Department of Chest Medicine, Centre Hospitalier Universitaire de Dinant-Godinne, Université catholique de Louvain, Yvoir, Belgium.
Institut de Recherche Expérimentale et Clinique, Pôle de Pneumologie, Université catholique de Louvain, Brussels, Belgium.
Allergy. 2016 Jun;71(6):840-9. doi: 10.1111/all.12872. Epub 2016 Apr 15.
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.
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.
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.
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).
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.
重组巴西橡胶树（rHev b）天然胶乳（NRL）过敏原成分已被开发出来，以评估患者的过敏原致敏情况，并改善 NRL 过敏的诊断。
研究针对一组重组过敏原成分的特异性 IgE（sIgE）反应是否有助于诊断 NRL 诱导的职业性哮喘（OA），并预测特定吸入性测试的结果。
对 82 例经 NRL 手套阳性特定吸入性挑战（SIC）证实的 OA 患者和 25 例阴性挑战的有症状患者，检测其对 NRL 提取物和 12 种重组 NRL 过敏原成分的 sIgE 水平。
与 SIC 结果相比，NRL-sIgE 水平≥0.35 kUA / l 的敏感性、特异性、阳性预测值和阴性预测值分别为 94%、48%、86%和 71%。当将临界值提高到 5.41 kUA / l 时，阳性预测值超过 95%。SIC 阳性患者对 rHev b 5、6.01、6.02 和 11 的 sIgE 反应率明显高于 SIC 阴性患者。rHev b 5 加 6.01/6.02 的 sIgE 总和评分≥1.46 kUA / l 提供了 >95%的阳性预测值，其敏感性（79%）和诊断效率（Youden 指数：0.67）均高于 NRL-sIgE≥5.41 kUA / l（分别为 49%和 0.41）。
在疑似 OA 患者中，针对 rHev b 5 的高 sIgE 水平与 rHev b 6.01 或 6.02 联合是对 NRL 支气管反应最有效的预测指标。
