Allergen Concentration in Natural Rubber Latex

Yeang, Hoong-Yeet; Hamilton, Robert G.; Bernstein, David I.; Arif, S.A.M.; Chow, Keng See; Loke, Y. H.; Raulf‐Heimsoth, Monika; Wagner, Stefan; Breiteneder, Heimo; Biagini, R.E.

doi:10.1016/j.jaci.2005.12.529

Cited by 8 publications

(11 citation statements)

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“…Only value in the diagnosis oflatex allergy (22). Moreover, Yeang and co-workers have recently evidenced that probably the exclusive use of the latex serum extract is not optimal for diagnosing latex allergy (23). Therefore, it is important to establish which latex material should be used to prepare a diagnostic tool for latex allergy.…”

Section: Resultsmentioning

confidence: 99%

Diagnostic Value of Three Different Latex Extracts

Bernardini

Mistrello

Pucci

et al. 2007

Int J Immunopathol Pharmacol

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The diagnosis of latex allergy is made on clinical history, but a confirmatory skin prick test (SPT) or a serological assay based on a commercial latex extract is always recommendable. Different raw materials can be used in the preparation of commercial latex extracts. Such extracts can consequently show both different qualitative profiles and a different diagnostic potential. Therefore, the selection of a proper latex extract is essential for in vitro and in vivo diagnosis of latex allergy. In the present study three different latex extracts, prepared from different raw materials (ammoniated -AL-, serum -SL-, or rubber particles -RPE-latex), are compared by in vitro techniques using sera from twenty patients with latex allergy. SDS-PAGE technique was used to compare the antigenic profile ofthe three latex extracts. Subsequently, their allergenic profiles were evaluated by immunoblotting technique using the individual sera from the twenty latex allergic patients. The diagnostic potential of the three latex extracts was also evaluated using direct Radio-Allergo-Sorbent Test (RAST) as well as skin priek-tests (SPTs). In order to establish the more appropriate latex extract in a perspective of in vivo diagnosis of latex sensitization, the same latex extracts were subsequently compared by an in vivo SPT involving ten of the above subjects. The SDS-PAGE profiles of the three latex extracts examined were quite different. SL extract showed numerous bands comprised between 10-100 kDa. RPE extract was characterized by two intense bands at 14 and 20 kDa while AL extract showed the poorer antigenic composition. Analogously, immunoblotting analysis evidenced a different profile in relation to both different patients and extracts. For only two out of the twenty sera, direct RAST results showed a same positive class in relation to the different latex extracts used. SPT with SL extract showed, in respect to the other extracts (AL, RPE), a significantly higher wheal. This study showed that SL extract is able to express the best in vitro and in vivo diagnostic potential. Thus, its use should be preferred for the diagnosis of patients affected by latex allergy.Latex has been used since XVII century to manufacture thousands of products (1). The first report of immediate-type reaction to natural rubber latex (NRL) was documented in 1927 (2). Clinical manifestations of latex allergy usually include urticaria, rhinitis, conjunctivitis, asthma and anaphylaxis (3-5). Nowadays latex allergy is recognized as a serious and increasing healthcare problem (6-7).The diagnosis of latex allergy is based on the

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Section: Resultsmentioning

confidence: 99%

Diagnostic Value of Three Different Latex Extracts

Bernardini

Mistrello

Pucci

et al. 2007

Int J Immunopathol Pharmacol

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“…To assess the role of Hev b 8 in latex allergy and associated syndromes, it is of utmost importance to clarify whether a patient became sensitized to latex in the first place, or if initial sensitization was due to other sources (pollen or plant foods). At the same time, it is useful to bear in mind that Hev b 8 is present in very low amounts or even absent in natural latex rubber gloves [48].…”

Section: The Role Of Profilin In Latex Allergymentioning

confidence: 99%

Profilin, a Change in the Paradigm

Río

Díaz‐Perales

Sánchez‐García

et al. 2018

J Investig Allergol Clin Immunol

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Profilin is a protein that is present in all eukaryotic cells and is responsible for cross-reactivity between pollen, latex, and plant foods. It has been classically acknowledged as a minor or nearly irrelevant allergen, although recent data are changing this conception. The objective of this manuscript is to provide a comprehensive review of published data on the role of this ubiquitous allergen in pollen, latex, and plant food allergy. The patterns of recognition of this minor allergen follow a north-south gradient. Although present in all pollens and vegetables, profilin is significantly associated with allergy to grass pollen and to Cucurbitaceae fruits. Heb v 8, the latex profilin, is usually a marker of profilin allergy in plant food-allergic patients, although it has no clinical relevance in latex allergy. Sensitization to profilin jeopardizes the diagnosis of pollen allergy and selection of immunotherapy, and although component-resolved diagnosis can identify its impact, there are no tailored treatments available. In recent years, several new publications have shown how profilin should be taken into account and, under certain circumstances, considered a marker of severity, an allergen capable of inducing respiratory symptoms, and, in its natural purified form, a potential candidate for etiological treatment of food allergy. Current data on profilin strongly support the need for a shift in the previously accepted paradigm for this allergen. More research should be done to assess the real clinical impact of sensitization in specific populations and to develop therapeutic strategies.

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“…Whereas this might appear to be an additional safeguard to ensure the patients were truly allergic to latex, note should be taken of the fact that the concentrations of individual allergens vary widely in natural rubber latex. These discrepancies are carried over to commercial diagnostic skin test reagents that are commonly prepared by diluting whole natural rubber latex without adjusting for individual allergen concentra-tions [13], other than -in some cases -supplementation with recombinant Hev b 5 [14]. Hev b 6 is by far the most abundant protein in natural rubber latex, its molecular concentration being, for example, some 25 times that of Hev b 2 and some 270 times that of Hev b 13 [13].…”

mentioning

confidence: 99%

“…These discrepancies are carried over to commercial diagnostic skin test reagents that are commonly prepared by diluting whole natural rubber latex without adjusting for individual allergen concentra-tions [13], other than -in some cases -supplementation with recombinant Hev b 5 [14]. Hev b 6 is by far the most abundant protein in natural rubber latex, its molecular concentration being, for example, some 25 times that of Hev b 2 and some 270 times that of Hev b 13 [13]. The disproportionately high concentration of Hev b 6 means that skin prick diagnostics with whole latex are likely to be biased towards detection of allergy to Hev b 6 in particular.…”

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confidence: 99%

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Assessing the prevalence of sensitization to specific latex allergens

Hy¹

2008

Clin Experimental Allergy

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I read with interest the paper entitled 'Latex allergy: low prevalence of immunoglobulin E to highly purified proteins Hev b 2 and Hev b 13 by Palosuo et al. [1]. The authors dispute that prevalence of sensitivity to Hev b 2 and Hev b 13 is sufficiently high for them to be classified as major latex allergens (450% binding to IgE of latexallergic individuals), contrary to the results from recent research [2, 3] and earlier reports [4,5]. They contend that only Hev b 5 and Hev b 6 are the major allergens among latex-allergic adults.In their paper, the authors isolated and purified Hev b 2 and Hev b 13 from natural rubber latex, and then went on to refine further what they describe as already highly purified proteins. Might these allergens have ended up being over purified?In the first instance, is it even possible to 'over-purify' a substance? If the subject of purification is homogeneous, then the answer is generally 'No'. But many allergens are heterogeneous by nature and occur as multiple molecular variants (isoforms). The International Union of Immunological Societies has provision for naming such isoallergens and their variants, although many more isoforms have been reported than officially classified. Except where the isoallergen is specified, a named allergen should refer to a balanced representation of its isoforms that are commonly encountered.Purifying something from a mixture is a matter of isolating the target substance and rejecting the remainder through a sequence of refining steps. There is no reason to doubt what the authors isolated at the end of their elaborate purification regime as indeed pure extracts of Hev b 2 and Hev b 13. But of no lesser importance here are the fractions that were thrown out in the course of purification. Were key isoallergens discarded en route?It is not always easy to distinguish between different isoallergens because changes in the DNA are often difficult to detect in the translated proteins. In the case of Hev b 2, however, the existence of isoforms is evident even from routine SDS-PAGE where it commonly appears as a doublet of about 35 kDa [6-8], with both protein bands similar enough to be recognized by the same monoclonal antibody [9]. Yagami et al.[8] resolved the Hev b 2 doublet into three distinct isoforms (from at least five molecular variants that exist [9]). The slower migrating (slightly larger) isoform was glycosylated, whereas the fast-migrating protein band yielded one glycosylated and another unglycosylated isoform. All three isoforms were shown by skin prick tests to be allergenic, but individual patients exhibited varying sensitization to the three variants. More recent work on Hev b 2 isoallergens indicate that glycans in the glycosylated isoforms play an active role in allergy, rather than being passive cross-reactive carbohydrate determinants [3, 10].The purification procedure described for Hev b 2 is closely similar to an earlier protocol (similar gel filtration technique, separation column, buffer and elution rate) from the same research group [11]...

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Allergen Concentration in Natural Rubber Latex

Cited by 8 publications

References 0 publications

Diagnostic Value of Three Different Latex Extracts

Diagnostic Value of Three Different Latex Extracts

Profilin, a Change in the Paradigm

Assessing the prevalence of sensitization to specific latex allergens

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