Latex Allergy in Children

Abstract

Natural rubber is a component of the latex of the tropical Hevea brasiliensis tree which is widely used in the manufacturing of medical devices and a large variety of articles for everyday use. Over a dozen allergens have been identified in the latex of H. brasiliensis. The allergens Hev b 1, Hev b 3, Hev b 6, and Hev b 7 are proteins that are involved in the biosynthesis of rubber or the coagulation of latex. Allergens that are part of the plant’s defense system are represented by Hev b 2 and class I endochitinases. The allergens Hev b 4, Hev b 5, and Hev b 8–10 were classified as either structural or housekeeping proteins. Immediate-type hypersensitivity reactions to proteins present in Hevea latex were first described in 1927. Since then, natural rubber latex (NRL) allergy has become an important medical problem for an increasing number of individuals. Sensitization mainly occurs by wound or mucosal contact with NRL devices during surgery or by inhalation of airborne allergens released from powdered latex gloves. The number of surgical interventions and an atopic disposition are the most important risk factors for developing latex allergy, especially in children with spina bifida. Exposure to NRL products should be carefully avoided for individuals who belong to high-risk groups. Initial studies on establishing a latex-free environment for surgery in all spina bifida patients have reported on a decrease in sensitization and allergy to NRL.

Latex allergy in health care workers in Taiwan: prevalence, clinical features

“…The latex allergens Hev b1, Hev b3, Hev b5, Hev b6, and Hev b7 are proteins involved in the biosynthesis of rubber or the coagulation of latex (Niggemann and Breiteneder 2000). These allergens can sensitize HCW by direct contact and/or aerosolization resulting in either a type I or type IV immune reaction.…”

Recombinant Allergens for Skin Testing

“…Latex as such is not a natural source of exposure and, therefore, latex allergy is limited to restricted groups of risk including occupational exposure in healthcare workers [128]and spina bifida patients [129, 130, 131]. Structurally, many latex allergens are related to other allergens detected in fruits [132]and moulds [133].…”

“…Especially skin tests with crude material such as food allergens (Crustacea, peanuts) or skin tests performed in highly sensitized patients (e.g. latex) have been reported to induce such deleterious reactions [129, 147]. One of the major problems in skin testing with undefined allergen preparations results from the unknown amounts of allergens applied which do not allow an estimation of the risk associated with the test.…”

Does Sensitization to Foods in Adults Occur Always in the Gut?

“…In young patients with spina bifida, latex sensitization has been frequently observed following multiple surgeries, probably as the result of repeated parenteral exposure to NRL allergens. In these patients a direct correlation between NRL sensitization and number of surgical treatments has been observed [28]. In contrast, in healthcare workers, which are the other main group at high risk for latex allergy (and probably represent the largest part of the latex-allergic population) sensitization may occur transdermally [29,30] or via the respiratory tract [31].…”