The role of allergen components for the diagnosis of latex‐induced occupational asthma. Issue 6 (15th April 2016)

• Record Type: Journal Article
• Authors: Vandenplas, O.; Froidure, A.; Meurer, U.; Rihs, H.‐P.; Rifflart, C.; Soetaert, S.; Jamart, J.; Pilette, C.; Raulf, M.
• Is Part Of: Allergy. Volume 71:Issue 6(2016:Jun.)
• Page Start: 840
• Page End: 849
• Publication Date: 2016-04-15
• Subjects: bronchial provocation test -- component‐resolved diagnosis -- latex -- occupational asthma -- recombinant allergens; Allergy -- Periodicals; 616.97
• DOI: 10.1111/all.12872
• Languages: English
• ISSNs: 0105-4538

Abstract

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.