Comparison of latex antigens from surgical gloves, ammoniated and nonammoniated latex: effect of ammonia treatment on natural rubber latex proteins.

Immediate hypersensitivity to latex proteins from contact with natural rubber latex gloves has been increasingly reported, especially in health care workers. Proteins in the latex responsible for these reactions may potentially be extractable, adsorbed on glove powder, or remain unextractable. Because these gloves are manufactured from ammoniated natural rubber latex, our knowledge on the effect of ammonia on latex proteins is incomplete. Therefore, we have investigated the effect of ammoniation on the protein profile and antigenicity or allergenicity of natural rubber latex proteins (NAL). Results indicate that ammonia treatment leads to breakdown and even precipitation of certain latex proteins. However, the antigenicity or allergenicity of NAL is preserved in the degraded proteins that present as extractable latex antigens of gloves. In addition to the proteins present in glove extract and proteins adsorbed to glove powder, certain latex proteins (23, 10, and 8 kd) remain firmly bound to glove film as "unextractable" latex antigens that cannot be removed by washing. The unextractable latex antigens may represent the antigens precipitated by ammonia treatment and may be associated with latex allergy.