Raulf Monika
Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum, Bochum, Germany.
Chem Immunol Allergy. 2014;100:248-55. doi: 10.1159/000358863. Epub 2014 May 22.
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.
巴西橡胶树的乳状汁液是天然橡胶乳胶(NRL)制品商业生产的原料,同时也是强效致敏蛋白的来源。随着生产适用于医疗产品(尤其是手套)的合适且柔韧的NRL材料技术能力的出现,NRL材料于1840年左右被引入医疗保健领域。20世纪80年代末,随着可传播疾病尤其是艾滋病毒感染的增加,NRL手套的使用量急剧上升。在20世纪90年代,NRL成为使用NRL手套的医护人员以及第一天接受手术的脊柱裂患者临床相关过敏的主要原因。对NRL过敏认识的提高、对过敏原特性和致敏机制研究的加强、在医疗机构开展的关于这种过敏的教育,以及引入蛋白质含量降低的无粉手套,这些都是与20世纪90年代末NRL过敏疑似病例数量下降相关的因素。NRL过敏是一个很好的“新过敏”例子,它突然出现并带来巨大的健康和经济影响,同时也是一个基于严格避免过敏原的成功一级预防策略在相对较短时间内成为历史的过敏案例。