The role of allergen components for the diagnosis of latex-induced occupational asthma.

BACKGROUND: 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. OBJECTIVE: 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. METHODS: 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. RESULTS: 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). CONCLUSION: 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.

The new latex allergen hev b 15: IgE-binding properties of a recombinant serine protease inhibitor

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Impact of cross-reactive carbohydrate determinants on wood dust sensitization.

BACKGROUND: Occupational wood dust exposure can induce allergy and may be one cause of respiratory health problems among woodworkers. OBJECTIVE: The objective was to determine the prevalence and quantitative level of specific immunoglobulin E (sIgE) to beech and pine wood in exposed workers. Wood sensitization was specified with regard to cross-reactivity and was correlated to the reported symptoms. METHODS: Danish workers (n=701) were investigated for sIgE to beech and pine. Wood samples from workplaces were analysed and coupled to ImmunoCAPs. Workers sensitized to wood were tested for cross-reactive carbohydrate determinants (CCDs) and environmental allergens. IgE binding was specified for glycogenic vs. proteinogenic epitopes by inhibition tests. RESULTS: The prevalence of wood sensitization among all workers was 3.7%. There was no association between sensitization prevalence or sIgE concentrations and self-reported allergic symptoms. Beech- and pine-sensitized workers showed a high prevalence of CCD sensitization (73%). However, workers with a single sensitization to wood had no sIgE to CCDs. Specifying IgE epitopes demonstrated that sera of workers reporting allergic symptoms recognized proteinogenic IgE-epitopes on wood allergens, whereas workers without allergic symptoms had primarily sIgE-epitopes to glycogenic structures. Although 96% of the wood-sensitized workers were atopic, no significant correlation was found between wood sensitization and sIgE to beech and birch pollen, but an association was found between sIgE against CCDs and pine pollen. CONCLUSION: Sensitization prevalence to beech and pine wood measured by tailored ImmunoCAPs was not correlated to allergic symptoms. We recommend the application of CCD tools to assess the relevance of individual wood sensitization.

Allergen content of grass pollen preparations for skin prick testing and sublingual immunotherapy.

BACKGROUND: The allergen content of diagnostics and immunotherapeutics is crucial for effective diagnosis and treatment. The aim of this study was to quantify and compare the allergen content of different grass pollen preparations for skin prick testing and sublingual immunotherapy (SLIT). METHODS: Five skin prick test (SPT) solutions and 10 sublingual immunotherapeutics were analysed for protein and allergen concentration by Bradford assay, inhibition of IgE-binding to Phleum pratense ImmunoCAPs and content of the main allergen Phl p 5 by two-site enzyme immunoassay. In addition, the grass pollen preparations were compared by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting analyses. RESULTS: Protein concentrations of SPT solutions ranged from 15 to 427 microg/ml, and Phl p 5 concentrations ranged from 0.15 to 18.3 microg/ml. The ranking of SPT solutions concerning Phl p 5 content and IgE inhibition capacity was the same, and the ranking of protein and allergen content was closely correlated (r = 0.9). Protein content of the maintenance doses of the immunotheurapeutics ranged from 5 to 153 microg, Phl p 5 content ranged from 0.2 to 21.6 microg. IgE inhibition capacity of the maintenance doses was closely correlated to their Phl p 5 and protein content. SDS-PAGE and immunoblots confirmed the differences in protein and allergen content. CONCLUSIONS: Grass pollen preparations for SPT and SLIT varied greatly concerning protein and allergen content. Whereas this result corresponds to previous analyses results of SPT solutions, it was the first comparison of grass pollen immunotherapeutics. For diagnosis and therapy, these differences should be taken into account.