Allergen Specific Nasal Challenge to Latex in Children with Latex Allergy: Clinical and Immunological Evaluation

Abstract

There are no data concerning the significance of allergen specific nasal challenge to latex (ASNCL) in the pediatric population and the effect of mometasone furoate nasal spray [(MFNS), topic corticosteroid exerting a potent anti-inflammatory activity] in children with latex allergic rhinitis. The aims of this study are: to investigate the clinical and immune pathological effects of ASNCL in children with latex allergy; to study the effects of MFNS pre-medication on the clinical and immune pathological effects of ASNCL in children with latex allergy. Thirteen children [6 male and 7 female, mean (SD) age 9.6 (2.9) years] with latex allergy and seven children [3 male and 4 female, mean (SD) age 9.9 (3.8) years] without latex allergy underwent ASNCL. Nasal symptoms were recorded, nasal lavage fluid was collected to measure tryptase, eosinophil cationic protein (ECP), interleukin-5, interferon-γ levels, and spirometric test was performed for each patient without or with pre-medication with MFNS. ASNCL induced a clinical allergic response and increased tryptase levels only in children with latex allergy. No serious adverse events occurred after ASNCL. MFNS pre-medication reduced both tryptase and ECP levels only in children with latex allergy. ASNCL is a simple, reliable and useful tool to make or confirm the diagnosis of nasal symptoms due to latex; it allows us to study both clinical symptoms and local immunological changes. MFNS pre-medication before an ASNCL may prevent some immunological responses induced by ASNCL without clinical allergic modifications.