Kurup Viswanath P, Sussman Gordon L, Yeang Hoong Y, Elms Nancy, Breiteneder Heimo, Arif Siti A M, Kelly Kevin J, Bansal Naveen K, Fink Jordan N
Allergy-Immunology Division, Medical College of Wisconsin, Milwaukee, WI, USA.
Clin Mol Allergy. 2005 Aug 10;3:11. doi: 10.1186/1476-7961-3-11.
In recent years, allergy to natural rubber latex has emerged as a major allergy among certain occupational groups and patients with underlying diseases. The sensitization and development of latex allergy has been attributed to exposure to products containing residual latex proteins. Although improved manufacturing procedures resulted in a considerable reduction of new cases, the potential risk for some patient groups is still great. In addition the prevalent cross-reactivity of latex proteins with other food allergens poses a major concern. A number of purified allergens and a few commercial kits are currently available, but no concerted effort was undertaken to evaluate them.
We studied 11 purified latex allergens, Hev b 1 to Hev b 10, and Hev b 13 along with several crude allergen extracts and two commercial ImmunoCAP assays to evaluate specific IgE antibody in the sera from latex allergic patients and controls. Health care workers and spina bifida patients with clinical symptoms of latex allergy, spina bifida patients without latex allergy, and non-atopic health care workers have been studied.
The results suggest that Hev b 2, 5, 6, and 13 together identified over 80 percent health care workers with latex allergy, while Hev b 6 along with Hev b 1 or 3 detected specific IgE antibody in all sera studied from patients with spina bifida and latex allergy. The ImmunoCAP results using both Hev b 5 amplified and non-amplified closely agreed with the clinical diagnosis of latex allergy in health care workers and in spina bifida.
Although the purified allergens and crude extracts reacted diversely with IgE from different patient groups, the results indicated that use of certain combinations of purified recombinant antigens will be useful in commercial kits or in in-house assays for detecting specific IgE antibody in the sera. The results suggest that a combination of Hev b 2, 3, 5, 6, and 13 together detected specific IgE in 80% of the sera from latex allergic patients. Both ImmunoCAPs correctly identified over 95% of latex allergic patients, however, showed reactivity with a few normal control subjects.
近年来，天然橡胶乳胶过敏已成为某些职业群体和患有基础疾病患者中的一种主要过敏症。乳胶过敏的致敏和发展归因于接触含有残留乳胶蛋白的产品。尽管改进的制造工艺使新病例大幅减少，但对某些患者群体来说潜在风险仍然很大。此外，乳胶蛋白与其他食物过敏原普遍存在的交叉反应性也引起了人们的重大关注。目前有多种纯化过敏原和一些商业试剂盒，但尚未进行协同努力来评估它们。
我们研究了11种纯化的乳胶过敏原，即Hev b 1至Hev b 10以及Hev b 13，同时研究了几种粗制过敏原提取物和两种商业免疫捕获检测方法，以评估乳胶过敏患者和对照血清中的特异性IgE抗体。研究对象包括有乳胶过敏临床症状的医护人员和脊柱裂患者、无乳胶过敏的脊柱裂患者以及非特应性医护人员。
结果表明，Hev b 2、5、6和13共同识别出超过80%的乳胶过敏医护人员，而Hev b 6与Hev b 1或3一起在所有来自脊柱裂且有乳胶过敏患者的研究血清中检测到特异性IgE抗体。使用Hev b 5扩增和未扩增的免疫捕获检测结果与医护人员和脊柱裂患者乳胶过敏的临床诊断高度一致。
尽管纯化过敏原和粗提物与不同患者群体的IgE反应各异，但结果表明，使用某些纯化重组抗原组合将有助于商业试剂盒或内部检测中检测血清中的特异性IgE抗体。结果表明，Hev b 2、3、5、6和13组合在80%的乳胶过敏患者血清中检测到特异性IgE。两种免疫捕获检测均正确识别出超过95%的乳胶过敏患者，然而，也显示出与一些正常对照受试者有反应。
