THE UTSW RESEARCH PROJECT WILL INVESTIGATE IMMUNOGLOBULIN E (IGE) GLYCOSYLATION TO REPLACE THE ORAL FOOD CHALLENGE TEST. IGE CUT-OFF LEVELS ARE UNCLEAR (CAN BE FALSELY POSITIVE) AND WHILE IMMUNOTHERAPY RESPONDERS DECREASE THEIR IGE, SIGE DOES NOT RELIABLY PREDICT RESPONSE, SO FOOD CHALLENGES MUST BE PERFORMED. RECENT WORK HAS DEMONSTRATED POST-TRANSLATIONAL MODIFICATIONS IN THE FORM OF GLYCOSYLATION REGULATES THE ANAPHYLACTIC POTENTIAL OF IGE AND COULD EXPLAIN THIS DISCONNECT. HOWEVER, THIS OBSERVATION WARRANTS DEEPER INVESTIGATION AND CLINICAL VALIDATION IN A FOOD ALLERGY TRIAL TO DETERMINE IF IGE GLYCOSYLATION CAN PREDICT ALLERGIC REACTIVITY. THIS GOAL WILL BE PURSUED BY JEFF SORELLE MD, A PHYSICIAN SCIENTIST (PI), WHOSE BASIC SCIENCE RESEARCH OF IGE HAS LED HIM TO STUDY THE IMPACT OF IGE GLYCOSYLATION ON ALLERGIES. HIS MEDICAL TRAINING IS IN VALIDATING CLINICAL DIAGNOSTICS AND HAS ASSEMBLED A TEAM EXPERIENCED IN THROUGH THE FOLLOWING AIMS: AIM 1: ANALYTICALLY VALIDATE AN IGE GLYCAN TEST (BY MASS-SPEC OR ALTERNATIVE METHOD), AIM 2: ESTABLISH IGE-GLYCOSYLATION CUT-OFF FOR ALLERGIC REACTIVITY, AND CLINICALLY VALIDATE IGE-GLYCOSYLATION AS A BIOMARKER ON A BROADLY REPRESENTATIVE POPULATIONFROM COHORTS TREATED WITH PEANUT ORAL IMMUNOTHERAPY OR CONTROL COHORTS WITHOUT PEANUT ALLERGY.