POPULATION DIFFERENCES IN PREVALENCE TO Hev B 1 OR Hev B 6.02 ARE NOT DEPENDENT ON DERMAL PENETRATION

Abstract

Health care workers (HCW) and spina bifida (SB) patients comprise two populations, which are particularly affected by latex allergy and demonstrate different profiles of sero-reactivity to individual latex proteins, with SB patients more frequently having antibodies to Hev b 1 and 3 and HCW to Hev b 5, 6, and 7. Given that HCW have extensive dermal exposure to latex proteins through the use of latex gloves, these studies were conducted to evaluate the percutaneous penetration of Hev b 1 and Hev b 6.02 as a potential factor in the divergent antibody responses observed in HCW and SB patients. Hairless guinea pig skin was used in in vitro flow through cells for percutaneous penetration studies and for immunohistological evaluation of protein localization in the skin. Skin samples were separated into intact and abraded exposure groups based on barrier integrity as measured by a 3H2O barrier test, and radioactive counts were determined for both skin and receptor fluid. Little protein penetration (less than 3%) was observed into or through intact skin samples following exposure to either protein. As expected, the degree of penetration through abraded samples was found to correlate significantly with the degree of abrasion for both proteins. Minimal disruption of the stratum corneum (less than 4% 3H2O penetration) was required to permit up to 50% Hev b 1 penetration. This was in contrast to the relationship observed for Hev b 6.02 where abrasion resulting in greater than 8% 3H2O penetration was required to permit more than 40% penetration of Hev b 6.02. Immunohistochemistry revealed Hev b 1 and Hev b 6.02 localized primarily in the stratum corneum when skin samples were intact and extending into the viable epidermis when abraded. These studies demonstrate that greater than 40% of Hev b 1 and Hev b 6.02 penetrate abraded skin with less abrasion required to achieve a higher degree of penetration with Hev b 1. Other factors including the amounts of individual proteins in latex products and physiological factors other than bioavailability through the skin must be considered in understanding the divergent antibody responses in HCW and SB patients.