Abstract:
Latex allergy is a hypersensitivity response to natural rubber latex (NRL) proteins or rubber chemicals used in the manufacture of latex products. An accurate diagnosis is the first step in the effective management of individuals with latex allergy, especially in high-risk groups, such as healthcare workers and those affected by spina bifida. Diagnosis is based on the clinical history and an accurate allergological evaluation. In the case of type I IgE-mediated hypersensitivity reactions, which can manifest urticaria, angioedema, rhinoconjunctivitis, asthma and anaphylaxis after latex exposure, skin prick tests or latex-specific IgE (sIgE) antibody detection using serological assays can be performed to confirm sensitization. Instead, in the case of contact dermatitis, a patch test can be applied to confirm the presence of a type IV T cell-mediated hypersensitivity reaction to rubber accelerators or additives. Basophils activation tests or challenge tests may be performed if there\'s an incongruity between the clinical history and the results of in vivo and in vitro tests. The aim of this review is to analyze the current state of the art of diagnostic techniques for latex allergy and algorithms employed in clinical practice and possible future developments in this field.
摘要:
乳胶过敏是对用于制造乳胶产品的天然橡胶乳胶(NRL)蛋白或橡胶化学品的超敏反应。准确的诊断是有效管理乳胶过敏患者的第一步,尤其是高危人群,例如医护人员和受脊柱裂影响的人。诊断基于临床病史和准确的变态反应学评估。在I型IgE介导的超敏反应的情况下,可以表现为荨麻疹,血管性水肿,鼻结膜炎,乳胶暴露后的哮喘和过敏反应,可以进行皮肤点刺试验或使用血清学测定的乳胶特异性IgE(sIgE)抗体检测以确认致敏。相反,在接触性皮肤病的情况下,斑贴试验可用于确认IV型T细胞介导的对橡胶促进剂或添加剂的超敏感性反应的存在。如果临床病史与体内和体外试验结果不一致,可进行嗜碱性粒细胞活化试验或攻击试验。这篇综述的目的是分析乳胶过敏诊断技术的现状和临床实践中采用的算法以及该领域未来可能的发展。