Latex allergy and NRL allergens

Latex allergy

Over the last 20 years, natural rubber latex (NRL) allergy has become a serious worldwide health problem. Up to 17% of healthcare workers and about 1% of the general population are allergic to natural rubber latex. While contact urticaria is the most common clinical manifestation of NRL allergy, the disease may present in its most serious form as anaphylaxis, a life threatening systemic reaction. NRL based medical devices (gloves, masks, etc.) are a potential source of sensitization to both healthcare personnel and patients. Potentially, anyone in contact with objects containing NRL (e.g. gloves, condoms, catheters, dental dams, balloons, toys, etc.) can become sensitized. On the other hand, there are several risks (HIV, etc.) threatening healthcare workers, and the reason for using medical devices is unavoidable. A long list of the latex products are in daily use.

Natural rubber latex allergens

Liquid latex from the rubber tree, Hevea brasiliensis, is the source of NRL and contains over 200 proteins; 14 have been identified as allergens. Only some of allergens retain their allergenic properties through the manufacturing processes. Thus, when trying to reduce the allergen content of NRL products, any good testing method must measure all components with clinical relevance present in the final product. The NRL allergens that have been shown to be clinically relevant to genuine NRL allergy, and present in the final NRL products with maintained allergenicity are Hev b 1, Hev b 3, Hev b 5 and Hev b 6.02. According to the latest studies, quantification of these four major allergens shows the allergenic potential of rubber products.

References 

  • Turjanmaa, K. et al., Allergy 51 (1996) 593 – 602; 
  • Liss, G. M. and Sussman, G. L., Am. J. Ind. Med. 35 (1999) 196 –200  
  • Poley Jr, G. E. and Slater, J. E., J. Allergy Clin. Immunol. 105 (1997) 1054 – 1062 
  • Palosuo, T. Alenius, H. Turjanmaa, K: Quantification of Latex Allergens. Methods 27 2002; 52-58
  • Palosuo, T. et al, Latex allergy: the sum quantity of four major allergens shows the allergenic potential of medical gloves. Allergy, 2007, 62:781-786 
  • International Union of Immunological Societies allergens list: http://www.allergen.org.  (Home> Plantae magnoliopsida > Malphigales > Hevea brasiliensis)