Protein and allergen content of various natural latex articles

Journal of Allergy and Clinical Immunology, 2004

Background: Sensitization to natural rubber latex has been linked to proteins from medical latex gloves. Various assays to estimate the amount of residual allergenic proteins extractable from latex gloves to assess their potential exposure hazard have inherent weaknesses. Objective: This investigation was aimed at developing 2-site immunoenzymetric assays and identifying appropriate protein markers to assess the allergenic potential of latex gloves. Methods: The presence of 6 latex allergens-Hev b 1, 2, 3, 5, 6, and 13-was measured in a cross-section of commercial latex medical gloves by using monoclonal and polyclonal antibodybased 2-site immunoenzymetric assays. The overall allergenic potential of these gloves was assessed by IgE-inhibition assay. Stepwise multiple regression analyses were performed to identify marker allergens that best explained the variation in latex glove allergenicity. Results: All 6 latex allergens were detected in at least some of the glove samples. Hev b 5 and Hev b 13 were identified as the marker allergens that combined best to explain the variation in the glove allergenicity. The significant multiple correlation (R = 0.855) between these 2 markers and glove allergenic potency forms the basis of an assay to gauge latex glove allergenicity. Conclusion: The overall allergenic potential of latex gloves can be estimated by using Hev b 5 and Hev b 13 as indicator allergens. The correlation between glove allergenicity and the level of these allergens was maintained for low-protein gloves (< 200 mg/g). This estimation of glove allergenicity was superior to that obtained by using total protein readings.

International Archives of Occupational and Environmental Health, 2006

Background: In this study the latex protein content in devices commonly used in hospitals and general practice were investigated. The main aim was to acquire information for preventing latex allergy in health care workers and in the general population. Methods: About 22 different types of medical devices and 23 devices commonly used in general practice were examined evaluating the total allergenic potency by a modified RAST-inhibition assay and quantitative determination of single allergens (Hev b1, Hev b5 and Hev b6.02) by using commercial ELISA kit. Results: A high level of inhibition was found in medical devices, such as elastic bandage (81.57%), tourniquet (74.09%), Foley urinary catheter (68.35%), Penrose drainage (67.25%) and taping (39.6%), and in common devices, such as rubber inner-sole (84.20%), toy balloon (78.62%), latex mattress (74.27%), household rubber gloves (49.10%), working gloves (38.25%), inflatable floating mattress (32.10%). Concentrations of latex extractable proteins and Hev b1, Hev b5 and Hev b6.02 antigens were high in some medical and general devices. Conclusions: Latex exposure sources were found in hospitals and the home. These findings, though only preliminary and far from conclusive, could enable sensitized persons to avoid risky exposures and prevent allergic reactions. From the point of view of prevention, the time may come when every natural rubber object could be systematically labelled as “containing latex” together with the warning that “this item may cause allergic reactions in sensitized subjects.”

Journal of Allergy and Clinical Immunology, 1996

Background: Natural rubber latex (NRL) gloves are the major source of proteins that cause latex allergic reactions in sensitized health care workers and patients.

Journal of Allergy and Clinical Immunology, 1996

Background: Type I allet?gy to latex is a growing plvblem, especially among health care workers. A detailed study of the peripheral blood cell responses to latex allergens has not been reported. Methods: Peripheral blood mononuclear cells of patients and healthy subjects were isolated and stimulated with protein extracts from latex sap and latex gloves and the purified latex allergen Hey b 1 (rubber elongation facto 0 at different concentrations to determine the anngen-specific plvliferation response. The examined patients were sensitized to latex by occupational exposure tn = 23) and had rhinitis, conjunctivitis, contact umcaria, and~or asthma. Two control groups of nonsensitized subJects were studied: one occupationally exposed to latex (n -8), and the second, not exposed to latex tn = 8). Results: In general, only latex-exposed subjects responded to the different latex antigen preparanons. Lymphocyte proliferation responses to latex sap extract were found in 65% of latexsensitized subjects and in 37.5% of the latex-exposed healthy subjects. Latex glove extract induced a significant proliferative response in 47.8% of latex-sensitized patients and in 25% of latexexposed individuals. Hev b 1 induced lymphocyte proliferation responses in 52% of the latexsensitized patients' and in 25% of the latex-exposed subjects, indicating that Hev b 1 is relevant antigen in these latex-sensitized and latex-exposed groups. Peripheral blood mononuclear cells of 39.1% of the latex-sensitized subjects responded to all three allergen preparations (latex sap and latex glove extract, as well as Hey b 1). We could find no correlation between latex-specific IgE level and latex-induced lymphocyte proliferation response. Conclusion: Our data indicate that the 14 kd protein Hey b 1 is a relevant allergen in health care workers. It can be detected by specific IgE antibodies to Hey b 1. as well as in lymphocyte proliferation assay. In addition, our study suggests that antigen-specific proliferation response to latex is associated with exposure to latex, but not with the level of specific latex IgE. This may be useful for the evaluation and prediction of latex hypersensitivity development. (J Allergy Clin Immunol 1996.'98.'640-51. j

Journal of athletic training, 2003

To provide information about latex allergies; to determine how to recognize, evaluate, and manage emergencies related to latex allergies; and how to identify those at risk for latex allergies. Additionally, ways to prevent latex exposure, to educate health care workers and athletes about latex allergy, and to provide safe alternatives to latex are investigated. We searched MEDLINE and SPORT Discus for the years 1998-2002 using the key words latex, allergies, rubber, anaphylaxis, gloves, cross-reaction, IgE (immunoglobulin G) proteins, and radioallergosorbent test (RAST). Latex, a sap from the rubber tree, is found in many products used in everyday life. Latex is composed of compounds that may cause an allergic reaction, whose severity can range from irritant dermatitis to type IV dermatitis to type I systemic reaction. Recognition of the signs and symptoms associated with these reactions by the health care professional may help to prevent a more severe reaction from occurring. React...

2005

Total extractable proteins, EPRRiMt determined by the RRIM test, ranged from 1326 pg/g to &lt; 20 fJg/gfor 90 gloves. Their corresponding £&quot;/* _ values, obtained by the ASTM test, varied from 1377 pg/g to &lt; 50 fJg/g. Statistical analysis showed a very significant correlation between them , with a coefficient of correlation, r = 0.93, P &lt; 0.001. Generally, EPRRJM values read higher than those ofJ£PAym. EPAsm of 50 fjg/g and lower were found to be associated with EPRRIM values ranging from 267 ^g/g to &lt; 20 [ig/g, suggesting higher sensitivity of the latter measurements. Relevance of the two sets of EP in relation to the allergenicity/allergic potential of latex gloves was discussed.

Clinical &lt;html_ent glyph="@amp;" ascii="&amp;amp;"/&gt; Experimental Allergy, 2006

Background Hevea brasiliensis latex serum is commonly used as the in vivo and in vitro reference antigen for latex allergy diagnosis as it contains the full complement of latex allergens. Objective This study quantifies the concentrations of the significant allergens in latex serum and examines its suitability as an antigen source in latex allergy diagnosis and immunotherapy. Methods The serum phase was extracted from centrifuged latex that was repeatedly freezethawed or glycerinated. Quantitation of latex allergens was performed by two-site immunoenzymetric assays. The abundance of RNA transcripts of the latex allergens was estimated from the number of their clones in an Expressed Sequence Tags library. Results The latex allergens, Hev b 1, 2, 3, 4, 5, 6, 7 and 13, were detected in freeze-thawed and glycerinated latex serum at levels ranging from 75 (Hev b 6) to 0.06 nmol/mg total proteins (Hev b 4). Hev b 6 content in the latex was up to a thousand times higher than the other seven latex allergens, depending on source and/or preparation procedure. Allergen concentration was reflected in the abundance of mRNA transcripts. When used as the antigen, latex serum may bias the outcome of latex allergy diagnostic tests towards sensitization to Hev b 6. Tests that make use of latex serum may fail to detect latex-specific IgE reactivity in subjects who are sensitized only to allergens that are present at low concentrations. Conclusion Latex allergy diagnostics and immunotherapy that use whole latex serum as the antigen source may not be optimal because of the marked imbalance of its constituent allergens.

Allergy, 1999

Latex allergy is now known to be related to type I hypersensitivity. In latex products, several reports have identified at least 10 allergens. However, 56 polypeptides have been shown to react to IgE by two-dimensional gel electrophoresis and immunoprints. All studies using immunoprints have analyzed a relatively small number of sera. The aim of the present study was to analyze the specificity and the isotypic expression of a wide sample of latex-sensitive patients. Latex proteins were separated by SDS–PAGE in an 8–18% gel gradient, transferred onto a nitrocellulose sheet by Western blot, and revealed by serum from latex-sensitive patients. The presence of IgE, IgA, IgG1, IgG2, IgG3, and IgG4 was analyzed for each of the 54 sera. The results showed Hev b 3 to be the most frequently recognized protein, followed by Hev b 1, Hev b 7, and molecules of 94 kDa and 6–8 kDa. The most common isotypic association was IgE-IgG1, frequently with IgA. IgG4 was also present in a little less than half of the IgE-positive sera. IgG3 was also expressed but frequently recognized nonallergenic molecules. IgG2 was present in only two cases. Thus, as several authors have proposed a protective role for IgG in the allergic reaction, it may be of interest to compare these results with the course of the disease.

Journal of Allergy and Clinical Immunology, 1994

Background: IgE-mediated sensitization to rubber proteins is being reported with increasing frequency in health care workers. To explore the relative importance of various sources of allergen exposure, we measured the total rubber allergen and protein levels in extracts of disposable rubber gloves and compared the allergen levels with those in extracts of other medical and consumer rubber products. Methods: Rubber allergens were measured by inhibition immunoassay with a rubber glove extract as the solid-phase allergen and pooled plasma from five rubber-sensitized health care workers as the IgE antibody source. Proteins were measured by Ninhydnn assay.

Allergologia et Immunopathologia, 2006

Background: Differences in latex allergen sensitization profiles have been described between children undergoing repeated surgical interventions and health care workers. The purpose of this study was to determine whether such sensitization profiles are associated with differences in the expression of latex allergen between the internal and external surfaces of surgical gloves. Methods: Extracts were obtained from whole surgical gloves as well as from their external and internal surfaces. The extracts were centrifuged, filtered, concentrated, dialyzed and lyophilized. The protein profile of the extracts was analyzed using hydrophobic interaction chromatography (HIC) and sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). Immunoblotting was performed using sera from two patients with confirmed latex allergy. Latex recombinant allergen-specific IgE in these two patients was determined using a fluorescence enzyme immunoassay (FEIA) method. Latex allergen quantification was determined on both glove surfaces using an ELISA method. Results: HIC and SDS-PAGE showed qualitative and quantitative differences in proteins between the internal and external glove surfaces, with the former being much richer in proteins. Immunoblotting of glove extracts using sera from two latex-allergic health workers showed differences between glove surface extracts. ELISA quantification of latex allergens demonstrated that the internal glove surface had high amounts of Hev b 5 and Hev b 6.02 whereas the external surface showed Hev b 1, Hev b 3, and Hev b 6.02. Conclusions: Our results reveal substantial differences in the composition of latex allergen profiles between the internal and external surfaces of surgical latex gloves, which may suggest a relationship between latex allergen localization and sensitization routes in different risk groups.