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 3 H 2 O 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 Cutaneous and Ocular Toxicology Downloaded from informahealthcare.com by McMaster University on 12/26/14 For personal use only.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% 3 H 2 O 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% 3 H 2 O 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.

Immunomodulatory roles of endotoxin and glutaraldehyde in the development of latex allergy

“…In contrast, it has been shown that bioavailability following dermal exposure is largely dependent on the condition of the skin. Recent studies using hairless guinea pigs have demonstrated that approximately 30 -50% of the applied dose of latex proteins penetrates into or through the skin following dermal application to disrupted skin (Hayes et al, 2000;Howell et al, 2002a). Following intratracheal aspiration it has been shown that greater than 75% of the applied intratracheal dose reaches the lungs and is therefore available for induction of an immune response (Ann Hubbs, personal communication).…”