Latex allergen IgE assays in the assessment of Veterans Affairs health care workers.
BACKGROUND
A previous multicenter study of Veterans Affairs health care workers evaluated hospital participants for latex hypersensitivity. Well-defined groups from that study allowed us to explore the diagnostic utility of newer antilatex allergen IgE immunoassays in the present study.


OBJECTIVE
To determine whether an enhanced CAP (ENHCAP) assay or an enzyme-linked immunosorbent assay (ELISA) identifies latex glove symptomatic individuals with antilatex allergen IgE that had not been detected by the CAP assay used in the original study and to determine the specificity of the ENHCAP assay.


METHODS
The ELISA measured IgE antibody to Malaysian nonammoniated natural rubber latex extract (MNA), Hev b1, Hev b5, and Hev b6. Four patient groups were tested: confirmed latex glove allergic, latex glove symptomatic, latex glove sensitized/asymptomatic, and latex glove nonallergic.


RESULTS
The ENHCAP assay and the MNA ELISA were highly concordant with the original CAP assay. In the subgroup with latex glove symptoms that were previously negative by the CAP assay, the ENHCAP assay value was elevated in 7 (11%) of 64 samples, only 3 of which were class 2 or higher. The MNA ELISA result was positive in only 4 (6%) of these 64 samples, and 3 of these were fractionally above the cutoff value for this assay.


CONCLUSIONS
The ENHCAP assay and the MNA ELISA identified a few additional positive individuals in the group that was latex glove symptomatic and originally CAP assay negative. The ENHCAP assay and the MNA ELISA produced only a modest improvement in diagnostic sensitivity over that of the original CAP assay.
Zeiss
Chester Raymond
CR
Jessie Brown VA Medical Center, Lakeside Division, Chicago, Illinois 60611, USA. crz528@northwestern.edu
Kurup
Viswanath P
VP
Elms
Nancy
N
Fink
Jordan N
JN
D052179:Antigens, Plant / Q000276:immunology; D006282:Health Personnel; D006801:Humans; D007118:Immunoassay; D007073:Immunoglobulin E / Q000097:blood* / Q000276:immunology; D007840:Latex / Q000276:immunology; D020315:Latex Hypersensitivity / Q000175:diagnosis* / Q000276:immunology; D009784:Occupational Diseases / Q000175:diagnosis / Q000276:immunology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014728:Veterans
D052179:Antigens, Plant; D007840:Latex; D007073:Immunoglobulin E