ABSTRACT During the last decade, latex IgE-mediated allergy has been recognized as a very important medical problem. At the same time, many studies have dealt with allergic cross-reactions between aeroallergens and foods. In this context, there is clear evidence now on the existence of significant clinical association between latex and fruit allergies. Therefore, a latex-fruit syndrome has been postulated.Several studies have demonstrated that from 20% to 60% of latex-allergic patients show IgE-mediated reactions to a wide variety of foods, mainly fruits. Although implicated foods vary among the studies, banana, avocado, chestnut and kiwi are the most frequently involved. Clinical manifestations of these reactions may vary from oral allergy syndrome to severe anaphylactic reactions, which are not uncommon, thus remarking the clinical relevance of this syndrome.The diagnosis of food hypersensitivities associated to latex allergy is based on the clinical history of immediate adverse reactions, suggestive of an IgE-mediated sensitivity. Prick by prick test with the fresh foods implicated in the reactions shows an 80% concordance with the clinical diagnosis, and therefore it seems to be the best diagnostic test available nowadays in order to confirm the suspicion of latex-fruit allergy. Once the diagnosis is achieved, a diet free of the offending fruits is mandatory.Recently, some of the common allergens responsible for the cross-reactions among latex and the fruits most commonly implicated in the syndrome have been identified. Class I chitinases, with an N-terminal hevein like domain, which cross-react with the major latex allergen hevein, seem to be the panallergens responsible for the latex-fruit syndrome.
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ABSTRACT: The occurrence of homologous proteins in foods, pollen and latex is the molecular basis of the plant sources' allergenic cross-reactivity. However, there is not a generic cross-reactivity. Each allergic patient is sensitized to particular allergens and even to particular IgE-binding epitopes. Molecular studies on the main panallergens may explain the major plant-food, pollen and latex syndromes. Some examples of the best- characterized plant panallergens are presented. Novel technologies on recombinant proteins and microarrayed allergens will provide allergen-sensitization profiles, associated to food allergies and cross-reactivity, that will enable the diagnosis and prediction of cross-reactions as well as individual treatment of these pathologies.
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ABSTRACT: Latex allergy and its clinical presentation are rising in prevalence across the globe, especially amongst patients with spina bifida (SB). While studies have been well-established in Europe and America, data from Asia are limited. The aim of this study is to investigate the scenario in Singapore. 35 subjects with SB, aged 5 to 32 years answered a questionnaire and underwent skin prick test (SPT) using a latex solution, 3 common house dust mites and 3 commonly cross-reacting food allergens (banana, kiwi and avocado). We also noted the relation between latex sensitization with atopy and doctor-diagnosed allergy. The prevalence of cross-reactivity with fruits was also studied. Sensitization to latex (i.e. a positive SPT) was found in 16 (46%, 95% confidence interval 29%-63%) of the subjects. Only 5 (31%) of the subjects who were sensitized to latex had clinical manifestations. Atopy (i.e. positive SPT to house dust mites) was present in 23 (66%) of the subjects and 13 (57%) of them was also sensitized to latex. There was a positive trend between latex sensitization and atopy (81.2% vs. 52.6%, p = 0.076), as well as latex sensitization with those having both atopy and doctor-diagnosed allergy (i.e. asthma, allergic rhinitis, eczema, drug allergy) (93.8% vs. 63.2%, p = 0.032). Only 6 (38%) subjects had allergy to the food allergens tested. Almost half of the SB patients in Singapore are sensitized to latex. This number is comparable to that in Europe and America. Positive trend between latex sensitization and those with both atopy and doctor-diagnosed allergy (p = 0.032) is suggestive of a possible cause-effect relationship.Asia Pacific allergy. 04/2013; 3(2):96-9.
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ABSTRACT: Immediate hypersensitivity reactions occurring during anaesthesia, whether IgE-mediated or non IgE-mediated, remain a major cause of concern. The authors report results from an eight-year survey conducted by the GERAP. From 1 January 1997 to 31 December 2004, 2516 patients who had experienced an immediate hypersensitivity reaction were included in this survey. A non-IgE mediated reaction was diagnosed in 700 cases (27.82%) and an IgE mediated reaction in 1816 cases (72.18%). The most common causes were neuromuscular blocking agents (n=1067, 58.08%), latex (n=361, 19.65%) and antibiotics (n=236, 12.85%). The results were significantly different in children: latex was incriminated in more than 50% of the cases, followed by neuromuscular blocking agents (39%) and antibiotics (10.2%). The data showed a female predominance in adults but not in children, whatever the mechanism of the reaction. These results emphasize the need for systematic screening in case of an immediate hypersensitivity reaction during anaesthesia and for the development of centres specializing in perioperative allergies capable of providing expert advice to anaesthesiologists and allergists.Revue Française d Allergologie et d Immunologie Clinique 04/2008; 48(3):217-221. · 0.24 Impact Factor