Ylitalo L, Alenius H, Turjanmaa K, Palosuo T, Reunala T
Department of Dermatology, Tampere University Hospital and Medical School of the University of Tampere, Finland.
Clin Exp Allergy. 2000 Nov;30(11):1611-7. doi: 10.1046/j.1365-2222.2000.00924.x.
Natural rubber latex (NRL) allergy occurs frequently in children with spina bifida and other children with disorders requiring multiple operations. Also atopic children who have not undergone surgery can be sensitized to NRL, but the outcome of these children has not been studied.
To study how NRL-allergic children manage at home and whether their skin prick test (SPT) reactivity, latex RAST or IgE antibody levels to NRL allergens change during the follow-up.
Twenty-four NRL-allergic children who had not undergone surgery and eight children with histories of multiple operations were followed up for a mean of 2.8 years. Clinical symptoms were recorded and all children were re-examined with SPT, latex RAST and ELISA for IgE antibodies to prohevein (Hev b 6.01), hevein (Hev b 6.02) and rubber elongation factor (REF, Hev b 1).
Nineteen of the 24 NRL-allergic children (79%) who had not undergone surgery had occasionally contacts to balloons and other NRL products at home, and 10 of them experienced symptoms ranging from contact urticaria to systemic reactions. Three of the eight NRL-allergic children with a history of multiple operations had contacts to rubber balloons without any symptoms, and five children underwent 1-8 uneventful operations in a latex-free environment. SPT reactivity to NRL allergens, latex-RAST or IgE antibody levels to prohevein or hevein did not change in either group of NRL-allergic children during the follow-up.
Occurrence of clinical symptoms and no decrease in SPT reactivity or IgE levels to NRL allergens in the course of the present follow-up study imply that more attention should be paid to the protection of NRL-allergic children from rubber contacts in the home environment.
天然橡胶乳胶（NRL）过敏在脊柱裂患儿及其他需要多次手术的疾病患儿中频繁发生。未接受手术的特应性儿童也可能对NRL致敏，但尚未对这些儿童的情况进行研究。
研究NRL过敏儿童在家中的应对方式，以及在随访期间他们对NRL变应原的皮肤点刺试验（SPT）反应性、乳胶RAST或IgE抗体水平是否发生变化。
对24名未接受手术的NRL过敏儿童和8名有多次手术史的儿童进行了平均2.8年的随访。记录临床症状，所有儿童均再次接受SPT、乳胶RAST检测及酶联免疫吸附测定（ELISA），以检测其对原肌球蛋白（Hev b 6.01）、肌动蛋白（Hev b 6.02）和橡胶延伸因子（REF，Hev b 1）的IgE抗体。
24名未接受手术的NRL过敏儿童中有19名（79%）在家中偶尔接触气球及其他NRL产品，其中10名出现了从接触性荨麻疹到全身反应的症状。8名有多次手术史的NRL过敏儿童中有3名接触了橡胶气球但未出现任何症状，5名儿童在无乳胶环境下进行了1 - 8次平安无事的手术。在随访期间，两组NRL过敏儿童对NRL变应原的SPT反应性、乳胶RAST或对原肌球蛋白或肌动蛋白的IgE抗体水平均未发生变化。
在本次随访研究过程中，临床症状的出现以及对NRL变应原的SPT反应性或IgE水平未降低，这意味着应更加关注保护NRL过敏儿童在家庭环境中不接触橡胶制品。
