Vandenplas O
Dept of Chest Medicine, Mont-Godinne Hospital, Catholic University of Louvain, Yvoir, Belgium.
Eur Respir J. 1995 Nov;8(11):1957-65. doi: 10.1183/09031936.95.08111957.
IgE-mediated sensitization in protein allergens of natural rubber latex (NRL) can induce immediate hypersensitivity reactions ranging from mild urticaria in life threatening anaphylaxis after cutaneous, mucosal or visceral exposure. Elutable allergens from NRL gloves absorb to the cornstarch powder particles, become airborne, and have the potential to cause respiratory reactions. Recent studies indicate that asthma is a frequent manifestation of NRL allergy among workers manufacturing NRL materials and among health-care providers using NRL workers. NRL-induced asthma should receive increasing attention as it can lead to permanent respiratory sequelae and occupational disability. The need for early and accurate diagnosis is outlined and the different diagnostic approaches are reviewed. Specific issues pertaining to the management of affected subjects and to the prevention of exposure to airborne NRL are discussed. Ares of future research should include: 1) further characterization of relevant NRL allergens; 2) development and validation of methods for quantitative assessment of allergen content in NRL devices and workplace environment; 3) evaluation of the natural history and risk factors of NRL-induced asthma; and 5) analysis of effectiveness and cost of preventive strategies.
天然橡胶乳胶（NRL）蛋白过敏原介导的IgE致敏可引发速发型超敏反应，从轻度荨麻疹到皮肤、黏膜或内脏接触后危及生命的过敏反应。从NRL手套中可洗脱的过敏原吸附到玉米淀粉粉末颗粒上，形成空气传播物，有可能引发呼吸道反应。最近的研究表明，哮喘是制造NRL材料的工人以及使用NRL制品的医护人员中NRL过敏的常见表现。NRL诱发的哮喘应受到越来越多的关注，因为它可导致永久性呼吸后遗症和职业残疾。概述了早期准确诊断的必要性，并综述了不同的诊断方法。讨论了与受影响个体的管理以及预防空气传播的NRL暴露相关的具体问题。未来的研究领域应包括：1）相关NRL过敏原的进一步表征；2）NRL装置和工作场所环境中过敏原含量定量评估方法的开发与验证；3）NRL诱发哮喘的自然史和危险因素评估；以及5）预防策略的有效性和成本分析。
