Update on latex allergy: New insights into an old problem

Abstract

Despite the efforts made to mitigate the consequences of this disease, natural rubber latex allergy (NRLA) continues to be a global health problem and is still considered one of the main worries in the working environment in many countries throughout the world. Due to thousands of products containing latex, it is not surprising that the current statistics suggest that prevalence remains high among healthcare workers and susceptible patients. In developed countries, reduction in the prevalence of IgE-mediated allergy to latex proteins from gloves may lead to lax attention by health care personnel. On the other hand, this situation is different in developing countries where there is a lack of epidemiological data associated with a deficit in education and awareness of this issue. The aim of this review is to provide an update of the current knowledge and practical recommendations regarding NRLA by allergologists from different parts of the world with experience in this field.

Update on local anesthetics hypersensitivity reactions

“…Despite being effective, provocation tests are of high risk for triggering anaphylaxis, being reserved for inconclusive cases. 28 Regarding reactions to LA, these are usually immediate reactions, and mostly caused by the toxicity of the drug or the associated vasoconstrictor. Thus, the medication often ends up being suspended without a real need, limiting the therapeutic options of patients.…”

Molecular Allergy Diagnosis in Clinical Practice: Frequently Asked Questions

“…Other allergen families responsible for less prevalent PFS include β-1,3 glucanases polygalacturonases and isoflavone reductases [7], and should be individually assessed according to the culprit allergenic sources. Singlepex sIgE assays are available for some of these latex allergens [44].…”

“…The systemic type I reaction can occur after sensitization to the any latex allergen except isolated Hev b 8 (profilin) There are at least 15 latex allergens identified: Hev b 1 to Hev b 15 belong to different allergen families [44] For patients who have latex allergy and may need surgery or other specialized procedures in operating/procedure rooms the recommendation are that subjects be cared for as the first case of the day and in latex free surgical room. Patients who presented isolated sensitization to Hev b 8 (profillin) [63] and/or CCDs with positive sIgE to latex whole extract without other latex allergens negative do not need to avoid latex in surgical procedures [64].…”

Acute Urticaria and Anaphylaxis: Differences and Similarities in Clinical Management

“…The decision on its execution is influenced by clinical history, age, type of symptom, time of the last reaction, results of skin testing and/or serum levels of specific IgE, and the joint decision between physician and patient, carefully evaluating risk vs. benefit. Those with a convincing history of anaphylaxis from a specific allergen and proven evidence of specific IgE sensitization should not undergo provocation tests ( 87 , 90 ).…”

“…The determination of molecular biology-based components has enabled advances in precision medicine by conferring greater specificity to diagnosis, allowing the identification of discriminative co-sensitization vs. cross-sensitization phenomena, stratifying the clinical risk associated with a specific sensitization pattern, and a better indication to the provocation test in cases of anaphylaxis by food (85)(86)(87). Molecular allergy diagnostics yielded best results in peanut and tree nut allergies (88,89).…”