mucosal brush biopsy of the oral cavity to detect local, peanut-specific immunoglobulin E

Authors

  • William R. Reisacher MD, FACS, FAAOA,

    Corresponding author
    1. Department of Otolaryngology–Head and Neck Surgery, Weill Cornell Medical College, New York, NY
    • Correspondence to: William R. Reisacher, MD, FACS, FAAOA, Department of Otolaryngology–Head and Neck Surgery, Weill Cornell Medical College, NewYork-Presbyterian Hospital, 1305 York Avenue, 5th Floor, New York, NY 10021; e-mail: wir2011@med.cornell.edu

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  • Justin C. Cohen MD

    1. Department of Otolaryngology–Head and Neck Surgery, Weill Cornell Medical College, New York, NY
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  • Funding sources for the study: Research grant from the American Academy of Otolaryngic Allergy Foundation (AAOAF).

  • Potential conflict of interest: None provided.

  • Presented at the American Academy of Otolaryngic Allergy (AAOA) Annual Meeting, September 7, 2012, Washington, DC.

Abstract

Background

This study compares the ability of mucosal brush biopsy (MBB) from 2 separate locations in the oral cavity to detect peanut-specific immunoglobulin E (IgE) in patients who report adverse oral cavity reactions when ingesting peanuts.

Methods

Twenty patients who reported a history of oral cavity itching or swelling when ingesting peanuts underwent either MBB of the dorsal tongue (n = 10) or the vestibule (n = 10). Serum testing for total and peanut-specific IgE, using standard immunofluorescent assay, was obtained for all patients. Total and specific IgE for each location were compared. Additionally, the correlation between MBB and peanut-specific IgE on serum was determined using Fisher's exact probability testing.

Results

Peanut-specific IgE was detected in 3 of 10 (30%) MBB specimens from the dorsal tongue and in 10 of 10 (100%) MBB specimens from the vestibule. The mean peanut-specific IgE on MBB (kU/L) in the dorsal tongue group was 0.03 vs 0.17 in the vestibule group (p = 0.0002). No significant association was noted for peanut-specific IgE between MBB and serum testing (p = 1.0).

Conclusion

This study demonstrates for the first time that peanut-specific IgE can be detected using MBB in the oral cavity of patients who are symptomatic when consuming peanuts. The vestibule was a superior location compared to the dorsal tongue for oral cavity MBB, correlating very well with self-reported symptoms. Peanut-specific IgE on MBB overall did not correlate well with serum testing for peanut-specific IgE.

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