Comparison of the Performance of Skin Prick, ImmunoCAP, and ISAC Tests in the Diagnosis of Patients with Allergy

Griffiths, Rebecca L M; El‐Shanawany, Tariq; Jolles, Stephen; Selwood, Clive; Heaps, Adrian; Carne, Emily; Williams, Paul

doi:10.1159/000464326

Cited by 52 publications

(49 citation statements)

References 11 publications

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“…This supports the statement from Griffiths et al [29] concluding that SPT should be the preferred test when diagnosing NRL allergy. It is therefore important to have standardized NRL SPT extracts available for testing.…”

Section: Discussionsupporting

confidence: 90%

The Clinical Relevance of Natural Rubber Latex-Specific IgE in Patients Sensitized to Timothy Grass Pollen

Brandi

Poulsen

Garvey

2019

Int Arch Allergy Immunol

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Background: In pollen-allergic patients, cross-reacting allergens including cross-reactive carbohydrate determinants (CCDs) and profilins may result in positive natural rubber latex (NRL)-specific IgE (sIgE) antibody tests but the relationship between this sensitization and clinical NRL type 1 allergy is poorly described. Objective: The aims of this study were to determine the frequency and clinical relevance of NRL sIgE in grass pollen-sensitized individuals and to investigate which NRL allergen components these individuals were sensitized to. Methods: A total of 383 grass-sensitized patients answered questions about NRL allergy symptoms and their stored sera from previous investigations were analyzed for NRL sIgE. Patients with NRL sIgE (n = 32) underwent further investigations comprising medical history, skin prick test with NRL and inhalational allergens, and an additional blood sample. The additional blood samples were analyzed for total IgE and sIgE against NRL, timothy grass, birch, rHev b 1, 3, 5, 6.01, 6.02, 8, 9, 11, rPhl p 12, and MUXF3, which was used as a marker of CCD sensitization. Results: Overall, 9.4% of all grass pollen-sensitized individuals showed IgE sensitization to NRL but only 1.6% had a confirmed type I NRL allergy. CCD and Hev b 8 explained the clinically irrelevant NRL IgE sensitization in 65% of the cases. We found a highly significant correlation between NRL profilin (Hev b 8) sensitization and grass profilin (Phl p 12) sensitization (p < 0.0001). Conclusions: Data from this study support the hypothesis that in patients with grass pollen sensitization, Hev b 8 mono-sensitization has little or no clinical relevance and is caused by cross sensitization from grass profilin (Phl p 12).

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Section: Discussionsupporting

confidence: 90%

The Clinical Relevance of Natural Rubber Latex-Specific IgE in Patients Sensitized to Timothy Grass Pollen

Brandi

Poulsen

Garvey

2019

Int Arch Allergy Immunol

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“…Other factors can also contribute to the onset of irritant CD -perspiration from glove occlusion or prolonged contact with an alkaline, skin sensitivity, prior skin damage, or an atopy such as atopic dermatitis (AD) [13]. In diagnostics of rubber glove allergies, the most common tests are skin prick tests (SPTs) and/or latex-specific IgE assay to determine immediate-type allergies to Hevea brasiliensis, and patch tests to determine delayed-type allergies to rubber additives [1,14,15].…”

mentioning

confidence: 99%

An Analysis of Skin Prick Tests to Latex and Patch Tests to Rubber Additives and other Causative Factors among Dental Professionals and Students with Contact Dermatoses

Japundžić¹,

Vodanović²,

Lugović-Mihić³

2018

Int Arch Allergy Immunol

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Background: Dental workers often experience unwanted allergic and nonallergic skin reactions resulting in different contact dermatoses (e.g., contact urticaria, irritant and allergic contact dermatitis) that are often attributed to rubber gloves. Objective: To examine allergic and nonallergic contact dermatoses by different methods amongst dental professionals and dental students, more specifically, reactions to natural rubber latex (NRL), rubber additives, and other causative factors. Methods: In this cross-sectional study we surveyed a total of 444 subjects (dentists, assistants, technicians, and students); 200 agreed to be tested to latex by the standard skin prick test (SPT) and prick-by-prick test, of whom 107 were patch tested to rubber additives (mercapto mix, thiuram mix, carba mix, and N-isopropyl-N-phenyl-4-phenylenediamine [IPPD]). Results: Skin lesions appeared significantly more frequently with longer work experience (p = 0.002; V = 0.181), frequent glove changes (p < 0.001; V = 0.310), and hand washing (p < 0.001; V = 0.263), and in subjects with a history of allergies (atopic dermatitis, allergic rhinitis, allergic conjunctivitis, and others) (p < 0.001; V = 0.183). Positive SPTs to latex occurred in 14/200 subjects (7%), of whom 5/14 subjects (35.7%) were also positive in prick-by-prick tests. Patch tests were positive in 5/104 subjects (4.8%) (mercapto mix 1%, thiuram mix 1.9%, and carba mix 1.9%). Conclusion: Only a small number of our subjects were allergic to latex (7%) or rubber additives (4.8%). Thus, self-reported contact dermatoses (during NRL product use) in dental professionals and students are not commonly caused by allergies to latex and rubber additives, as is often assumed, but by other factors.

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“…(Tabla 1) 4,6,[15][16][17] Según un reciente estudio 18 , aún se recomienda realizar como primer estudio el prick test, pero existen otras téc-nicas que han ido adquiriendo un rol más importante para comprender mejor los alérgenos involucrados en la alergia al látex. Estas técnicas son ImmunoCAP® y immuno-solid phase allergen chip (ISAC).…”

Section: Tablaunclassified

“…ImmunoCAP permite detectar anticuerpos IgE de alta y baja afinidad con los alérgenos específicos de alergia al látex (Hev b). ISAC es un sistema diseñado para detectar anticuerpos IgE específicos, pero de alta afinidad con el alergeno 18 . Por razones de costo, por lo general ISAC se realiza en pacientes seleccionados, en los que el diagnóstico aún no es claro, incluso después de haber realizado un prick test e immunoCAP 18 .…”

Section: Tablaunclassified

“…ISAC es un sistema diseñado para detectar anticuerpos IgE específicos, pero de alta afinidad con el alergeno 18 . Por razones de costo, por lo general ISAC se realiza en pacientes seleccionados, en los que el diagnóstico aún no es claro, incluso después de haber realizado un prick test e immunoCAP 18 . ImmunoCAP se está haciendo cada vez más disponible y puede ser usado en pacientes que tienen alguna condición médica que contraindique un prick test, como una dermatitis extensa, urticaria activa o uso reciente de antihistamínicos 19 .…”

Section: Tablaunclassified

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Alergia al látex, puesta al día

Álvarez

Rojas

2018

Rev. chil. dermatol

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ResumenEl látex o caucho natural es un producto vegetal que se obtiene de la savia de la Hevea brasiliensis. Ampliamente utilizado para la fabricación de productos de uso doméstico (guantes, preservativos, globos, etc.) y del área de la salud, donde se estima que el 50% de los artículos médicos contienen látex. La alergia al látex es un problema de salud mundial. Se estima que la prevalencia de sensibilización al látex en población general es del 1%. Clínicamente, puede generar una reacción de hipersensibilidad tipo I, IgE mediada, en respuesta a las proteínas del látex que se manifiesta como una urticaria hasta la anafilaxia. También se describe dermatitis de contacto irritativa y la dermatitis de contacto alérgica, 12 a 96 horas luego del contacto, por una reacción de hipersensibilidad retardada tipo IV, secundaria a los aditivos del látex. El diagnóstico se basa en la sospecha clínica, confirmado con pruebas cutáneas y medición de IgEs específicas. Realizar una anamnesis que permita sospechar una alergia al látex y si se determina que el paciente tiene riesgo, realizar el estudio complementario para confirmar el diagnóstico. El enfrentamiento se basa en la prevención de la exposición y el tratamiento de la reacción aguda. Es necesario conocer los alérgenos y procesos implicados en la alergia al látex pues de este modo se podrá sospechar e identificar a pacientes o funcionarios que puedan sufrir o estar en riesgo de presentarla, disminuyendo de este modo las posibles complicaciones.Palabras clave: Alergia; hipersensibilidad; sensibilización; látex. summaRyLatex or natural rubber is a vegetable product which is obtained from the sap of the Hevea brasiliensis. It is widely used to manufacture domestic products (gloves, condoms, balloons, etc.) and used in the health area, where it is estimated that 50% of medical articles contain latex. Latex allergy is a global health problem. It is estimated that the prevalence of latex sensitization is 1% in the general population. The clinical presentation can be a type I hypersensitivity reaction, IgE mediated, in response to latex proteins, manifested as a rash or even as an anaphylaxis. Irritant contact dermatitis and allergic contact dermatitis, 12 to 96 hours after contact, is also described, due to a delayed type IV hypersensitivity reaction, secondary to latex additives. The diagnosis of latex allergy is based on clinical suspicion and confirmed with skin tests measuring specific IgEs. Management is based on the exposure prevention and treatment of the acute reaction. A detailed anamnesis must be made to suspect a latex allergy and if the patient is at risk of presenting it, perform additional study to confirm the diagnosis. It is necessary to know the allergens and processes involved in latex allergy, to be able to suspect and identify patients or staff who may suffer or be at risk of presenting it, thus reducing potential complications.

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Comparison of the Performance of Skin Prick, ImmunoCAP, and ISAC Tests in the Diagnosis of Patients with Allergy

Cited by 52 publications

References 11 publications

The Clinical Relevance of Natural Rubber Latex-Specific IgE in Patients Sensitized to Timothy Grass Pollen

The Clinical Relevance of Natural Rubber Latex-Specific IgE in Patients Sensitized to Timothy Grass Pollen

An Analysis of Skin Prick Tests to Latex and Patch Tests to Rubber Additives and other Causative Factors among Dental Professionals and Students with Contact Dermatoses

Alergia al látex, puesta al día

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