title: Component-resolved immunologic modifications, efficacy, and tolerance of latex sublingual immunotherapy in children.
abstract: BACKGROUND
  As the frequency of natural rubber latex (NRL) allergy has increased, attempts have been made to diminish exposure in high-risk patients. Despite some good results, complete NRL avoidance was not possible, so latex immunotherapy was developed.
  
  
  OBJECTIVE
  To examine variations in immunologic parameters, clinical efficacy, and safety of NRL sublingual immunotherapy (SLIT).
  
  
  METHODS
  This prospective, observational, open, case-control study included 23 patients (18 patients receiving NRL SLIT and 5 controls). Skin prick, conjunctival provocation, and in-use tests with NRL, specific IgE and specific IgG4 to NRL, specific IgE to recombinant NRL allergens, and basophil activation test (BAT) with whole latex, natural, and recombinant allergens were performed before immunotherapy (T0) and at 6 (T1) and 12 months (T2) of treatment.
  
  
  RESULTS
  Patients were sensitized to Hev b 5, Hev b 6.01, and Hev b 6.02 proteins, optimal for SLIT. Changes in specific IgE were not significant. Increases in specific IgG4 between T1 and T2 were larger in the active group. BAT determinations showed significant decreases in recombinant Hev b 6.01 and natural Hev b 6.02 in the active group at T1 but not at T2. Both groups had new sensitizations at T1 but not at T2. The active group had significant increases in the response threshold in the in vivo tests at T1 and T2. Adverse effects were limited to local reactions.
  
  
  CONCLUSIONS
  NRL SLIT is effective and safe in children with latex allergy. Our results suggest that specific IgE determinations and BAT measurements to natural and recombinant latex allergens may allow obtaining an allergen-based diagnosis to help determine specific immunotherapy.
authors.affiliation: Allergology and Pediatrics Service, Hospital Universitario Donostia, San Sebastián, Spain. eva.lasaluaces@osakidetza.net
authors.forename: Eva María
authors.initials: EM
authors.lastname: Lasa Luaces
authors.forename: Ana Isabel
authors.initials: AI
authors.lastname: Tabar Purroy
authors.forename: Blanca Esther
authors.initials: BE
authors.lastname: García Figueroa
authors.forename: Marta
authors.initials: M
authors.lastname: Anda Apiñaniz
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Sanz Laruga
authors.forename: Monika
authors.initials: M
authors.lastname: Raulf-Heimsoth
authors.forename: Domingo
authors.initials: D
authors.lastname: Barber Hernández
mesh_terms: D000286:Administration, Sublingual; D000293:Adolescent; D000485:Allergens / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology; D052179:Antigens, Plant / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology; D023181:Antimicrobial Cationic Peptides / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology*; D001491:Basophils / Q000276:immunology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003888:Desensitization, Immunologic / Q000379:methods*; D005260:Female; D006801:Humans; D007108:Immune Tolerance / Q000276:immunology; D007073:Immunoglobulin E / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D020315:Latex Hypersensitivity / Q000276:immunology / Q000628:therapy*; D008297:Male; D037121:Plant Lectins / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology*; D010940:Plant Proteins / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology; D011446:Prospective Studies; D012408:Rubber / Q000008:administration & dosage / Q000737:chemistry; D012882:Skin Tests; D016896:Treatment Outcome
chemical_list: D000485:Allergens; D052179:Antigens, Plant; D023181:Antimicrobial Cationic Peptides; C097982:Hev b 6.01 protein, Hevea brasiliensis; D007074:Immunoglobulin G; D037121:Plant Lectins; D010940:Plant Proteins; C101800:allergen Hev b 5; C045875:hevein; D007073:Immunoglobulin E; D012408:Rubber