Natural rubber latex and chestnut allergy: cross‐reactivity or co‐sensitization?

Raulf‐Heimsoth, Monika; Kespohl, S.; Crespo, Jesús F.; Rodríguez, Julia; Felíu, A. Reig; Brüning, T.; Rihs, Hans‐Peter

doi:10.1111/j.1398-9995.2007.01489.x

Cited by 35 publications

(18 citation statements)

References 14 publications

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“…Thus, the existence of the clinically well-established latex-fruit syndrome needs to be explained by other families of cross-reactive allergens such as profilins, β1,3-glucanases and non-specific lipid transfer proteins. In contrast to its apparent minor clinical relevance in the pollen-plant food cross-reactivity (Wensing et al, 2002), a role of profilin as the dominant allergen responsible for the cross-reactivity between chestnut and latex was suggested by a study performing IgE inhibition assays with sera of latex sensitized, chestnut-allergic patients (Raulf-Heimsoth et al, 2007). Hence, the results of the present study may initiate further examination of the cross-reactivity and clinical relevance for food allergy of latex allergens other than hevein.…”

Section: Discussionmentioning

confidence: 99%

Latex-allergic patients sensitized to the major allergen hevein and hevein-like domains of class I chitinases show no increased frequency of latex-associated plant food allergy

Radauer

Adhami

Fürtler

et al. 2011

Molecular Immunology

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Allergies to certain fruits such as banana, avocado, chestnut and kiwi are described in 30–70% of latex-allergic patients. This association is attributed to the cross-reactivity between the major latex allergen hevein and hevein-like domains (HLDs) from fruit class I chitinases. We aimed to assess the extent of cross-reactivity between hevein and HLDs using sera from latex-allergic patients with and without plant food allergy. Hevein and HLDs of latex, banana, and avocado chitinases were expressed in Escherichia coli as fusion proteins with the maltose-binding protein and purified by affinity chromatography. IgE binding to these proteins was studied in sera from 59 latex-allergic patients and 20 banana-allergic patients without latex allergy by ELISA and ELISA inhibition. Additionally, 16,408 allergic patients’ sera were tested for IgE binding to hevein, latex chitinase, and wheat germ agglutinin using an allergen microarray. Hevein-specific IgE was detected in 34/59 (58%) latex-allergic patients’ sera. HLDs of latex, banana, and avocado chitinases were recognized by 21 (36%), 20 (34%), and 9 (15%) sera, respectively. In contrast, only one of 20 banana-allergic patients without latex allergy was sensitized to chitinase HLDs. In most tested latex-allergic patients’ sera, IgE binding to hevein was only partially reduced by preincubation with HLDs. Among hevein-sensitized, latex-allergic patients, the percentage of plant food allergy (15/34 = 44%) was equal to latex-allergic patients without hevein sensitization (11/25 = 44%). In the general allergic population, 230 of 16,408 sera (1.4%) reacted to hevein and/or a hevein-like allergen. Of these, 128 sera showed an isolated sensitization to hevein, whereas only 17 bound to latex chitinase or wheat germ agglutinin without hevein sensitization. In conclusion, the IgE response to HLDs is elicited by hevein as sensitizing allergen in most cases. Despite considerable cross-reactivity between these allergens, no correlation between latex-associated plant food allergy and sensitization to hevein or HLDs was found.

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Section: Discussionmentioning

confidence: 99%

Latex-allergic patients sensitized to the major allergen hevein and hevein-like domains of class I chitinases show no increased frequency of latex-associated plant food allergy

Radauer

Adhami

Fürtler

et al. 2011

Molecular Immunology

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“…The association was called latexfruit syndrome [ 35 , 36 ] and a huge and constantly increasing number of fruits are described, and the most commonly involved are avocado, banana, chestnut and kiwi. Several latex allergens have been discussed as being responsible for the latex-fruit cross-reactivity, such as Hev b 2 [37] , Hev b 6.02 [38][39][40] , Hev b 7 [41] , Hev b 8 [42] and Hev b 12 ( fig. 2 ) [43] .…”

Section: Latex-fruit/plant Syndrome -Problems With Cross-reactivitymentioning

confidence: 99%

The Latex Story

Raulf

2014

History of Allergy

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The milky sap of the rubber tree Hevea brasiliensis is the source of the commercial production of natural rubber latex (NRL) devices, and also represents a source of potent allergenic proteins. NRL materials were introduced in the health care field in about 1840 with the advent of technical abilities to produce suitable and flexible NRL materials for medical products, especially gloves. In the late 1980s, with the increase of transmittable diseases, particularly HIV infection, the use of NRL gloves increased dramatically. During the 1990s, NRL emerged as a major cause of clinically relevant allergy in health care workers using NRL gloves and spina bifida patients with operation on the first day. The increased recognition of NRL allergies, the enhanced research on allergen characterization and sensitization mechanisms, and education about this allergy in health care facilities combined with the introduction of powder-free gloves with reduced protein levels are all factors associated with a decline in the number of suspected cases of NRL allergies in the late 1990s. NRL allergy is a very good example of a 'new allergy' that suddenly arises with tremendous health and economic implications, and also of an allergy which becomes history in a relatively short period of time based on successful primary prevention strategies by strict allergen avoidance.

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“…This practice has led to a sustained, widespread prevalence of latex allergy among health care workers, which has been proved in earlier studies [1,2]. The risk of latex allergy may be attributed to several factors, including recurrent exposure to latex or cross-reactive tropical fruits or vegetables as well as atopy [3,4,5,6,7,8]. Thus, health care workers, industry workers exposed to natural rubber latex and people undergoing multiple medical interventions may be particularly predisposed [9].…”

Section: Introductionmentioning

confidence: 99%

Clinical Value of Conjunctival Allergen Challenge in Diagnosing Allergic Conjunctivitis Related to Latex

Chełmińska

Niedoszytko

Jassem³

2010

Int Arch Allergy Immunol

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Background: The clinical value of conjunctival allergen challenge (CAC) with latex allergen in patients with allergic conjunctivitis remains undefined. The aim of this study was to assess the value of conjunctival allergen challenge with latex extract in a group of patients with latex sensitization and a history of conjunctivitis after contact with latex products. Methods: Fifty patients who had symptoms of conjunctivitis following contact with latex were studied. The control group consisted of 30 subjects without any symptoms of conjunctivitis, negative skin prick test and sIgE <0.35 kU/l for latex. Questionnaires on signs and symptoms, skin prick tests with latex, sIgE and CAC with latex extract were administered. The study was performed at the Department of Allergology of the Medical University of Gdansk in Poland. Results: CAC with latex was positive in 46 patients (92%) and in none of the control group. CAC was the most sensitive diagnostic method (92% sensitivity and 100% specificity). The sensitivity of other methods (skin prick test and sIgE) was lower: 84 and 88%, respectively. Provocation did not induce any serious adverse events. Conclusion: Our study demonstrated the high sensitivity and safety of CAC with the extract of latex allergens in the diagnosis of patients with latex allergy. This method may be considered a diagnostic option in cases with uncertain diagnosis.

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Natural rubber latex and chestnut allergy: cross‐reactivity or co‐sensitization?

Abstract: Although patients have concomitant IgE antibody reactivity to chestnut and NRL, cross-reactivity could be demonstrated mainly in those patients with IgE to Hev b 8 (profilin) from NRL.

Cited by 35 publications

References 14 publications

Latex-allergic patients sensitized to the major allergen hevein and hevein-like domains of class I chitinases show no increased frequency of latex-associated plant food allergy

Latex-allergic patients sensitized to the major allergen hevein and hevein-like domains of class I chitinases show no increased frequency of latex-associated plant food allergy

The Latex Story

Clinical Value of Conjunctival Allergen Challenge in Diagnosing Allergic Conjunctivitis Related to Latex

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