Department of Occupational Diseases and Environmental Health, Nofer Institute of Occupational Medicine, Lodz, Poland.
J Occup Health. 2019 Sep;61(5):378-386. doi: 10.1002/1348-9585.12064. Epub 2019 May 15.
Specific challenge tests (SICs) are considered reference tests for allergic occupational diseases diagnosis. However, in numerous cases, SICs cannot be carried out in the diagnosis of allergy to latex due to the risk of generalized reactions. The aim of the study was to evaluate the usefulness of sIgE determination to recombinant latex allergens in diagnostics of occupational respiratory allergy.
The study group comprised 44 healthcare workers (HCW) suspected of suffering from occupational respiratory allergy to latex (they underwent a physical examination, skin-prick tests (SPTs) to common and latex allergens, spirometry and SIC) and 17 controls not occupationally exposed to latex, with a positive sIgE against latex. Each serum was tested for allergen-specific IgE to aeroallergens, latex, eight recombinant latex allergens and CCD-markers.
Specific IgE against Hev b5, 6.01, and 6.02 were significantly more frequently detected in HCWs and their mean serum levels were higher compared with the control group. In 26 HCWs with occupational asthma (OA), sensitization to Hev b5, Hev b6.01, Hev b6.02 was significantly more frequent than in 18 HCWs with work-exacerbated asthma (WEA); they had positive results SPT to latex significantly more frequently in comparison with subjects with WEA.
Test for recombinant latex allergens is much more accurate in recognition of latex allergy than test for latex extract, which seems to produce false-positive results in patients with pollen allergy. The measurements of sIgE against recombinant latex allergens Hev b 6.01, 6.02, 5, and 8 are useful in differentiating OA from WEA.
特定挑战测试(SICs)被认为是诊断过敏性职业疾病的参考测试。然而,在许多情况下,由于存在全身性反应的风险,乳胶过敏的 SIC 无法进行。本研究旨在评估重组乳胶过敏原 sIgE 测定在职业性呼吸道过敏诊断中的有用性。
研究组包括 44 名疑似乳胶职业性呼吸道过敏的医护人员(他们接受了体格检查、常见和乳胶过敏原的皮肤点刺试验(SPTs)、肺功能检查和 SIC)和 17 名未接触乳胶的对照者,对乳胶呈 sIgE 阳性。每个血清均检测对过敏原特异性 IgE 进行了 Aeroallergens、乳胶、八种重组乳胶过敏原和 CCD 标志物的检测。
HCW 中 Hev b5、6.01 和 6.02 的特异性 IgE 明显更为频繁,其平均血清水平也高于对照组。在 26 名患有职业性哮喘(OA)的 HCWs 中,对 Hev b5、Hev b6.01、Hev b6.02 的致敏作用明显比在 18 名患有工作加重哮喘(WEA)的 HCWs 更为频繁;与 WEA 患者相比,他们对乳胶的 SPT 阳性结果更为频繁。
与乳胶提取物相比,重组乳胶过敏原的检测对乳胶过敏的识别更为准确,乳胶提取物似乎会在花粉过敏患者中产生假阳性结果。测量针对重组乳胶过敏原 Hev b 6.01、6.02、5 和 8 的 sIgE 有助于区分 OA 和 WEA。