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Arasi S, Barni S, Caminiti L, Castagnoli R, Giovannini M, Liotti L, Mastrorilli C, Mori F, Pecoraro L, Saretta F, Gelsomino M, Klain A, Miraglia del Giudice M, Novembre E. Latex Allergy in Children. J Clin Med 2023; 13:124. [PMID: 38202131 PMCID: PMC10779698 DOI: 10.3390/jcm13010124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/11/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Notwithstanding the efforts made in the last decades to mitigate the consequences of natural rubber latex allergy, this disease continues to be a major health problem, especially in developing countries. The categories of patients with greater and frequent exposure to latex (such as health care professionals and, in the pediatric field, subjects who undergo repeated surgery, e.g., those suffering from spina bifida and urogenital malformations) have an increased risk of developing sensitization and allergy to latex. Herein we provide an overview of the current knowledge and practical recommendations with a focus on epidemiology, diagnostics, and management (including both prevention and therapy) in order to guide a correct recognition and containment of this potentially fatal condition.
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Affiliation(s)
- Stefania Arasi
- Pediatric Allergology Unit, Allergy Diseases Research Area, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy;
| | - Simona Barni
- Allergy Unit, Meyer Children’s Hospital IRCCS, 50139 Florence, Italy; (S.B.); (M.G.); (F.M.); (E.N.)
| | - Lucia Caminiti
- Allergy Unit, Department of Pediatrics, AOU Policlinico Gaetano Martino, 98124 Messina, Italy;
| | - Riccardo Castagnoli
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy;
| | - Mattia Giovannini
- Allergy Unit, Meyer Children’s Hospital IRCCS, 50139 Florence, Italy; (S.B.); (M.G.); (F.M.); (E.N.)
- Department of Health Sciences, University of Florence, 50139 Florence, Italy
| | - Lucia Liotti
- Pediatric Unit, Department of Mother and Child Health, Salesi Children’s Hospital, 60123 Ancona, Italy;
| | - Carla Mastrorilli
- Pediatric and Emergency Department, Pediatric Hospital Giovanni XXIII, AOU Policlinic of Bari, 70126 Bari, Italy;
| | - Francesca Mori
- Allergy Unit, Meyer Children’s Hospital IRCCS, 50139 Florence, Italy; (S.B.); (M.G.); (F.M.); (E.N.)
| | - Luca Pecoraro
- Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37126 Verona, Italy;
| | - Francesca Saretta
- Pediatric Department, Latisana-Palmanova Hospital, Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, Italy;
| | - Mariannita Gelsomino
- Pediatric Allergy Unit, Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of the Sacred Heart, 00168 Rome, Italy
| | - Angela Klain
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (A.K.); (M.M.d.G.)
| | - Michele Miraglia del Giudice
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (A.K.); (M.M.d.G.)
| | - Elio Novembre
- Allergy Unit, Meyer Children’s Hospital IRCCS, 50139 Florence, Italy; (S.B.); (M.G.); (F.M.); (E.N.)
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Westphal GA, Rihs HP, Schaffranek A, Zeiler T, Werfel T, Heratizadeh A, Dickel H, Weisshaar E, Bauer A, Schliemann S, Reich K, Breuer K, Schröder-Kraft C, Worm M, Molin S, Brans R, Schäkel K, Schwantes H, Pföhler C, Szliska C, Kreft B, Löffler H, Bünger J, Brüning T, Geier J, Schnuch A. A variant of the CXCL11 gene may influence susceptibility to contact allergy, particularly in polysensitized patients. Contact Dermatitis 2017; 75:303-307. [PMID: 27356947 DOI: 10.1111/cod.12623] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 04/27/2016] [Accepted: 04/28/2016] [Indexed: 01/18/2023]
Abstract
BACKGROUND Hereditary factors may influence individual susceptibility to contact allergy. OBJECTIVES To investigate genetic variants with impacts on early inflammatory reactions and T cell functions that possibly increase the risk of contact allergy. PATIENTS AND METHODS Three hundred and seventy two patients undergoing patch testing were recruited from the Information Network of Departments of Dermatology (IVDK). Of these, 133 were monosensitized and 239 were polysensitized, defined as reacting to three or more unrelated sensitizers. Within the polysensitized individuals, a subgroup with at least one particularly strong patch test reaction (strong reactors; n = 194) was considered. Three hundred and forty-seven blood bank donors served as controls. Fifteen genetic variants in 13 genes were analysed. RESULTS The homozygous variant CXCL11 AA genotype (rs6817952) was significantly more frequent among polysensitized patients (10 of 239 = 4.2%; p = 0.0048; odds ratio 7.49; 95%CI: 1.7-36.1) than among monosensitized patients (2.2%) and in the control group (0.6%). None of the remaining genetic variants investigated were characterized by similarly strong associations. However, the significance was lost after correction for multiple comparisons. CONCLUSIONS The homozygous variant CXCL11 genotype is associated with an increased risk of contact allergy. To confirm this exploratory finding, further independent studies are needed.
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Affiliation(s)
- Götz A Westphal
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Ruhr-University Bochum, 44789, Bochum, Germany.
| | - Hans-Peter Rihs
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Ruhr-University Bochum, 44789, Bochum, Germany
| | - Antje Schaffranek
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Ruhr-University Bochum, 44789, Bochum, Germany
| | - Thomas Zeiler
- DRK-Blood Transfusion Service West, Centre for Transfusion Medicine Breitscheid, 40885, Ratingen, Germany
| | - Thomas Werfel
- Klinik für Dermatologie, Allergologie und Venerologie Medizinische Hochschule, 30625, Hannover, Germany
| | - Annice Heratizadeh
- Klinik für Dermatologie, Allergologie und Venerologie Medizinische Hochschule, 30625, Hannover, Germany
| | - Heinrich Dickel
- Department of Dermatology, Venereology and Allergology, St. Josef-Hospital, Ruhr-University Bochum, 44791, Bochum, Germany
| | - Elke Weisshaar
- Department of Clinical Social Medicine, Centre of Occupational and Environmental Dermatology, Heidelberg University Hospital, 69115, Heidelberg, Germany
| | - Andrea Bauer
- Department of Dermatology, Universitätsklinikum Carl Gustav Carus, 01307, Dresden, Germany
| | - Sibylle Schliemann
- Department of Dermatology, Jena University Hospital, 07743, Jena, Germany
| | | | | | - Claudia Schröder-Kraft
- Berufsgenossenschaftliches, Unfallkrankenhaus Hamburg Dermatologie, 21033, Hamburg, Germany
| | - Margitta Worm
- Department of Dermatology and Allergy, Allergy-Center Charite, Universitätsmedizin Berlin, 10117, Berlin, Germany
| | - Sonja Molin
- Department of Dermatology and Allergy, Ludwig Maximilian University, 80337, Munich, Germany
| | - Richard Brans
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, 49090, Osnabrück, Germany
| | - Knut Schäkel
- Department of Dermatology, University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Hilmar Schwantes
- Department of Occupational Dermatology, Berufsgenossenschaftliche-Klinik Falkenstein, 08223, Falkenstein, Germany
| | - Claudia Pföhler
- Department of Dermatology, Saarland University Medical School, 66424, Homburg, Saar, Germany
| | - Christiane Szliska
- Department of Dermatology, Bethesda Hospital, 57258, Freudenberg, Germany
| | - Burkhard Kreft
- Department of Dermatology and Venereology, Martin Luther University Halle-Wittenberg, 06120, Halle, Saale, Germany
| | - Harald Löffler
- Department of Dermatology, SLK Hospital Heilbronn, 74078, Heilbronn, Germany
| | - Jürgen Bünger
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Ruhr-University Bochum, 44789, Bochum, Germany
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Ruhr-University Bochum, 44789, Bochum, Germany
| | - Johannes Geier
- Information Network of Departments of Dermatology (IVDK), Georg-August-University Göttingen, 37075, Göttingen, Germany
| | - Axel Schnuch
- Information Network of Departments of Dermatology (IVDK), Georg-August-University Göttingen, 37075, Göttingen, Germany
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Radon K, Nowak D, Vogelberg C, Ruëff F. Career Advice for Young Allergy Patients. DEUTSCHES ARZTEBLATT INTERNATIONAL 2016; 113:519-24. [PMID: 27581504 PMCID: PMC5012160 DOI: 10.3238/arztebl.2016.0519] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 04/14/2016] [Accepted: 04/14/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND One-third of all young persons entering the work force have a history of atopic disease. Occupationally induced allergy and asthma generally arise in the first few months on the job, while pre-existing symptoms tend to worsen. Young persons with a history of an atopic disease should receive evidence-based advice before choosing a career. METHODS We systematically searched PubMed for cohort studies investigating the new onset of asthma, rhinitis, or hand eczema among job trainees from before the start of training and onward into the first few years on the job. The search revealed 514 articles; we read their abstracts and selected 85 full-text articles for further analysis. 24 of these met the inclusion criteria. RESULTS According to present evidence, atopy and a history of allergic disease (allergic rhinitis, atopic dermatitis) are the main risk factors for occupationally induced disease. The predictive value of a personal history of allergic diseases for the later development of an occupationally induced disease varies from 9% to 64% in the studies we analyzed. It follows that only young people with severe asthma or severe atopic eczema should be advised against choosing a job that is associated with a high risk of allergy, e.g., hairdressing or working with laboratory animals. Young people with a history of other atopic diseases should be counseled about their individual risk profile. CONCLUSION In view of the relatively poor predictive value of pre-existing atopic disease, secondary prevention is particularly important. This includes frequent medical follow-up of the course of symptoms over the first few years on the job. If sensitization or allergic symptoms arise, it should be carefully considered whether exposure reduction will enable the apprentice to stay on the job.
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Affiliation(s)
- Katja Radon
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, AllergieZENTRUM, Klinikum der Universität München
- Comprehensive Pneumology Center, DZL, Deutsches Zentrum für Lungenforschung, München
| | - Dennis Nowak
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, AllergieZENTRUM, Klinikum der Universität München
- Comprehensive Pneumology Center, DZL, Deutsches Zentrum für Lungenforschung, München
| | | | - Franziska Ruëff
- Department of Dermatology and Allergology, AllergieZENTRUM, Klinikum der Universität München
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