Basophil Activation Test and specific IgE measurements using a panel of recombinant natural rubber latex allergens to determine the latex allergen sensitization profile in children

Abstract

There are no documented studies that describe natural rubber latex (NRL) sensitization in children with a history of surgical intervention but without any congenital malformation (urogenital anomalies, spina bifida, etc.), although some authors have studied NRL allergy in children without a history of surgical intervention. The aim of this work was to evaluate the sensitization profile to single NRL allergens in children without spina bifida and without repeated surgical interventions, by using different recombinant and natural latex allergens in two analytical techniques: specific serum immunoglobulin E (IgE) quantification and flow cytometry determination of activated basophils expressing CD63, after stimulating cells from patients with NRL allergens. A total of 23 patients and 10 healthy children were selected. Conjunctival and in-use NRL provocation tests were carried out, as well as specific IgE determination in all patients' and controls' sera with the recombinant NRL allergens: rHev b 1, rHev b 2, rHev b 3, rHev b 5, rHev b 6.01, rHev b 6.02, rHev b 8, rHev b 9 and rHev b 11 and with NRL (k82) using appropriate ImmunoCAPs. The Basophil Activation Test (BAT) was performed with whole latex extract and with the recombinant allergens rHev b 5 and rHev b 6.01, as well as with the natural allergen Hev b 6.02. The sensitivity and the specificity of NRL-specific IgE (k82) were 100%. Positive IgE responses to rHev b 5 were found in sera of 10 children, to rHev b 6.01 in 16 and for rHev b 6.02 in 15 children's sera. Specific IgE to rHev b 8 was found in four sera of the children. We only found significant differences in sensitization to rHev b 5 in children with two or more surgical interventions compared with the non-intervened group or those with only one intervention. Specific IgE in sera of children with latex-fruit syndrome recognized rHev b 6.02, but not to rHev b 11. The patients sensitized to Hev b 8, Hev b 9 and/or Hev b 11 were atopic. The four patients presenting a positive response to the NRL profilin Hev b 8 were allergic to pollen. The BAT against whole NRL extract was positive in 22 of 23 children; against rHev b 5 in 14 of the patients studied; against rHev b 6.01 in seven cases and against nHev b 6.02 in 19 children. In all the control subjects, the results using this technique were negative. If combined rHev b 5, rHev b 6.01 and nHev b 6.02 together, BAT could detect 20 of the 23 children with latex allergy. The combined use of ImmunoCAP with all the recombinant NRL allergens and BAT with rHev b 5, rHev b 6.01 and nHev b 6.02, enabled the identification of NRL allergy in 22 of 23 patients. There is a positive and significant correlation between sensitization to Hev b 5 and the number of interventions. BAT and allergen-specific IgE determination could be used as first-line in vitro diagnostic tests in patients with NRL allergy.

Occupational Allergy to Latex among Loom Tuners in a Textile Factory

“…The stimulatory effect of the extracted latex allergens could be demonstrated by activation of basophils from sensitised workers as previously demonstrated in other settings [23]. Data from other studies on latex exposure have demonstrated that latex allergen levels above 1 µg/g of glove are potentially sensitising [24], confirming the elevated health risk of the workers exposed to the processed elastics in the investigated factory.…”

Diagnostic Tests Based on Human Basophils: More Potentials and Perspectives than Pitfalls

“…In several validated studies [57,58,59,60,61,62,63] (table 3), BAT was shown to demonstrate a sensitivity and specificity for CD63 expression of >90%, with one exception in which sensitivity was reported to be 75% for CD203c and 50% for the CD63 assay [60]. BAT is the test which reflects the most closely clinical provocation.…”

“…Many of these studies have been reviewed recently [8,9,10]. Herewith, tables 1, 2, 3, 4, 5, 6, 7summarize the results of validated clinical studies performed with various allergens such as inhalant allergens [25,26,27,28,29,30,31,32,33] (table 1), hymenoptera venoms [34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56] (table 2), latex [57,58,59,60,61,62,63] (table 3), food [64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80] (table 4) and drugs [81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98,99,100,101,…”

Evaluación de técnicas inmunológicas in vitro para el diagnóstico de alergias: metanálisis 2000-2012

“…En las que emplearon IgE específica fue la presencia de concentraciones mayores a 0,35UIL y en los que emplearon como estándar de referencia el diagnóstico clínico se evaluó la En la tabla 2 se presenta la descripción de los valores para la evaluación diagnós-tica, sumado al porcentaje del peso que presenta cada estudio individual en el valor global del CP+, el CP-y la ORD. En esta se observó que el estudio de Sturm et al 20 con alergeno de avispas presentó el mayor peso en los resultados del CP+, mientras que para el CP-fue el de Sanz M et al 19 (tabla 2).…”