In vivo sensitization to purified Hevea brasiliensis proteins in health care workers sensitized to natural rubber latex
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- 作者：David I. Bernstein ; Raymond E. Biagini ; Ravi Karnani ; Robert Hamilton ; Karen Murphy ; Cheryl Bernstein ; Siti Arija M. Arif ; Brian Berendts ; H. Y. Yeang
- 刊名：Journal of Allergy and Clinical Immunology
- 出版年：2003
- 出版时间：March 2003
- 年：2003
- 卷：111
- 期：3
- 页码：610-616
- 全文大小：151 K
文摘
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 × 10−5 μg/mL to 50 μg/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. (J Allergy Clin Immunol 2003;111:610-6.)