In vivo sensitization to purified Hevea brasiliensis proteins in health care workers sensitized to natural rubber latex
Open accessAbstract
Background Thirteen proteins of natural rubber latex (Hevea brasiliensis) known to bind human IgE have been isolated and characterized as Hev b allergens. However, the in vivo importance of native Hev b allergens has not been defined in health care workers (HCWs) with natural rubber latex (NRL) allergy.Objectives The principal aim of this study was to identify the major in vivo Hev b allergens in HCWs with NRL allergy confirmed by percutaneous sensitivity to nonammoniated latex (NAL).Methods Skin prick testing was performed with 7 (native) proteins purified from NAL (Hev b 1, 2, 3, 4, 6.01, 7.01, and a newly described Hev b 13) and recombinant Hev b 5 in 62 HCWs with histories of NRL allergy (group 1) confirmed by percutaneous reactivity to NAL and in 49 atopic HCWs without NRL allergy (group 2). Serial 10-fold concentrations of Hev b proteins (5 x 10(-5) microg/mL to 50 microg/mL) were tested; serum samples of subjects were assayed for serum specific IgE by immunoassays.Results Hev b 2, Hev b 5, Hev b 6.01, and Hev b 13 produced skin reactions in more than 60% of group 1 subjects, with Hev b 1, 3, 4, and 7.01 eliciting reactions in less than 50%. Only 1 of 49 group 2 workers reacted to a single Hev b antigen (Hev b 13). Specificity of 7 Hev b allergens was 100% and 98% for Hev b 13 in identifying workers with confirmed NRL allergy. Specific IgE by AlaSTAT and CAP immunoassays was elevated in 40 of 60 (67%) and 33 of 62 (53%) of NAL-reactive workers and produced false-positive test results in 4 of 49 (8%) and 3 of 48 (6%) group 2 subjects, respectively.Conclusion Hev b 2, 5, and 6.01 are major in vivo allergens and Hev b 13 is a new major in vivo allergen among HCWs with allergy to NRL.
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Modern SPT of aeroallergens can be up to 25% more sensitive than specific IgE serology depending on the patient population and methodologies employed.
“Modern SPT of aeroallergens can be up to 25% more sensitive than sIgE serology depending on the patient population and the methodologies employed.793,930-934”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [933]
The Environmental and occupational disorders section says latex skin prick testing was more sensitive than serum-specific IgE assays for detecting natural rubber latex allergy in health care workers. The Study design section mentions aeroallergen skin tests, but the serum IgE tests measured latex; the paper does not establish the claimed comparison for aeroallergens or the ‘up to 25%’ figure. (LLM, conf=0.88)
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- Authors
- Bernstein, D. I., Biagini, R. E., Karnani, R., Hamilton, R., Murphy, K., Bernstein, C., Arif, S. A. M., Berendts, B., & Yeang, H. Y.
- Affiliations
- University of Cincinnati (US)
- National Institute for Occupational Safety and Health (US)
- Centers for Disease Control and Prevention (US)
- Bernstein Clinical Research Center (US)
- Venue
- Journal of Allergy and Clinical Immunology
- Publisher
- Elsevier BV
- Published
- 2003-03
- Volume
- 111
- Issue
- 3
- Pages
- 610-616
- ISSN
- 0091-6749 (ISSN-L)
- OpenAlex
- W2098577852
- Cited by
- 102
- References
- 14
- Citations by year
- 2025: 2 · 2023: 4 · 2021: 1 · 2020: 2 · 2018: 2 · 2017: 3 · 2016: 4 · 2015: 5 · 2014: 3 · 2013: 3 · 2012: 6
- FWCI
- 12.26
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Allergy and Clinical Immunology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Environmental Health Sciences (Y02ES10189)
- National Institute for Occupational Safety and Health
- Topics
- Health Sciences › Medicine › Dermatology › Contact Dermatitis and Allergies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational exposure and asthma
- Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
- Keywords
- latex allergy, healthcare workers, skin prick test, specific IgE, allergen identification
- MeSH terms
- Adult, Aged, Allergens, Female, Health Personnel, Humans, Immunoassay, Male, Middle Aged, Plant Proteins, Skin Tests, Latex Hypersensitivity, Hevea, Antigens, Plant
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