Exploratory Assessment of Leukocyte Adherence Inhibition Test and Tube Precipitation Responses to Evaluate Cross-reactivity between Latex and Pollen Allergens in Patients with Allergic Multimorbidity

Abstract

Background: Clinical hypersensitivity to pollen and latex allergens has been studied and linked to hypersensitivity to a variety of fruits and vegetables, making this a complex field of study for respiratory, occupational, and food-allergic patients. Aim: To evaluate the potential of the Tube Titration of Precipitins (TTP) and the Leukocyte Adherence Inhibition Test (LAIT) to characterise and endotype humoral and cellular immunoreactivity to latex and pollen allergens, respectively, and to investigate patterns of immunological cross-reactivity between these allergens in patients with clinically diagnosed allergic morbidity. Study Design: This retrospective, single-centre study involved a review of the medical records of two cohorts of patients diagnosed with allergic multimorbidity. The first cohort underwent parallel TTP using latex and pollen extracts, whereas the second cohort was assessed using ex vivo challenge testing, with responses monitored by LAIT, against the same latex and pollen extracts. Methodology: For the first cohort, the parallel TTP measurements obtained for latex and pollen extracts were categorised into defined ranges and presented using cascade distribution charts to characterise the variability of the observed responses. Similarly, the recorded Leukocyte Adherence Inhibition (LAI) measurements for latex and pollen extracts in the second cohort were grouped into ranges and displayed using cascade distribution charts to demonstrate the distribution and variability of the results. Results: The paired t-test demonstrated a small, non-significant difference between latex TTP and pollen TTP (t(99) = 0.5; p = 0.6). Pearson's correlation analysis identified a significant, small positive association between latex TTP and pollen TTP (r(98) = 0.247; p = 0.013). In contrast, the paired t-test revealed a small but statistically significant difference between latex LAIT and pollen LAIT (t(98) = 2.5; p = 0.014). Pearson's correlation analysis demonstrated a significant, medium positive association between latex LAIT and pollen LAIT (r(98) = 0.32; p < 0.001). The cascade distribution charts further demonstrated substantial variability across the observed TTP and LAI results. Conclusion: The preliminary findings from this exploratory, hypothesis-generating retrospective compilation suggest that TTP and LAIT conducted with latex and pollen extracts may identify differing degrees of humoral and cellular immunoreactivity among patients with allergic multimorbidity. The findings also indicate the possibility of some degree of immunological cross-reactivity between these two allergens. Further investigation in appropriately designed prospective studies is warranted to evaluate these preliminary observations.