title: The role of allergen components for the diagnosis of latex-induced occupational asthma.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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).
  
  
  
  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.
authors.affiliation: Department of Chest Medicine, Centre Hospitalier Universitaire de Dinant-Godinne, Université catholique de Louvain, Yvoir, Belgium.|Institut de Recherche Expérimentale et Clinique, Pôle de Pneumologie, Université catholique de Louvain, Brussels, Belgium.|Walloon Institute for Excellence in Lifesciences and Biotechnology (WELBIO), Brussels, Belgium.
authors.forename: O
authors.initials: O
authors.lastname: Vandenplas
authors.affiliation: Institut de Recherche Expérimentale et Clinique, Pôle de Pneumologie, Université catholique de Louvain, Brussels, Belgium.|Walloon Institute for Excellence in Lifesciences and Biotechnology (WELBIO), Brussels, Belgium.|Department of Chest Medicine, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: Froidure
authors.affiliation: IPA Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum, Bochum, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Meurer
authors.affiliation: IPA Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum, Bochum, Germany.
authors.forename: H-P
authors.initials: HP
authors.lastname: Rihs
authors.affiliation: Department of Chest Medicine, Centre Hospitalier Universitaire de Dinant-Godinne, Université catholique de Louvain, Yvoir, Belgium.
authors.forename: C
authors.initials: C
authors.lastname: Rifflart
authors.affiliation: Prévention et Protection au Travail - Centre de Service Interentreprises (CESI), Brussels, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: Soetaert
authors.affiliation: Scientific Support Unit, Centre Hospitalier Universitaire de Dinant-Godinne, Université catholique de Louvain, Yvoir, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: Jamart
authors.affiliation: Institut de Recherche Expérimentale et Clinique, Pôle de Pneumologie, Université catholique de Louvain, Brussels, Belgium.|Walloon Institute for Excellence in Lifesciences and Biotechnology (WELBIO), Brussels, Belgium.|Department of Chest Medicine, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium.
authors.forename: C
authors.initials: C
authors.lastname: Pilette
authors.affiliation: IPA Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum, Bochum, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Raulf
mesh_terms: D000328:Adult; D000485:Allergens / Q000276:immunology*; D052179:Antigens, Plant / Q000276:immunology; D059366:Asthma, Occupational / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology*; D015415:Biomarkers; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D007840:Latex / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012408:Rubber / Q000009:adverse effects; D012680:Sensitivity and Specificity
chemical_list: D000485:Allergens; D052179:Antigens, Plant; D015415:Biomarkers; D007840:Latex; D007073:Immunoglobulin E; D012408:Rubber
keywords: bronchial provocation test; component-resolved diagnosis; latex; occupational asthma; recombinant allergens