Latex Allergy Research Articles

Impact of Latex Sensitization on Asthma and Rhinitis Progression: A Study at Abidjan-Cocody University Hospital - Côte d’Ivoire (Progression of Asthma and Rhinitis related to Latex Sensitization)

Background: The frequency of latex allergy is increasing, posing a major health problem. This increase is related to the widespread use of latex materials and cross-reactions between latex proteins and certain foods. This cross-reactivity makes latex avoidance difficult, and latex sensitization is likely to worsen atopic conditions. Objective: The authors evaluated the role of latex sensitization in the poor control of asthma and rhinitis. Methodology: An analytical cross-sectional study was conducted on 1860 patients of all ages and genders, followed up for allergic asthma and rhinitis since March 2012 in the Immuno-Allergology Unit of the Cocody University Hospital in Abidjan. Prick tests with native extracts and the European standard battery were performed to identify allergenic sensitization. The impact of latex sensitization on asthma and rhinitis control was assessed by calculating odds ratios. Results: A high frequency of latex sensitization was associated with asthma and rhinitis. The risks of poor control were related to monosensitization to latex and were even higher in the context of polysensitization. Conclusion: The impact of latex sensitization on the progression of asthma and rhinitis has been well demonstrated. It is recommended to integrate the latex sensitization status into the therapeutic management strategy of these two pathologies.

Revisiting Latex-Fruit Syndrome after 30 Years of Research: A Comprehensive Literature Review and Description of Two Cases.

Thirty years have passed since the concept of latex-fruit syndrome (LFS) was first introduced. Since then, this phenomenon, characterized by cross-reactivity between natural latex rubber allergens and certain fruit allergens, has been extensively studied. This literature review sought to determine the prevalence of LFS in latex-allergic patients, identify the most common cross-reactions with fruit allergens in individuals with LFS, and understand the clinical manifestations of this syndrome. An extensive literature search was carried out using PubMed and Scopus databases, while applying the Preferred Reporting Items for Systematic Reviews and Meta-Analysis methodology. The analysis of original studies revealed a wide variation in LFS prevalence (4-88%) influenced by diverse diagnostic tools, different geographical regions, and the size of study populations. Our findings indicate that the most prevalent allergenic fruits in patients with LFS are banana, avocado, kiwifruit, and papaya. After evaluating the symptoms of the fruit hypersensitivity of patients with LFS, the clinical manifestation of hypersensitivity constituted 73% of systemic allergy symptoms and only 27% of reported symptoms described the localized allergy. Furthermore, the clinical picture of latex-fruit syndrome is illustrated through two cases, one typical and one with an unusual presentation. Their clinical features were assessed and contrasted utilizing different anaphylaxis severity grading criteria. To properly manage LFS, it is essential to establish standardized diagnostic criteria and severity grading systems, as these are crucial for accurate diagnosis and effective treatment.

Reduced protein levels in latex gloves may play an alternative approach to lowering latex sensitization risks among health workers; a cross-sectional analytical study

BackgroundLatex gloves are essential for protecting healthcare workers from biological hazards but pose a risk of latex allergy, particularly due to powdered, protein, and allergen content. Recent advancements in latex glove manufacturing have led to reduced levels of extractable proteins, a known factor triggering allergenic reaction. This study aimed to compare latex sensitization between nursing staff using low-protein and high-protein latex gloves at a tertiary university hospital in Thailand.MethodsA cross-sectional analytical study categorized participants into two groups based on glove exposure: the low extractable protein group (only exposed to non-powdered latex gloves with extractable protein levels below 50 µg/g) and the high extractable protein group (exposed to powdered latex gloves with levels above 50 µg/g). The sample size comprised 163 individuals in the low protein group and 318 in the high protein group (1:2). Latex allergy symptoms and sensitization were assessed using a self-administered questionnaire and latex-specific IgE measurement (ImmunoCAP), respectively. Data analysis involved descriptive and inferential statistics, including odds ratios and 95%CI.ResultsDemographic data was mostly similar in both exposure groups except for age. No significant differences in latex sensitization between the low and high protein groups were found via latex-specific IgE measurement (crude OR 1.90, 95%CI: 0.5, 7.18), potentially attributed to lower extractable protein levels in powdered latex gloves compared to previous studies. In contrast, the low protein group exhibited significantly fewer current latex allergy symptoms in both bivariate (crude OR 0.24, 95%CI: 0.06, 0.74) and multiple variable analysis (adjusted OR 0.18, 95%CI: 0.04, 0.86). Moreover, there was a significant reduction in latex allergy symptoms among the low protein group, decreasing from 9.8% who reported experiencing symptoms (when powdered latex gloves were used) to 1.2% who still reported current symptoms (OR 0.11, 95%CI: 0.02, 0.44).ConclusionsThis study underscores the importance of using non-powdered and low-protein latex gloves to reduce latex allergy symptoms while emphasizing the need for further investigation into the relationship between extractable protein levels in addition to the attempt of the major allergen removal and latex sensitization amid evolving glove manufacturing practices.

Utilizing the Banana S-Adenosyl-L-Homocysteine Hydrolase Allergen to Identify Cross-Reactive IgE in Ryegrass-, Latex-, and Kiwifruit-Allergic Individuals.

Food allergies mediated by specific IgE (sIgE) have a significant socioeconomic impact on society. Evaluating the IgE cross-reactivity between allergens from different allergen sources can enable the better management of these potentially life-threatening adverse reactions to food proteins and enhance food safety. A novel banana fruit allergen, S-adenosyl-L-homocysteine hydrolase (SAHH), has been recently identified and its recombinant homolog was heterologously overproduced in E. coli. In this study, we performed a search in the NCBI (National Center for Biotechnology Information) for SAHH homologs in ryegrass, latex, and kiwifruit, all of which are commonly associated with pollen-latex-fruit syndrome. In addition, Western immunoblot analysis was utilized to identify the cross-reactive IgE to banana SAHH in the sera of patients with a latex allergy, kiwifruit allergy, and ryegrass allergy. ClustalOmega analysis showed more than 92% amino acid sequence identity among the banana SAHH homologs in ryegrass, latex, and kiwifruit. In addition to five B-cell epitopes, in silico analysis predicted eleven T-cell epitopes in banana SAHH, seventeen in kiwifruit SAHH, twelve in ryegrass SAHH, and eight in latex SAHH, which were related to the seven-allele HLA reference set (HLA-DRB1*03:01, HLA-DRB1*07:01, HLA-DRB1*15:01, HLA-DRB3*01:01, HLA-DRB3*02:02, HLA-DRB4*01:01, HLA-DRB5*01:01). Four T-cell epitopes were identical in banana and kiwifruit SAHH (positions 328, 278, 142, 341), as well as banana and ryegrass SAHH (positions 278, 142, 96, and 341). All four SAHHs shared two T-cell epitopes (positions 278 and 341). In line with the high amino acid sequence identity and B-cell epitope homology among the analyzed proteins, the cross-reactive IgE to banana SAHH was detected in three of three latex-allergic patients, five of six ryegrass-allergic patients, and two of three kiwifruit-allergic patients. Although banana SAHH has only been studied in a small group of allergic individuals, it is a novel cross-reactive food allergen that should be considered when testing for pollen-latex-fruit syndrome.

Guidelines in Practice: A Safe Environment of Care.

Creating a safe environment for performing surgical procedures is essential to achieve successful patient outcomes and protect the perioperative personnel who are providing care. Numerous factors challenge the provision of a safe environment of care and create a complex setting for perioperative nurses to manage. The updated AORN "Guideline for a safe environment of care" provides perioperative nurses with recommendations for establishing a safe environment for both patients and personnel. This article provides an overview of the guideline and discusses recommendations for implementing fire safety protocols, using warming cabinets, and creating a latex-safe environment. It also includes a scenario describing the care of a patient with an unidentified latex allergy who is undergoing a laparoscopic sleeve gastrectomy and hiatal hernia repair. Perioperative nurses should review the guideline in its entirety and implement recommendations as applicable in operative and other procedural settings.

Analysis of the electrophoretic profiles of the protein extracts of the species Manihot esculenta (Crantz, 1975), Persea Americana (Mill., 1768) and Actinidia delicious (A. Chevalier., 1984), and their association with the latex-fruit syndrome for searching for potential allergens

Determine the electrophoretic profiles of the extracts of Manihot esculenta, Actinidia Deliciosa and Persea Americana and their possible relationship with Latex-Fruit Syndrome. Protein extracts of M. esculenta, P. Americana and A. Deliciosa were prepared through the processes of maceration and solvent extraction from plant samples. In the case of the avocado, a prior extraction by soxhlet was carried out to eliminate the fat. The extracts were vacuum filtered, dialyzed and finally lyophilized. Separation of proteins based on molecular weight was performed by SDS PAGE electrophoresis. The electrophoretic profiles obtained were compared with the allergenic proteins previously identified in the latex extract, in order to determine a possible relationship with Latex-Fruit Syndrome, depending on the molecular weight. The extracts of M. esculenta and P. Americana showed a wide range of protein fractions with molecular weights varying from 10 to 250 KD, finding that the region with the highest concentration of bands was between 20 and 89 KD, (60 and 65%), respectively. A 20-band profile was obtained for the M. esculenta extract (Figure 1), with seven bands sharing similar weights with the latex allergens (Hev b 1, Hev b 2, Hev b3, Hev b 4, Hev b 5, Hev b 6.03, Hev b 8 and Hev b 10) (3-5). For the P. Americana extract, 20 bands were also observed (Figure 2), seven of which presented approximate weights to the Latex allergens (Hev b 1, Hev b 2 Hev b 4 Hev b 6.01 Hev b 6.03 Hev b 8 , Hev b 10 Hev b 11 Hev b 14). The Kiwi extract showed two bands of 19.1 and 22.9 KD, with weights close to latex proteins (figure 3), (Hev b 3 and Hev b 6.01), and allergens (Act d 2 and Act d 6), reported in the literature for this fruit. When analyzing the relationship between the separated protein fractions and the latex allergens described in the literature, a possible association of 35% was found for the extracts of M. esculenta and P. Americana, and 10% for A. Delicious, with great relevance being the association found with the allergens Hev b 4, Hev b 2, Hev 8 and Hev b 11, which are involved in Latex-Fruit Syndrome. The electrophoretic profiles of the prepared extracts were determined and compared with the Latex allergens. This information generates a contribution for the development of new research and advances in the standardization of these extracts on a large scale and for their future use in diagnostic tests.

Latex Allergy - From Discovery to Component-resolved Diagnosis.

Latex allergy is a hypersensitivity response to natural rubber latex (NRL) proteins or rubber chemicals used in the manufacture of latex products. An accurate diagnosis is the first step in the effective management of individuals with latex allergy, especially in high-risk groups, such as healthcare workers and those affected by spina bifida. Diagnosis is based on the clinical history and an accurate allergological evaluation. In the case of type I IgE-mediated hypersensitivity reactions, which can manifest urticaria, angioedema, rhinoconjunctivitis, asthma and anaphylaxis after latex exposure, skin prick tests or latex-specific IgE (sIgE) antibody detection using serological assays can be performed to confirm sensitization. Instead, in the case of contact dermatitis, a patch test can be applied to confirm the presence of a type IV T cell-mediated hypersensitivity reaction to rubber accelerators or additives. Basophils activation tests or challenge tests may be performed if there's an incongruity between the clinical history and the results of in vivo and in vitro tests. The aim of this review is to analyze the current state of the art of diagnostic techniques for latex allergy and algorithms employed in clinical practice and possible future developments in this field.

Global assessment of the knowledge and confidence in managing allergic disorders among primary care pediatricians across Europe: An EAACI task force report.

Pediatricians are often the first point of contact for children in Primary Care (PC), but still perceive gaps in their allergy knowledge. We investigated self-perceived knowledge gaps and educational needs in pediatricians across healthcare systems in Europe so that future educational initiatives may better support the delivery of allergy services in PC. A multinational survey was circulated to pediatricians who care for children and adolescents with allergy problems in PC by the EAACI Allergy Educational Needs in Primary Care Pediatricians Task Force from February to March 2023. A 5-point Likert scale was used to assess the level of agreement with questionnaire statements. Thirty surveys per country were the cut-off for inclusion and statistical analysis. In this study, 1991 respondents were obtained from 56 countries across Europe and 210 responses were from countries with a cut-off below 30 participants per country. Primary care pediatricians (PCPs) comprised 74.4% of the respondents. The majority (65.3%) were contracted to state or district health services. 61.7% had awareness of guidelines for onward allergy referral in their countries but only 22.3% were aware of the EAACI competencies document for allied health professionals for allergy. Total sample respondents versus PCPs showed 52% and 47% of them have access to allergy investigations in their PC facility (mainly specific IgE and skin prick tests); 67.6% and 58.9% have access to immunotherapy, respectively. The main barrier to referral to a specialist was a consideration that the patient's condition could be diagnosed and treated in this PC facility, (57.8% and 63.6% respectively). The main reasons for referral were the need for hospital assessment, and partial response to first-line treatment (55.4% and 59.2%, 47% and 50.7%, respectively). Learning and assessment methods preference was fairly equally divided between Traditional methods (45.7% and 50.1% respectively) and e-learning 45.5% and 44.9%, respectively. Generalist physicians (GPs) have the poorest access to allergy investigations (32.7%, p = .000). The majority of the total sample (91.9%) assess patients with allergic pathology. 868 (43.6%) and 1117 (46.1%), received allergy training as undergraduates and postgraduates respectively [these proportions in PCPs were higher (45% and 59%), respectively]. PCPs with a special interest in allergology experienced greater exposure to allergy teaching as postgraduates. GPs received the largest amount of allergy teaching as undergraduates. Identifying allergic disease based on clinical presentation, respondents felt most confident in the management of eczema/atopic dermatitis (87.4%) and rhinitis/asthma (86.2%), and least confident in allergen immunotherapy (36.9%) and latex allergy (30.8%). This study exploring the confidence of PCPs to diagnose, manage, and refer patients with allergies, demonstrated knowledge gaps and educational needs for allergy clinical practice. It detects areas in need of urgent improvement especially in latex and allergen immunotherapy. It is important to ensure the dissemination of allergy guidelines and supporting EAACI documents since the majority of PCPs lack awareness of them. This survey has enabled us to identify what the educational priorities of PCPs are and how they would like to have them met.

Safety of EUS latex balloon use in patients with a latex allergy

Balloons are used in endoscopic ultrasonography (EUS) to improve visualization. However, data on the safety of latex balloons in patients with latex allergies is limited, and non-latex alternatives can be costly. We aimed to investigate the safety of latex balloon use during EUS. A retrospective review was conducted at a tertiary center between 2019-2022. Patients with reported latex allergies who underwent linear EUS were included. Baseline demographics, EUS characteristics, and adverse events were collected. The primary outcome was the rate of adverse events. 87 procedures were performed on 57 unique patients (mean age 65.3± 14.5 years). Latex balloons were used in 59 procedures (67.8%), with only 8 procedures (13.6%) using prophylactic medications. No adverse events occurred during or after procedures, regardless of medication use or history of anaphylaxis. The use of EUS latex balloons in patients with a latex allergy was associated with no adverse events.

Assessing the impact of the COVID-19 pandemic on latex glove usage and latex allergy complaints among nurses: A descriptive study.

The coronavirus 2019 (COVID-19) pandemic has led to a significant increase in the use of latex gloves among nurses. However, concerns about the rise in latex allergies and related complaints due to this increase remain uncertain. This study aims to assess the rates of latex glove usage and allergy-related complaints among nurses working in hospitals during the COVID-19 pandemic. Between May 15 and June 15, 2021, ethical approvals were obtained for a cross-sectional study involving 448 volunteer nurses. Descriptive statistics were used to represent categorical values as counts (n) and percentages (%), while continuous values were represented as mean±standard deviation. The normal distribution of the data was assessed using the Kolmogorov-Smirnov and Shapiro-Wilk tests. Comparative analyses were conducted using paired sample t-test, Pearson's chi-squared (x2) test, McNemar's chi-squared (x2) test, and Spearman correlation analysis. Before the pandemic, the average number of invasive procedures was 45.13±26.48, whereas during the pandemic, this rate increased to 50.23±29.14. The average glove usage duration went from 7.69±3.13 hours to 14.73±3.68 hours during the pandemic. Among nurses, the rate of allergic symptoms, which was previously at 31.5%, rose to 33.3% during the pandemic. This study revealed a significant increase in daily invasive procedures and the use of latex gloves among nurses during the pandemic period. Simultaneously, the frequency of allergic symptoms also rose. These findings underscore the importance of awareness and preventive measures, particularly regarding latex allergies, in the healthcare field.

A Current Overview of Latex Allergy

A Current Overview of Latex Allergy

Latex Allergy in Children.

Notwithstanding the efforts made in the last decades to mitigate the consequences of natural rubber latex allergy, this disease continues to be a major health problem, especially in developing countries. The categories of patients with greater and frequent exposure to latex (such as health care professionals and, in the pediatric field, subjects who undergo repeated surgery, e.g., those suffering from spina bifida and urogenital malformations) have an increased risk of developing sensitization and allergy to latex. Herein we provide an overview of the current knowledge and practical recommendations with a focus on epidemiology, diagnostics, and management (including both prevention and therapy) in order to guide a correct recognition and containment of this potentially fatal condition.

Latex allergy in healthcare workers: A review

Allergy to latex is one of the reported concerns among healthcare workers. It has been found in various studies that latex sensitivity is 3–5 times higher in doctors and nurses as compared to non-healthcare workers. The main source of latex allergy is exposure to powdered gloves. Chronic exposure to latex can lead to various symptoms such as pruritus, dermatitis, erythema and urticaria, rhinitis, conjunctivitis, and asthma. There is sparse Indian data due to a lack of awareness and diagnostic facilities; therefore, studies are required to evaluate latex-related symptoms and sensitisation with the use of powdered gloves as compared to the use of non-powdered gloves and to institute appropriate preventive strategies.

Cost-effective method to prevent latex allergy in healthcare workers

Cost-effective method to prevent latex allergy in healthcare workers

Аллергия на латекс

Latex, made from Hevea brasiliensis sap, is the material used to make many medical products, including catheters, balloons and gloves. Hundreds of allergens from natural rubber latex have been identified, and 15 of them were numbered, from Hev b1 to Hev b15. Natural proteins in rubber cause both asymptomatic sensitization and type I IgE-mediated hypersensitivity. Treatment of latex makes use of chemical antioxidants that can also bring about type IV hypersensitivity reactions. Latex allergy is one of the most common causes of anaphylaxis in the operating room, and its prevalence has been growing since 1980s, together with the popularity of latex gloves. It is a well-known problem among medical professionals, with gloves and inhaled aerosol particles being the sources thereof. This study aimed to review the current scientific research and practical data in this only partially investigated area. In addition, increasing the awareness of doctors and patients minimizes the existing risks of latex allergy.

A Case Report of Anaphylaxis in Health Care Personnel: The Importance of History-Taking and Occupational Health Management

The authors described a 43-year-old male Thai practical nurse (PN) who developed anaphylaxis several times between 2013 and 2019, possibly caused by jackfruit (Artocarpus heterophyllus) and eggplant (Solanum melongena) ingestion. The occupational medicine physician suspected that the anaphylaxis might be due to a cross reaction of these plants to latex protein in medical gloves as this PN had a history of contact urticaria while using disposable latex gloves in December 2014. The symptoms disappeared after he used sterile latex powdered gloves with reusable. According to the history and the result of specific IgE against latex of 28.1 KUA/L and jackfruit of 1.61 KUA/L, although no skin prick test was performed, he was then diagnosed with latex-fruit syndrome. The use of nitrile gloves and latex products avoidance were advised. At the 1-year follow-up, he had no recurrent allergic symptoms or anaphylaxis. Keywords: Anaphylaxis; Eggplant; Jackfruit; Latex allergy; Latex-fruit syndrome

Integrated approaches to prevent exposure risks related to latex-derived products

Natural rubber latex is a widely used industrial raw material to produce many consumer and commercial products. Chronic exposures to latex allergenic proteins residual in the finished products can promote hypersensitive immune responses, which affects millions of workers and the general public worldwide. Research has shown the average prevalence of latex allergy worldwide remains approximately 10% among healthcare workers, 7% among susceptible patients, and 4% among general population. Although most effective in preventing latex allergy, completely avoiding contact to latex-derived products is extremely challenging, given the fact that millions of products possibly contain latex, but few are regulated and properly labeled. Due to the difficulty to assure a product completely absent of latex allergens, the United States Food and Drug Administration has recommended to stop using labels like “latex-free” or “does not contain latex.” Here we evaluate published data, industrial standards and regulations, identify possible countermeasures, and propose an integrated strategy, including some more practicable approaches (e.g., education/training, product labeling, the use of proper personal protective equipment, occupational selection, and searchable product database) and novel medical treatments (e.g., immunotherapy) to help decreasing latex allergy prevalence.

Identification of S-adenosyl-l-homocysteine hydrolase from banana fruit as a novel plant panallergen

Banana allergy is often associated with the pollen and latex allergies, which led us to the hypothesis that some yet unidentified banana allergen could provide a basis of the latex-pollen-fruit syndrome. S-adenosyl-l-homocysteine hydrolase (SAHH) was recently identified in the literature as a novel plant allergen. This study aimed to assess the allergenic potential of the naturally occurring banana SAHH (nSAHH) and its recombinant homolog produced in E. coli (rSAHH). nSAHH showed IgE reactivity with a serum pool of twelve banana-allergic persons, while rSAHH displayed IgE reactivity in ten out of the twelve tested patients. Five linear B-cell epitopes were identified on the rSAHH surface, exhibiting ≥ 90 % sequence homology with relevant plant SAHH allergens. Our findings have elucidated SAHH as a novel plant panallergen, underlying the cross-reactivity between plant-derived food and respiratory allergens, confirming our initial hypothesis.

Synergistic effects of gold nanoparticles enhanced the sensitivity of enzyme-linked immunosorbent assay for latex allergens

Hevea brasiliensis rubber elongation factor (Hev b1), a non-glycosylated protein, is a notable allergen in natural latex products. This study aims to assess enzyme-linked immunosorbent assay (ELISA) combined with gold nanoparticles (AuNPs) as a Hev b1 detection substrate. AuNP synthesis precursor and reducing agent concentrations were optimized using factorial design and multiple linear regression (MLR). The optimized conditions yielded spherical AuNPs with an average particle size of 73 ± 23 nm. This substrate enhanced detection sensitivity by around 50% compared to the limit of detection of the bare substrate, in the linear range of 0.25–1.75 μg/mL. Additionally, the heightened absorbance intensity observed during Hev b1 ELISA signifies both augmented surface immobilization of the analyte and optical induction arising from the aggregation of suitably small AuNPs (<80 nm) into dimer clusters, supported by discrete dipole approximation (DDA). Overall, the findings highlighted the synergistic effects of AuNPs in enhancing the performance of ELISA for Hev b1 detection.

Prevalence of Type I Allergy to Latex and Type IV Allergy to Rubber Additives in Turkish Healthcare Workers.

Glove-induced dermatoses are frequently seen among healthcare workers (HCWs) and are often mistakenly defined as latex allergy. To determine the prevalences of (i) the symptoms of immediate type hypersensitivity reactions, (ii) the symptoms of hand eczema, (iii) latex sensitization detected using skin prick test (SPT), and (iv) contact hypersensitivity to rubber additives or glove pieces detected using patch test, in Turkish HCWs. Ninety-eight HCWs were included in the study. All subjects completed a questionnaire. All participants were skin prick tested for latex, and foods previously identified as concomitant allergens in latex-sensitive individuals; patch tested for 7 rubber additives, 3 additional haptens, and glove pieces. The mean age was 32.1 (± 9.4) years, and 71 (72.4%) participants were nurses. Eighty-four (85.7%) subjects had a history of mucocutaneous symptoms of immediate-type hypersensitivity occurring within the first 24 hours after latex glove contact, while 9 (9.2%) subjects demonstrated SPT positivity for latex. Eighty (81.6%) subjects had a history of glove-induced hand eczema symptoms, while patch test positivity for the rubber additives or glove pieces was in 17.3%. About one-tenth of those with a history of glove-induced type I hypersensitivity symptoms had true latex allergy, and one-quarter of those with a history of glove-related hand eczema symptoms had contact hypersensitivity to glove products. Therefore, rote avoidance of latex use is generally ineffective in the management of glove-related skin complaints. Individual measures should focus on reducing the use of soaps and disinfectants, and promoting the use of moisturizers, rather than glove choice.