Latex immunotherapy: evidence of effectiveness

Abstract

IntroductionThe only etiological and decisive therapy, able to influence the natural history of latex allergy is the specific desensitization.AimTo verify the clinical efficacy and immunological changes determined by latex sublingual immunotherapy in allergic patients who underwent this treatment for at least 3 years.Material and methodsWe enrolled 76 patients (16 males and 60 females, mean age 34 years old) with evidence of a natural rubber latex allergy. To assess the effectiveness of the immunotherapy we performed a latex skin prick test, specific IgE and IgG4 and challenge tests before and after at least 3 years of desensitization.ResultsWe observed a reduction in the mean diameter of the wheal area at the skin prick test and a decrease in latex specific IgE while no significant changes of latex IgG4 values were found. Moreover a reduction of symptoms and scores at the provocation tests were remarked.ConclusionsAlthough the primary prevention (which still remains the gold standard treatment for patients suffering from the latex allergy) sublingual immunotherapy can be offered with efficacy in addition to symptomatic treatment to selected patients.

Update on latex allergy: New insights into an old problem

“… 69 The most recent and largest study (in 76 adults) on latex SLIT was published in 2018. 70 In this observational case series, skin reactivity, latex IgE levels, and provocation tests significantly improved, even though IgG4 levels did not change. 67 …”

Occupational Allergies in Dentistry: A Cross-Sectional Study in a Group of French Dentists

“…The effectiveness and safety of AIT with standardized latex extracts has only been evaluated by small randomized clinical trials with conflicting results. Some authors reported a good clinical efficacy [49][50][51][52], whereas others failed to show a significant improvement of allergic symptoms [53,54] and even highlighted a high incidence of systemic reactions [54]. Six participants reported that they underwent AIT as maintenance therapy, but we did not ask in our questionnaire about the allergen extract that was administered.…”

“…Large randomized controlled trials are required before translating the use of latex AIT into clinical practice, and further investigations are needed to extend the use of AIT to other occupational allergens. Therefore, to date, primary prevention, i.e., allergen exposure avoidance, still remains the most effective method to reduce the burden of occupational allergies [52]. Although none of the participating dentists presenting occupational allergies reported permanent work cessation, temporary work interruption was needed in 10% of the cases.…”

<p>Latex Allergy: Current Status and Future Perspectives</p>

“…After desensitization, in this study there was a marked reduction in serum levels of latex-specific IgE and, according to the literature, a reduction in symptoms and scores on provocation tests, while IgG 4 levels did not change. 95 On the other hand, the literature also describes cases that show a lack of effectiveness of the treatment; for example, Morfin Maciel et al describe the case of a boy who, despite an AIT for latex, experienced anaphylaxis after an airport inspection with latex gloves. 96 Gastaminza et al showed no significant difference in specific provocation tests or in vitro testing after a year of SLIT-Latex, with the exception of a reduction in the percentage of basophil activation both in the active group after 2 years of therapy and in the placebo group after 1 year of treatment.…”

“…After desensitization, in this study there was a marked reduction in serum levels of latex-specific IgE and, according to the literature, a reduction in symptoms and scores on provocation tests, while IgG 4 levels did not change. 95 …”