Natural rubber latex skin testing reagents: Safety and diagnostic accuracy of nonammoniated latex, ammoniated latex, and latex rubber glove extracts

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Presentation transcript:

Natural rubber latex skin testing reagents: Safety and diagnostic accuracy of nonammoniated latex, ammoniated latex, and latex rubber glove extracts Robert G. Hamilton, PhD, N.Franklin Adkinson, MD Journal of Allergy and Clinical Immunology Volume 98, Issue 5, Pages 872-883 (November 1996) DOI: 10.1016/S0091-6749(96)80003-0 Copyright © 1996 Mosby, Inc. Terms and Conditions

FIG. 1 Cumulative percentage of P-ST positivity of group without latex allergy (NA) (n = 24, clinical score = 0) and group with latex allergy (A) (n = 54, clinical score = 2 to 4) observed with NAL, AL, and GLO extracts at 1 μg/ml, 100 μg/ml, and 1 mg/ml. Subject with food allergy who had a negative history, positive ST response, and positive IgE antibody response was included in group with no latex allergy, and four subjects with positive history, negative ST result, and negative IgE antibody response who were not available for glove provocation confirmation of their latex allergy were included in group with latex allergy. Journal of Allergy and Clinical Immunology 1996 98, 872-883DOI: (10.1016/S0091-6749(96)80003-0) Copyright © 1996 Mosby, Inc. Terms and Conditions

FIG. 2 Cumulative percentage of ID-ST positivity of group with no latex allergy (NA) (n = 24, clinical score = 0) and group with latex allergy (A) (n = 54, clinical score = 2 to 4) observed with NAL, AL, and GLO extracts at incremental tenfold concentrations from 1 pg/ml to 100 μg/ml. Subject with food allergy who had a negative history, positive ST response, and positive IgE antibody response was included in group with no latex allergy, and four subjects with positive history, negative ST result, and negative IgE antibody response who were not available for glove provocation confirmation of their latex allergy were included in the group with latex allergy. Group with latex allergy did not receive an ID-ST with concentrations of extracts ≥1 μg/ml to maximize safety. Journal of Allergy and Clinical Immunology 1996 98, 872-883DOI: (10.1016/S0091-6749(96)80003-0) Copyright © 1996 Mosby, Inc. Terms and Conditions

FIG. 3 ROC plots for NAL extracts used in ID-ST titration studies. “Diagnostic sensitivity” or true-positive fraction is plotted versus “1-diagnostic specificity” or false-positive fraction observed for each of nine NAL extract concentrations from 1 pg/ml to 100 μg/ml. Optimal balance of diagnostic sensitivity and specificity was achieved at an NAL ID-ST concentration of 1 μg/ml. ROC plots for AL and GLO extracts are comparable to NAL ROC curve in this figure; they have analogous areas under their curves (see Results). AL and GLO curves are therefore not individually depicted (see text for definition of populations used to compute sensitivity and specificity). Journal of Allergy and Clinical Immunology 1996 98, 872-883DOI: (10.1016/S0091-6749(96)80003-0) Copyright © 1996 Mosby, Inc. Terms and Conditions