Dust Mite Allergy Research Articles

Asthma bronchiale bei Kindern und Jugendlichen

Asthma is characterized by variable bronchial obstruction and bronchial hyperreactivity associated with chronic inflammation in which eosinophils, mast cells, macrophages, epithelial cells, fibroblasts and smooth muscle cells are involved and activated. Hyperreactivity is manifested by coughing or dyspnea induced by allergens, nonspecific stimuli (i.e. cold air, dust, tobacco smoke) and respiratory tract infection. Diagnosis is based on careful medical history with respect to bronchial hyperreactivity, on clinical findings including wheezing at forced long expiration manoeuvres, on lung function tests, and on allergen testing. An asthma attack requires oxygen insufflation, stronger inhaled or even systemic bronchodilation, and a high-dose systemic anti-inflammatory therapy. Long-term asthma therapy aims at a symptom-free course of the disease, which cannot be achieved in all patients, and at the prevention of chronic inflammation which results in an irreversible remodeling process. Drug treatment is performed according to evidence-based guidelines with increasing extent in 4 steps (I - IV). In persisting asthma (II - IV), inhaled corticosteroids are an essential component of asthma therapy. Subcutaneous specific immunotherapy is recommended if an allergen is clinically relevant and cannot be avoided. Patients with house dust mite allergy benefit from encasing of pillow and mattress. In children older than 12 years with severe allergic asthma, treatment with recombinant humanized anti-IgE antibody is a new option. A continuing individual education of all patients and parents is essential to establish correct disease management for all patients. If there is no satisfactory stabilization, a careful differential diagnosis is required using various lung function tests, recently developed techniques for the diagnosis of cystic fibrosis (e.g. measuring nasal potential difference to evaluate the trasnsepithelial chloride transport, complete mutation analysis of the cystic fibrosis gene) and, if necessary, bronchoscopy to exclude foreign body aspiration etc. In addition, pulmonary rehabilitation, including group education, should be attained by means of validated rehabilitation hospitals.

Determinants of House Dust Mite Allergenicity

Results: The studies summarized here show that quantitative measurements of allergen panels provide a better assessment of total anti-mite IgE than assays with mite extracts, and that major allergen Der p 1 induced correspondingly higher T helper cell type 2 (Th2) and Th1 cytokine responses than subordinate allergens Der p 5 and 7. The importance of the knowledge of variants of the major allergens is presented as well recent advances in the characterization of the molecules. Conclusions: Der p 1 and Der p 2 are major allergens of Dermatophagoides pteronyssinus. The minor allergens, however, constitute 50% of the IgE binding and the use of a panel of allergens provides a better measure of house dust mite allergy than IgE binding to extracts. The minor allergens will also be important for studying the immunoregulatory pathways that lead to high and low allergenicity.

Nasal carriage of Staphylococcus aureus in house dust mite allergic patients and healthy controls

Staphylococcal colonization may influence the course of allergic diseases such as atopic dermatitis or allergic rhinitis. The frequency of Staphylococcus aureus (SA) nasal carriage and its possible influence on persistent allergic rhinitis was investigated. In nasal lavages from 22 patients with house dust mite allergy and 18 healthy controls, the number of SA colony forming units per ml were assessed and related to nasal symptom scores, the concentrations of three inflammatory cell activation markers, nasal total IgE and 17 cytokines in nasal secretions. SA was found in 15/22 allergic patients and 4/18 controls (P < 0.01). Comparing allergic SA carriers with allergic noncarriers, nasal symptom scores tended to be higher (P < 0.1), and the cell activation markers ECP (10(2.23+/-0.33)vs 10(1.45+/-0.50) ng/ml; P < 0.05) and elastase (10(2.70+/-0.21)vs 10(2.12+/-0.34) ng/ml; P < 0.01), and nasal total IgE-levels (10(1.66+/-0.38)vs 10(1.2+/-0.28) kU/ml; P < 0.05) were significantly higher in allergic SA carriers. Nasal SA carriers had a higher nasal IL-13/IFN-gamma ratio (P < 0.01), and this was correlated with higher nasal total IgE in allergic patients (r = 0.6, P < 0.05). Nasal SA carriage is frequent in patients with persistent allergic rhinitis. The data of this study suggest that they are not only secondary bystanders, but actively modulate the disease by promoting local IgE production.

The prevalence of house dust mite (HDM) allergy and the use of HDM-impermeable bed covers in a primary care population of patients with persistent asthma in the Netherlands

: House dust mite (HDM) allergen is one of the most common allergens to which asthma patients are sensitised. Prevalence of HDM allergy varies in the literature. Use of HDM-impermeable bed covers reduces exposure to HDM allergen. The aim of this study was to assess the prevalence of HDM allergy in a primary care population of asthma patients, as well as the use of HDM-impermeable bed covers by these patients. : A random sample of asthma patients between 16 and 60 years old was taken from general practices. Allergy was assessed with a radio allegro sorbent test (RAST). A questionnaire was used to identify demographic characteristics and the actual use of bed covers. : 534 patients were invited and 160 patients participated. 53 patients not willing to participate were randomly selected to test the external validity of our findings. The sample was representative for the primary care asthma population. 48.8% of the asthma population was sensitised to HDM allergen. 25.6% of the HDM-allergic asthma patients were using HDM-impermeable bed covers. : Almost half of the patients with asthma were sensitised to HDM allergen. Only a minority of the patients used HDM-impermeable bed covers.

Vaccination with the recombinant allergen ProDer p 1 complexed with the cationic lipid DiC14-amidine prevents allergic responses to house dust mite

The present study evaluated the prophylactic potential of ProDer p 1, the recombinant precursor form of the major mite allergen Der p 1, combined with the cationic lipid diC14-amidine in a murine model of house dust mite allergy. Naive mice vaccinated with the amidine/allergen complex developed a Th1-biased immune response characterized by the absence of specific IgE, the production of specific IgG2a, and the presence of IFN-gamma in splenocyte cultures. In contrast, ProDer p 1 adjuvanted with alum induced typical strictly Th2-biased allergic responses with strong IgG1 and IgE titers and IL-5 secretion. Removal of negatively charged sialic acids in ProDer p 1 or increasing the ionic strength reduced the binding of ProDer p 1 to the cationic liposomes and resulted in a decrease of the allergen immunogenicity, suggesting that complexation is required for triggering an optimal immune response. Finally, prophylactic vaccination with ProDer p 1-diC14-amidine reduced drastically the production of specific IgE and airway eosinophilia following subsequent immunization with Der p 1-alum and challenge with aerosolized house dust mite extracts. In conclusion, recombinant ProDer p 1 complexed with diC14-amidine could represent an efficient prophylactic vaccine against house dust mite allergy.

Effects of early intake of fruit or vegetables in relation to later asthma and allergic sensitization in school‐age children

To assess the associations between nutrition supplements in infancy and later asthma and allergy in school-age children, and to explore the impact of environmental factors in early life. Five hundred and two children underwent clinical examination, skin prick test and a second parentally completed questionnaire within 2 y of a cross-sectional questionnairebased study, including 4585 primary school children (6-16 y old) in 1994 from urban Oslo (37%), the mountainous area of Hallingdal (42%), and the industrial, coastal area of Odda (21%). The children were selected from the 1994 survey on the basis of reported diagnosed asthma (n=166), wheeze in the last 12 mo (n=155) and no asthma/no wheeze (n=181). Questions were related to nutrition and environmental exposure in early life. Possible associations between allergic sensitization or asthma at school age and exposures were estimated by logistic regression analysis, adjusting for potential confounders. Daily intake of fresh fruit or vegetables, but not extra vitamins or cod liver oil supplements, in infancy decreased the risk of asthma (adjusted odds ratio (aOR) 0.57 (95% confidence interval (CI): 0.37-0.88). Early supplements of cod liver oil and extra vitamins were associated with increased allergic sensitization (aOR 1.78 (95% CI: 1.03-3.07) and 1.71 (95% CI: 1.01-2.88), respectively). A significantly higher prevalence of allergic sensitization was found in children living in Hallingdal compared to Odda, while the latter children, on the other hand, had the highest prevalence of house dust mite allergy (p = 0.001 vs Hallingdal and p = 0.04 vs Oslo). The present study suggests that the early introduction of daily fresh fruit or vegetables may decrease the risk of asthma after 1 y of life, whereas allergic sensitization at school age seemed to increase with extra vitamin and cod liver oil supplements during infancy. Living area influenced allergic sensitization, with differences between coastal and inland areas.

Component-resolved diagnosis of house dust mite allergy with a large repertoire of purified natural and recombinant allergens from the major species of mites worldwide

Component-resolved diagnosis of house dust mite allergy with a large repertoire of purified natural and recombinant allergens from the major species of mites worldwide

Intranasal Co-application of lactic acid bacteria (LAB) and Der p 1 promotes a prophylactic Th1 response in a murine model of house dust mite allergy

Intranasal Co-application of lactic acid bacteria (LAB) and Der p 1 promotes a prophylactic Th1 response in a murine model of house dust mite allergy

Confirmation of the Diagnosis of Natural Rubber Latex Allergy by the Basotest® Method

Background: The flow cytometry CD63-based basophil activation test (Basotest^®) has already been validated for the diagnosis of immediate-type allergy such as venom, house dust mite or cypress pollen allergies. The aim of this study was to evaluate the performance (specificity and sensitivity) of Basotest in the diagnosis of natural rubber latex allergy. Methods: We included 46 latex allergic patients (clinical symptoms of latex allergy, positive latex skin prick tests and/or latex specific IgE) and 33 control subjects and performed Basotest on all subjects. Results: The sensitivity and specificity of Basotest were 84.8 and 87.9%, respectively, when we considered the theoretic cut-off at 15% of CD63-positive cells. Using ROC curves, the optimal cut-off was evaluated at 22%, for which sensitivity and specificity were 79.3 and 96.7%, respectively. Conclusion: The Basotest is a reliable test in addition to clinical history and tests already validated (such as skin prick tests and specific IgE) to confirm the diagnosis of natural rubber latex allergy.

Effects of Diesel Exhaust Particles and Carbon Black on Induction of Dust Mite Allergy in Brown Norway Rats

Particulate matter (PM) components of air pollution have been associated with mortality and health risks in susceptible populations including asthmatics. More than a decade of PM research has demonstrated that these effects do not occur indiscriminately and are related to particle size, surface area, and chemical composition. Experimental evidence in rodents indicates that inhaled or instilled diesel exhaust particles (DEPs) increase lung injury, inflammation, and allergic airway responses, and that ultra-fine carbon black (UFCB) particles cause more pulmonary inflammation than fine carbon black (FCB) particles in a dose-dependent manner. Our preliminary work determined that a dose of 100 μg of FCB, UFCB, or DEPs (NIST SRM 2975) was sufficient to enhance pulmonary inflammation in Brown Norway (BN) rats 24 hours after intratracheal (IT) instillation of the particles. In the current investigation, we sought to compare, on a mass basis, the effects of a 100 μg dose of these particles on allergic sensitization to house dust mite (HDM) antigen. Immediate airway responses (IAR) to HDM challenge and a battery of proinflammatory, allergic, and acute injury responses in the lung were then measured two and seven days post-challenge. DEPs exposure increased 8 of 10 responses including IAR and levels of IL-4, IL-13, TNFα, total protein, cysteinyl leukotrienes, and eosinophils in bronchoalveolar lavage fluid (BALF). UFCB and FCB significantly enhanced 4 of 10 and 2 of 10 of these responses compared to saline, respectively. Among other responses that were not statistically elevated with particle treatment, mean values for FCB were higher than for UFCB. Particles administered prior to challenge rather than prior to sensitization did not significantly enhance any of these responses above levels of saline controls. We conclude that on a mass basis, DEPs had the greatest potential to enhance allergic induction, indicating that chemical composition is more important than particle size in determining potency for this health effect.

アンケート調査によるアレルギー性鼻炎患者ＱＯＬに影響する因子についての検討

To assess the possible negative aspects in the quality of life (QOL) of patients with allergic rhinitis based on the factors such as the symptoms and examination of the nasal cavity, we examined QOL deficits using the Japanese Rhino-conjunctivitis Quality of Life Questionnaire (JRQLQ No1). Thirteen hundred seventy eight allergic rhinitis patients who visited clinics or hospitals between April and July 2003 were assessed for clinical symptoms, had the examination of their nasal cavity graded and answered QOL questionnaires. Gender, period of the disease, antigen, clinical symptoms and the results of the nasal cavity examination were evaluated and analyzed to reveal risk factors associated with negative QOL factors. These negative QOL factors tended to be more severe in women than in men, and more severe in pollen allergy than in house dust mite allergy. There was no association of the period of the disease with negative QOL factors. It was revealed that nasal discharge was the strongest risk factor for problems in usual daily activities, outdoor activities and social functioning in six QOL domains, and nasal congestion was the major factor associated with sleep problems, general physical problems and emotional function. Nasal congestion was also the strongest risk factor in the total score of the QOL questionnaire and the overall face scale of the patients. In the nasal cavity examination, the amount of aqueous secretion was the strongest risk factor for all items associated with negative QOL factors. According to the risk factors we identified, we can treat allergic rhinitis patients taking their QOL into consideration.

The effect of encasings on quality of life in adult house dust mite allergic patients with rhinitis, asthma and/or atopic dermatitis

Environmental control has been put forward as an integral part of the management of house dust mite (HDM) allergy in sensitized patients. To validate this statement allergic disorders involved in HDM allergy--allergic asthma, rhinitis and atopic eczema/dermatitis syndrome (AEDS)--should be taken together and studied in terms of the efficacy of environmental control. Because a generic quality of life questionnaire exceeds the border of disease, this may be used as major outcome parameter. To study the effects of bedding encasings in HDM allergic patients with asthma, rhinitis and AEDS. A total of 224 adult HDM allergic patients with rhinitis and/or asthma and/or dermatitis were randomly allocated impermeable or nonimpermeable encasings for mattress, pillow and duvet. Short form 36 (SF-36) was filled in at baseline and after 12 months. Lower physical (P = 0.01) and emotional (P < 0.001) sumscores were seen in females. Also, the presence of asthma resulted in lower physical sumscore (P = 0.01). However, no effect was seen of encasings on either sumscore. Bedding encasings do not improve quality of life in a mixed population of subjects with combinations with rhinitis, asthma and atopic dermatitis and sensitized to HDMs.

Sublingual immunotherapy for allergic rhinitis: systematic review and meta‐analysis*

Allergic rhinitis is a common condition which, at its most severe, can significantly impair quality of life despite optimal treatment with antihistamines and topical nasal corticosteroids. Allergen injection immunotherapy significantly reduces symptoms and medication requirements in allergic rhinitis but its use is limited by the possibility of severe systemic reactions. There has therefore been considerable interest in alternative routes for delivery of allergen immunotherapy, particularly the sublingual route. The objective was to evaluate the efficacy of sublingual immunotherapy (SLIT), compared with placebo, for reductions in symptoms and medication requirements. The Cochrane Controlled Clinical Trials Register, MEDLINE (1966-2002), EMBASE (1974-2002) and Scisearch were searched, up to September 2002, using the terms (Rhin* OR hay fever) AND (immunotherap* OR desensiti*ation) AND (sublingual). All studies identified by the searches were assessed by the reviewers to identify Randomized Controlled Trials involving participants with symptoms of allergic rhinitis and proven allergen sensitivity, treated with SLIT or corresponding placebo. Data from identified studies was abstracted onto a standard extraction sheet and subsequently entered into RevMan 4.1. Analysis was performed by the method of standardized mean differences (SMD) using a random effects model. P-values < 0.05 were considered statistically significant. Subgroup analyses were performed according to the type of allergen administered, the age of participants and the duration of treatment. Twenty-two trials involving 979 patients, were included. There were six trials of SLIT for house dust mite allergy, five for grass pollen, five for parietaria, two for olive and one each for, ragweed, cat, tree and cupressus. Five studies enrolled exclusively children. Seventeen studies administered the allergen by sublingual drops subsequently swallowed, three by drops subsequently spat out and two by sublingual tablets. Eight studies involved treatment for less than 6 months, 10 studies for 6-12 months and four studies for greater than 12 months. All included studies were double-blind placebo-controlled trials of parallell group design. Concealment of treatment allocation was considered adequate in all studies and the use of identical placebo preparations was almost universal. There was significant heterogeneity, most likely due to widely differing scoring systems between studies, for most comparisons. Overall there was a significant reduction in both symptoms (SMD -0.42, 95% confidence interval -0.69 to -0.15; P = 0.002) and medication requirements [SMD -0.43 (-0.63, -0.23); P = 0.00003] following immunotherapy. Subgroup analyses failed to identify a disproportionate benefit of treatment according to the allergen administered. There was no significant reduction in symptoms and medication scores in those studies involving only children but total numbers of participants was too small to make this a reliable conclusion. Increasing duration of treatment does not clearly increase efficacy. The total dose of allergen administered may be important but insufficient data was available to analyse this factor.

Sublingual immunotherapy: from proven prevention to putative rapid relief of allergic symptoms

Sublingual immunotherapy: from proven prevention to putative rapid relief of allergic symptoms

Allergologie pédiatrique. Quoi de neuf ? Une revue de la littérature internationale d'octobre 2002 à septembre 2003

Most epidemiological studies published in 2002-2003 confirm, in a large number of children, the results of previous studies. Most important results show that the risk of severe and persistent atopy and/or asthma is significantly higher in children with numerous risk factors than in children with a limited number of risk factors. Moreover, risks of severity and persistence are increased in children with early onset allergic disease, and with severe symptoms at the time of diagnosis. Effects of early exposure to furred pets are related to the degree of exposure at home, but are also modulated by the degree of exposure in the general population. In contrast with previous results, a large pediatric study shows that, at the age of 5 years, the prevalence of atopic diseases is inversely correlated with the number of vaccine infections. The efficacy of sublingual-swallow hyposensitization is long-lasting (up to 4-5 years after the discontinuation of treatment) in children with asthma due to house dust mite allergy. In contrast, individualized homeopathy, as an adjunct in the treatment of childhood asthma, is not superior to placebo in improving the quality of life of children with mild to moderate asthma. Supplementation of infant formulas with viable but not heat-inactivated probiotic bacteria is beneficial in the management of atopic dermatitis and cow's milk allergy. Finally the prevalence of peanut allergy has significantly increased between 1989 and 1994-1996 in European children, and at present, in France, the management in schools of children with food allergy is clearly inadequate.

Comparison of a generic and a rhinitis‐specific quality‐of‐life (QOL) instrument in patients with house dust mite allergy: relationship between the SF‐36 and Rhinitis QOL Questionnaire

Generic and disease-specific quality-of-life (QOL) questionnaires are commonly used in subjects with allergic rhinitis (AR). AR, however, is closely associated with other disorders such as bronchial asthma and atopic dermatitis (AD). These co-morbid associations may have an effect on the inter-relation of generic and disease-specific QOL outcomes and the behaviour of this inter-relation in time. To unravel the inter-relationships between the outcome of a generic instrument (SF-36) and a disease-specific instrument (Rhinitis QOL Questionnaire (RQLQ)). In the framework of a randomized clinical trial with respect to the efficacy of impermeable bedding covers in house dust mite (HDM) allergy, SF-36 and RQLQ were administered to 224 adults with AR and/or allergic asthma and/or AD at baseline and after 12 months of intervention. Regression analysis and canonical correlation were used to estimate overlap. Overlap between SF-36 and RQLQ domains in terms of explained variance ranged from 6% to 56%. Canonical correlation yielded low coefficients (0.16-0.27). Moreover, both SF-36 and RQLQ scores did not change significantly during the intervention. In patients with HDM allergy characterized by co-morbid associations, SF-36 and RQLQ cover different aspects in QOL. It is advocated to use both simultaneously in performing QOL studies.

EVALUATING THE EFFICACY OF ENVIRONMENTAL INTERVENTIONS FOR ALLEVIATING ASTHMA SYMPTOMS AND QUALITY OF LIFE AMONG CHILDREN IN URBAN PUBLIC HOUSING

ISEE-330 Introduction: Asthma severity disproportionately impacts lower-income urban children, in communities where complex environmental, social, and economic exposures exacerbate this multifactorial disease. The Healthy Public Housing Initiative (HPHI), a community-based collaborative of university, government, and community partners, explored whether environmental interventions can be effectively introduced to alleviate asthma symptoms among children in this setting. Methods: Seventy-eight children aged 4 through 17 were recruited from three public housing developments; 58 were retained for longitudinal follow-up of 8 to 20 months. Cockroach and dust mite antigens, mouse urinary protein, and pesticides were sampled before and after interventions (which included intensive cleaning, Integrated Pest Management, mattress replacement, and air cleaners) to estimate pollutant reductions. Outcomes data, collected monthly before and after interventions by trained Community Health Advocates, included Juniper Asthma Quality of Life (AQLQ) questionnaires for both child and caregiver, reports of symptoms, unplanned ED/clinic visits, and changes in medication use. Allergy testing was conducted once, and spirometry was performed at multiple points in time. Information on social exposures associated with immune function (perceived stress, violence, and social support) was collected monthly. Results: Baseline data indicate that only 36% of persistent asthmatics in the intake group used maintenance medications. Allergy testing on a subset of children indicated high prevalence of cockroach (59%) and dust mite (61%) allergies. This prevalent atopy and under-medication suggest strong potential for health improvements with environmental intervention and increased social and medical support. Baseline cross-sectional multivariate regression suggests that time spent around smokers (p=.08) and household size (p=.02) predicts symptoms, which in turn predict child's AQLQ score (p=.0002). Caregiver AQLQ is associated with child's respiratory symptoms (p<.0001), perceived stress (p=.002), and child's having been treated in NICU (p=.09). Longitudinal analyses of AQLQ scores will be presented to evaluate intervention efficacy; the method accounts for seasonality and autocorrelation between repeated measures. Differential response by medical, social, and environmental risk factors related to susceptibility to environmental exposures (including allergy status and perceived stress levels) will be examined. Pre- and post-intervention spirometry scores will be used to corroborate longitudinal results. Discussion: The baseline HPHI results help to identify key factors that influence asthma severity in public housing developments (including time spent around smokers and household size), and to explore the multifactorial nature of the disease by considering many types of exposures (environmental, social, and economic). Longitudinal analysis will allow us to understand whether, and for which children, environmental interventions may reduce asthma severity. We extend our sincere thanks to the West Broadway Task Force, Committee for Boston Public Housing, Boston Housing Authority, Boston Public Health Commission, Tufts University School of Public Health, and many many others who worked long days on the HPHI effort.

Aspirin intolerance and allergy to house dust mites: important factors associated with development of severe asthma

Although the occurrence of bronchial asthma is still increasing, the possible factors associated with the development of severe asthma have not been completely determined. To measure the incidence of severe asthma and its determinants in outpatients. Aspirin intolerance, house dust mite (HDM) allergy, male sex, age older than 65 years, and duration of asthma exceeding 10 years were investigated as factors potentially related to the severity of asthma. The study population included 598 women and 408 men, mean age of 44.59 years (SD +/- 16.45 years), randomly chosen from patients with asthma under follow-up surveillance in an outpatient clinic. Their medical histories were reviewed; spirometry and skin prick tests were performed. The asthma was diagnosed as intermittent in 35.39%, persistently mild in 33.40%, moderate in 23.76%, and severe in 7.45% of the study cohort. In the patients with atopy, HDM allergy was a significant factor associated with the development of severe asthma [odds ratio (OR) = 5.65]. Of the 1,006 patients, 341 (33.90%) had had asthma for at least 10 years, which was a significant factor in the overall study group (OR = 3.64). We found 95 cases (9.44% of the study group) of aspirin intolerance, including 23 of the 75 patients with severe asthma (30.67%; OR = 5.44). Logistic regression analysis showed that aspirin intolerance was most closely associated with severe asthma (beta = 5.79; P < .001). The data from this study show that aspirin intolerance, HDM allergy, and asthma duration exceeding 10 years are major factors associated with severe asthma in outpatients.

Effects of Allergen Avoidance at High Altitude on Children with Asthma or Atopic Dermatitis

Patients with atopic diseases benefit from a high-altitude climate, the effectiveness of which may be related to established house dust mite allergy. A relationship between these variables and disease severity as well as inflammatory activity has not been previously studied. The study objectives were: (1) to assess changes in inflammatory levels for children and adolescents with asthma or atopic dermatitis during a 4-week inpatient rehabilitation stay at high altitude, (2) to examine the role of house dust mite sensitization, and (3) to compare the results for the two diagnostic groups. A total of 115 children and adolescents aged 10-16 years were enrolled in the study: 60 suffered from asthma and 55 from atopic dermatitis. The prevalence of house dust mite sensitization was 36.52%. Urine and blood samples were collected on admission to an inpatient rehabilitation clinic and at their discharge 1 month later. Urinary eosinophil protein X (U-EPX) and serum eosinophil cationic protein (S-EPC)-levels were ana...

Diagnosis of natural rubber latex allergy by the Basotest method

Rationale The flow cytometry CD63 based basophil activation test (Basotest®) has already been validated for the diagnosis of immediate-type allergy such as venom, house dust mite or cypress pollen allergies. The aim of this study was to evaluate the interest of Basotest® for the diagnosis of natural rubber latex allergy. Methods We included 46 latex allergic patients (who presented clinical symptoms of latex allergy, positive latex skin prick tests and specific IgE) and 33 control subjects and performed Basotest® in all subjects. Results The sensitivity and specificity of Basotest® were 84.8% and 87.9% respectively when we considered the cut-off at 15% of CD63 positive cells. Using ROC curves, the optimal cut-off was evaluated at 22%, for which sensitivity and specificity were 79.3% and 96.7% respectively. Conclusion The Basotest® is a reliable test in complement to clinical history and already validated tests (such as skin prick tests and specific IgE) to confirm the diagnosis of natural rubber latex allergy.