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

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Vandenplas, Olivier [UCL] Froidure, Antoine [UCL] Meurer, Ursula Rihs, Hans-Peter Rifflart, Catherine [UCL] Soetaert, Sammie [UCL] Jamart, Jacques [UCL] Pilette, Charles [UCL] Raulf, Monika

(eng) 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.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès restreint
Publication date 2016
Language Anglais
Journal information "Allergy" - Vol. 71, no. 6, p. 840-849 (2016)
Peer reviewed yes
Publisher Wiley-Blackwell Publishing Ltd. ((Denmark) Copenhagen)
issn 0105-4538
e-issn 1398-9995
Publication status Publié
Affiliations UCL - (MGD) Service de pneumologie
UCL - (MGD) Unité de support scientifique
UCL - SSS/IREC/MONT - Pôle Mont Godinne
UCL - SSS/IREC/LUNS - Pôle pneumologie, ORL (airways) et dermatologie (skin)
UCL - (SLuc) Service de pneumologie
Keywords Bronchial provocation test ; Component-resolved diagnosis ; Latex ; Occupational asthma ; Recombinant allergens
Links
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Bibliographic reference Vandenplas, Olivier ; Froidure, Antoine ; Meurer, Ursula ; Rihs, Hans-Peter ; Rifflart, Catherine ; et. al. The role of allergen components for the diagnosis of latex-induced occupational asthma.. In: Allergy, Vol. 71, no. 6, p. 840-849 (2016)
Permanent URL http://hdl.handle.net/2078.1/174865