Latex type I sensitization and allergy in children with atopic dermatitis.Evaluation of cross-reactivity to some foods

Recent studies have demonstrated that allergy to natural rubber latex (NRL) is associated with cross-reactivity to certain foods. The aim of this stud y was to investigate the prevalence of NRT, sensitization and allergy in ch ildren with atopic dermatitis (n=74). We also examined cross-reactions betw een latex and foods, and compared the frequency of suspected latex cross-re acting fruits in children with and without NRL-specific immunoglobulin E (I gE). Twelve of the 74 atopic children studied (16.2%; 95% confidence interv al(CI), 8.7-26.6%) had circulating IgE antibodies to latex. These NRL-sensi tized children were older and they showed significantly higher total IgE va lues (p<0.003) when compared with the group of children without NRL sensiti zation. Of the specific food IgE evaluations, 18.4% (93 out of 505) were po sitive, and 69.9% were observed in the group of children with latex-specifi c IgE, most frequently to potato, tomato, sweet pepper, and avocado. An iso lated latex-specific IgE response without food-specific IgE was never obser ved. Exclusively in the latex-positive group, conformity with the report of allergic symptoms after ingestion of food and increased food-specific IgE was found. Twenty children without proven latex sensitization showed increa sed food-specific IgE, most frequently to potato, banana, and chestnut. Avo cado-specific IgE was never determined in this patient group. No significan t differences were detected concerning the sensitization to potato, banana, and kiwi between NRL-sensitized children and the group of 20 children with out latex-specific IgE. The competitive CAP inhibition using sera from chil dren with specific IgE to both latex and food showed different cross-reacti vities between latex and the specific food. A close relationship existed be tween latex and avocado (median inhibition: 100%), whereas sensitization to latex and kiwi seemed to be independent in our study group (inhibition: <2 5%). In particular, for potato, cross-reactivity and co-sensitization exist ed. Our study demonstrated that children with atopic dermatitis are a high- risk group for latex sensitization. Increasing age, additional sensitizatio n to ubiquitous inhaled allergens, and enhanced total serum IgE values seem ed to be important variables for latex sensitization and further sensitizat ion to the latex-associated foods. Cross-reactivity and, in some cases, co- sensitization to specific fruits and vegetables, were observed.