Research Agenda Item: Conduct research to further characterize the immune response to natural rubber. This effort should include studies of the incidence and prevalence of natural-rubber-related allergic disease.

MECHANISMS OF IMMUNE FUNCTION

Evidence suggests that the adjuvant effects associated with macrophage activation are related to endotoxin. Additional research is necessary, however, to clarify this phenomenon.

Research Agenda Item: Determine whether bacterial products (such as endotoxin) or fungal products may act as adjuvants in the immune responses to indoor allergens.

The magnitude of allergen exposure appears to be related to the risk of sensitization. Allergen exposure is also related to the risk of developing asthma and the age at which asthma develops. However, genetic and other local host factors are also important in atopy and asthma. Understanding the relative importance of these individual factors and their interaction with each other is essential to understanding the mechanisms of immune function.

Research Agenda Item: Conduct research to identify risk factors other than exposure, and clarify their potential significance relative to indoor allergy. This effort should include an evaluation of the role of genetic and local host factors in allergen sensitization.

MEDICAL TESTING METHODS
Medical History and Diagnosis

In spite of universal agreement on the primary importance of a patient's allergy history, very little space in medical textbooks is devoted to the topic, and no standard exists for collecting appropriate information. A standardized, validated allergy-history questionnaire would be useful in both clinical and research settings.

Research Agenda Item: Develop, test, and validate a standardized allergy-history questionnaire for use in multi-center studies.

Skin Tests

A major unknown in skin testing is the identity of the more prevalent allergens involved in many indoor exposures. Studies to characterize these allergens are important for the development of reliable diagnostic reagents.



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