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Profile Shift in Latex Sensitization over the Last 20 Years
Mohamed M Saleh1, Susann Forkel1, Michael P Schön1,2,3
1Department of Dermatology, Venereology, and Allergology, University Medical Center, Georg August University, Göttingen, Germany.
International Archives of Allergy and Immunology
|September 14, 2018
Summary
Diagnosing natural rubber latex (NRL) allergy is changing, with fewer patients showing specific IgE to latex and relevant medical histories over time. Accurate diagnosis requires combining patient history, skin tests, and IgE analysis.
Area of Science:
- Immunology
- Allergy and Clinical Immunology
- Medical Diagnostics
Background:
- Natural rubber latex (NRL) allergy diagnosis traditionally relies on medical history, skin tests, and serology.
- Skin testing for NRL allergy is declining due to practical and regulatory challenges.
- This study investigates shifts in diagnostic profiles for suspected NRL allergy patients.
Purpose of the Study:
- To evaluate changes in sensitization and allergy profiles of patients with suspected NRL allergy over two decades.
- To compare diagnostic criteria between historical and current patient cohorts.
Main Methods:
- Simultaneous analysis of specific IgE to latex using ImmunoCAP in historical (1995-2001) and current (2014-2015) patient cohorts.
- Component-resolved diagnostics, including profilins and CCDs, were performed for positive serological screenings.
- Comparison of medical history, skin test results, and specific IgE levels between cohorts.
Main Results:
- A significant decrease in specific IgE positivity to latex was observed, from 88% in the 1990s to 51.1% in the current cohort.
- Current patients with positive skin tests rarely reported relevant medical histories (8.5%) compared to the 1990s cohort (48.3%).
- Specific IgE levels were significantly higher in former allergic patients, but this difference was not significant in current allergic patients.
Conclusions:
- Significant changes in NRL sensitization profiles have occurred over the past 20 years.
- Distinguishing between NRL sensitization and clinical allergy remains a diagnostic challenge.
- A combined approach using patient history, skin tests, and specific IgE analysis is crucial for accurate NRL allergy diagnosis.
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