Latex Allergy

Setlock, Mary A.; Cotter, Tracy P.; Rosner, Diane R.

doi:10.1213/00000539-199303000-00037

Cited by 72 publications

(5 citation statements)

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“…The only treatment is avoidance (11,12), and health care workers with severe latex allergy may be required to change careers or leave health care entirely to avoid potentially dangerous exposure. Since anaphylactic episodes have occurred following skin testing with crude latex extracts (13)(14)(15)(16), immunotherapy is not possible with currently available crude preparations.…”

mentioning

confidence: 99%

Identification, Cloning, and Sequence of a Major Allergen (Hev b 5) from Natural Rubber Latex (Hevea brasiliensis)

Slater

Vedvick

Arthur-Smith

et al. 1996

Journal of Biological Chemistry

128

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Natural rubber latex in medical devices and consumer products has been implicated in over 1100 anaphylactic reactions that resulted in at least 15 deaths between 1988 and 1992 (1, 2). These reactions are caused by proteins that elute from the surfaces of certain latex products, especially gloves, barium enema catheters, balloons, and condoms. The proteins bind to antigen-specific IgE on tissue mast cells and trigger an anaphylactic response. While the production of IgE to latex proteins can occur in any individual, some individuals with uniquely high exposure to latex products appear to be at significantly greater risk for the production of these antibodies than the general population. These include health care workers and children with spina bifida (3-5). Interestingly, there appears to be significant clinical and immunochemical cross-reactivity between some latex proteins and allergens in certain fruits and vegetables, such as banana, kiwi, avocado, and potato, and patients with fruit and vegetable allergy may be at increased risk for reacting to latex proteins (6 -10).Latex allergy can be a devastating disease, with serious and occasionally fatal outcomes. The only treatment is avoidance (11,12), and health care workers with severe latex allergy may be required to change careers or leave health care entirely to avoid potentially dangerous exposure. Since anaphylactic episodes have occurred following skin testing with crude latex extracts (13-16), immunotherapy is not possible with currently available crude preparations. The identification and isolation of pure antigens, and the analysis of the B-and T-cell epitopes of these antigens, will facilitate the design and testing of safer regimens of immunotherapy.The proteins in natural rubber latex are derived from the commercial rubber tree, Hevea brasiliensis. Latex is produced in laticifers, which are specialized structures that consist of anastamosed latex-producing cells. Harvested Hevea latex is a complete cytosol with a high protein content (17, 18). Hevea latex is typically ammoniated when tapped to prevent premature coagulation and bacterial growth. Ammoniated latex is the source material for most of the products that elicit allergic reactions; thus, it clearly contains immunogenic material. However, immunochemical studies with ammoniated latex have failed to reveal the wealth of IgE-binding proteins found in non-ammoniated latex (NAL) 1 (19), which is collected into a liquid nitrogen-cooled container.From the first observations that products made from Hevea latex can elicit catastrophic allergic reactions in susceptible individuals, the component allergens have eluded conclusive identification. In part, this has been due to the complexity and instability of the proteins of Hevea latex. In addition, many investigators have been unable to obtain quantities of fresh material for examination and have been limited to the use of finished products or ammoniated latex (19) for their studies. In spite of these difficulties, several potential allergens have been i...

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mentioning

confidence: 99%

Identification, Cloning, and Sequence of a Major Allergen (Hev b 5) from Natural Rubber Latex (Hevea brasiliensis)

Slater

Vedvick

Arthur-Smith

et al. 1996

Journal of Biological Chemistry

128

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“…20,33,35,77 It is generally accepted that antihistamines or corticosteroids will not mitigate IgE-mediated reactions. 78 Although evidence is only indirect, 79 guidelines indicate the use of H1 antihistamines can be considered 20 or recommended 34 in cases where non-allergic histamine release is suspected. Slower administration of incremental doses of drugs associated with non-allergic histamine release such as opioids, NMBAs, vancomycin has also been proposed.…”

Section: Perioperative Anaphylaxismentioning

confidence: 99%

Prevention of Drug Hypersensitivity Reactions: Prescreening and Premedication

Thong

Vultaggio

Rerkpattanapipat

et al. 2021

The Journal of Allergy and Clinical Immunology: In Practice

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“…The most frequent initial symptoms of anaphylaxis during anaesthesia are hypotension, increased airway pressure and a generalized erythema [125, 126]. Other clinical signs include urticaria, angio‐oedema (swelling) of the face and larynx, coughing and wheezing and tachycardia.…”

Section: Applications To Anaesthesia and Treatment Of Anaphylaxismentioning

confidence: 99%

“…Preoperative pharmacological prophylaxis with antihistamines and corticosteroids in patients with latex allergy is currently not generally recommended because of lack of scientific data proving the efficacy of this strategy in IgE‐mediated reactions [121]. There are several case reports demonstrating the failure of pharmacological prophylaxis to protect against severe allergic reactions [123, 126]. In addition, this approach is also thought to mask early symptoms of latex allergy and create a false sense of security, potentially leading to greater exposure.…”

Section: Applications To Anaesthesia and Treatment Of Anaphylaxismentioning

confidence: 99%