Natural rubber latex allergy in children: clinical and immunological effects of 3-years sublingual immunotherapy

SUMMARY

Background: We previously demonstrated that one year of sublingual immunotherapy (SLIT) with natural rubber latex (NRL) was safe and efficacious in paediatric patients with NRL allergy. Research Design and Methods: We studied 12 NRL-allergic children (age 4-15), previously assigned to the treated arm of a double-blind placebo controlled study, who received a commercial latex SLIT for three years. Adverse reactions were monitored. The primary end-point was the NRL glove-use test. As secondary end-points, skin prick test with NRL and NRL serum specific IgE were used. Main outcomes measures: No SLIT-related side effects were observed. A significant reduction of the glove-use score was observed after one-year treatment (5.1 ± 4.2 vs. 14.8 ± 5.7, p=0.0031). This parameter was further reduced in the second year since SLIT start (2.0 ± 2.7, p=000007). After 3 years of SLIT all patients had a negative glove-use test (p<0.0001). Baseline wheal areas of skin prick test (6.8 ± 2.5 mm2) were significantly reduced after 2 (5.3 ± 1.8 mm2) and 3 years (4.0 ± 1.8 mm2) of SLIT (p=0.039 and 0.027, respectively). Baseline values of serum specific IgE (23 ± 34 KU/l) were significantly reduced after 3 years since SLIT start (6.4 ± 5.0, p=0.0371). Conclusions: Three years of latex SLIT is safe and consolidates the efficacy previously observed after one year of treatment in paediatric patients.