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Wearing test with 2 different types of latex gloves with and without the use of a skin protection cream

Allmers H

Contact Derm., 2001 Jan;44(1):30-3.
PMID: 11156008

72 subjects reporting symptoms indicating Type I hypersensitivity reactions to natural rubber latex (NRL) gloves were included in this study. 44 of them had a positive prick test to NRL. They underwent wearing tests using 2 types of NRL gloves with high (n=63) and low (n=70) allergen contents. Unigloves Malaysia with a high allergen content caused positive skin reactions in 47% of SPT-positive and no IgE-negative subjects. After application of Hand Sense skin protection cream, the frequency of positive skin responses in wearing tests decreased to 30% in prick-test-positive subjects. The Biogel Diagnostic gloves with low allergen caused hypersensitivity with and without Hand Sense in 2 cases (5%) of the prick-test-positive. 60% of all test participants had a positive prick test to NRL. No prick-test-negative subjects showed any urticaria during the glove-wearing test. Our study demonstrates that high allergen contents in latex gloves frequently elicit skin responses in NRL-sensitized subjects. Since other skin protection creams have shown to increase allergic symptoms, it is encouraging to report that Hand Sense skin cream may hamper the uptake of allergens from gloves, thus decreasing allergic reactions.

Matched MeSH terms: Latex Hypersensitivity/etiology
Natural rubber latex allergens: new developments

Yeang HY

Curr Opin Allergy Clin Immunol, 2004 Apr;4(2):99-104.
PMID: 15021061

PURPOSE OF REVIEW:
New allergenic latex proteins have been identified, whereas further information on known latex allergens has emerged in recent years. Although prevalence figures for sensitization to the various latex allergens have been published in several studies in the past, the data have not been collated to facilitate cross-comparison.

RECENT FINDINGS:
Salient characteristics of the three most recently identified latex allergens, Hev b 11, 12 and 13 are described, whereas new findings on some of the previously recognized allergens are examined. Hev b 2 is viewed from the standpoint of allergenicity and protein glycosylation, Hev b 4 in relation to its biochemical identity and molecular cloning, Hev b 5 with respect to its recombinant form, and Hev b 6 in connection with conformational IgE epitopes. Reports on sensitization or allergic reaction to purified latex allergens from recent and past work are summarized. The use of latex allergens in latex allergy diagnostics is reviewed and discussed.

SUMMARY:
Thirteen latex allergens have been recognized by the International Union of Immunological Societies. Based on the results of published studies, native Hev b 2, recombinant Hev b 5, native or recombinant Hev b 6, native Hev b 13, and possibly native Hev b 4 are the major allergens relevant to latex-sensitized adults. Although there is an increasing tendency to identify and characterize latex allergens largely on the basis of their recombinant forms, not all such recombinant proteins have been fully validated against their native counterparts with respect to clinical significance.

Matched MeSH terms: Latex Hypersensitivity/etiology*
Appraisal of latex glove proteins in the induction of sensitivity to multiple latex allergens

Yeang HY, Chow KS, Yusof F, Arif SA, Chew NP, Loke YH

J Investig Allergol Clin Immunol, 2000 Jul-Aug;10(4):215-22.
PMID: 11039838

Six Hevea brasiliensis latex protein allergens, Hevb 1, Hev b 2, Hev b 3, Hev b 4, and two variants of Hev b 7 (7b and 7c), were purified from Hevea latex, while a seventh protein, Hev b 5, was prepared in recombinant form. The presence of these proteins in glove extracts was indicated by their respective antibodies in the serum of rabbits immunized against the extracts. The relative propensities of IgE binding to the individual latex allergens were compared using sera from latex-allergic patients. IgE recognition of Hev b 4, Hev b 7b, Hev b 5 and Hev b 2 was most frequently encountered, with 75, 61, 31 and 28%, respectively, of the patient sera reacting. Sensitivity to multiple latex proteins was common, and out of the 31 seropositive patients, 23 (74%/ ) had IgE against at least two latex allergens, while 12 (39%) had IgE specific for at least three allergens. Statistical analysis of the data suggested that many patients might have acquired sensitivity to Hev b 2, Hev b 4 and Hev b 7b from a common source. (e.g., from latex products). On the other hand, sensitivity to Hev b 5 and to Hev b 7c were interrelated. It is plausible that sensitivity to these two proteins might have been acquired from sources other than latex products (e.g., from certain foods).

Matched MeSH terms: Latex Hypersensitivity/etiology*
Detection of immunoglobulin antibodies in the sera of patients using purified latex allergens

Kurup VP, Yeang HY, Sussman GL, Bansal NK, Beezhold DH, Kelly KJ, et al.

Clin Exp Allergy, 2000 Mar;30(3):359-69.
PMID: 10691894

BACKGROUND: Latex allergy is largely an occupational allergy due to sensitization to natural rubber latex allergens present in a number of health care and household products. Although several purified allergens are currently available for study, information on the usefulness of these purified, native or recombinant allergens in the demonstration of specific immunoglobulin (Ig) E in the sera of patients is lacking.
OBJECTIVE: To evaluate the purified latex allergens and to demonstrate specific IgE antibody in the sera of health care workers and spina bifida patients with clinical latex allergy.
METHODS: Two radioallergosorbent and an enzyme-linked immunosorbent assay (ELISA) using latex proteins Hev b 1, 2, 3, 4, 6 and 7 along with two glove extracts and Malaysian nonammoniated latex (MNA) were evaluated to demonstrate IgE in the sera of health care workers and spina bifida with latex allergy and controls with no history of latex allergy.
RESULTS: ELISA using the purified latex allergens demonstrated specific IgE in 32-65% health care workers and 54-100% of spina bifida patients with latex allergy. The corresponding figures for RAST were 13-48 and 23-85 for RAST-1 and 19-61 and 36-57 for RAST-2. These results were comparable with the results obtained with glove extracts and crude rubber latex proteins.
CONCLUSIONS: When used simultaneously, latex proteins Hev b 2 and Hev b 7 reacted significantly with specific serum IgE in 80% of health care workers and 92% of spina bifida patients with latex allergy by ELISA technique, while this combination gave lower positivity when the RASTs were used. By the addition of Hev b 3, specific IgE was detected in all spina bifida patients with latex allergy. Both RASTs failed to show specific IgE in the control subjects, while the ELISA showed significant latex-specific IgE in 22% of controls.

Matched MeSH terms: Latex Hypersensitivity/etiology