Format

Send to

Choose Destination
Allergy. 2016 Jun;71(6):840-9. doi: 10.1111/all.12872. Epub 2016 Apr 15.

The role of allergen components for the diagnosis of latex-induced occupational asthma.

Author information

1
Department of Chest Medicine, Centre Hospitalier Universitaire de Dinant-Godinne, Université catholique de Louvain, Yvoir, Belgium.
2
Institut de Recherche Expérimentale et Clinique, Pôle de Pneumologie, Université catholique de Louvain, Brussels, Belgium.
3
Walloon Institute for Excellence in Lifesciences and Biotechnology (WELBIO), Brussels, Belgium.
4
Department of Chest Medicine, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium.
5
IPA Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum, Bochum, Germany.
6
Prévention et Protection au Travail - Centre de Service Interentreprises (CESI), Brussels, Belgium.
7
Scientific Support Unit, Centre Hospitalier Universitaire de Dinant-Godinne, Université catholique de Louvain, Yvoir, Belgium.

Abstract

BACKGROUND:

Recombinant Hevea brasiliensis (rHev b) natural rubber latex (NRL) allergen components have been developed to assess the patients' allergen sensitization profile and to improve the diagnosis of NRL allergy.

OBJECTIVE:

To examine whether the determination of specific IgE (sIgE) reactivity to a panel of recombinant allergen components would be helpful for diagnosing NRL-induced occupational asthma (OA) in predicting the outcome of a specific inhalation test.

METHODS:

sIgE levels to NRL extract and 12 recombinant NRL allergen components were assessed in 82 subjects with OA ascertained by a positive specific inhalation challenge (SIC) with NRL gloves and in 25 symptomatic subjects with a negative challenge.

RESULTS:

The sensitivity, specificity, positive predictive value, and negative predictive value of a NRL-sIgE level ≥0.35 kUA /l as compared to the result of SICs were 94%, 48%, 86%, and 71%, respectively. The positive predictive value increased above 95% when increasing the cutoff value to 5.41 kUA /l. Subjects with a positive SIC showed a significantly higher rate of sIgE reactivity to rHev b 5, 6.01, 6.02, and 11 than those with a negative SIC. A sIgE sum score against rHev b 5 plus 6.01/6.02 ≥ 1.46 kUA /l provided a positive predictive value >95% with a higher sensitivity (79%) and diagnostic efficiency (Youden index: 0.67) as compared with a NRL-sIgE ≥5.41 kUA /l (49% and 0.41, respectively).

CONCLUSION:

In suspected OA, high levels of sIgE against rHev b 5 combined with rHev b 6.01 or 6.02 are the most efficient predictors of a bronchial response to NRL.

KEYWORDS:

bronchial provocation test; component-resolved diagnosis; latex; occupational asthma; recombinant allergens

PMID:
26940537
DOI:
10.1111/all.12872
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center