title: In vivo sensitization to purified Hevea brasiliensis proteins in health care workers sensitized to natural rubber latex.
abstract: BACKGROUND
  Thirteen proteins of natural rubber latex (Hevea brasiliensis) known to bind human IgE have been isolated and characterized as Hev b allergens. However, the in vivo importance of native Hev b allergens has not been defined in health care workers (HCWs) with natural rubber latex (NRL) allergy.
  
  
  OBJECTIVE
  The principal aim of this study was to identify the major in vivo Hev b allergens in HCWs with NRL allergy confirmed by percutaneous sensitivity to nonammoniated latex (NAL).
  
  
  METHODS
  Skin prick testing was performed with 7 (native) proteins purified from NAL (Hev b 1, 2, 3, 4, 6.01, 7.01, and a newly described Hev b 13) and recombinant Hev b 5 in 62 HCWs with histories of NRL allergy (group 1) confirmed by percutaneous reactivity to NAL and in 49 atopic HCWs without NRL allergy (group 2). Serial 10-fold concentrations of Hev b proteins (5 x 10(-5) microg/mL to 50 microg/mL) were tested; serum samples of subjects were assayed for serum specific IgE by immunoassays.
  
  
  RESULTS
  Hev b 2, Hev b 5, Hev b 6.01, and Hev b 13 produced skin reactions in more than 60% of group 1 subjects, with Hev b 1, 3, 4, and 7.01 eliciting reactions in less than 50%. Only 1 of 49 group 2 workers reacted to a single Hev b antigen (Hev b 13). Specificity of 7 Hev b allergens was 100% and 98% for Hev b 13 in identifying workers with confirmed NRL allergy. Specific IgE by AlaSTAT and CAP immunoassays was elevated in 40 of 60 (67%) and 33 of 62 (53%) of NAL-reactive workers and produced false-positive test results in 4 of 49 (8%) and 3 of 48 (6%) group 2 subjects, respectively.
  
  
  CONCLUSIONS
  Hev b 2, 5, and 6.01 are major in vivo allergens and Hev b 13 is a new major in vivo allergen among HCWs with allergy to NRL.
authors.affiliation: University of Cincinnati College of Medicine, Ohio, USA.
authors.forename: David I
authors.initials: DI
authors.lastname: Bernstein
authors.forename: Raymond E
authors.initials: RE
authors.lastname: Biagini
authors.forename: Ravi
authors.initials: R
authors.lastname: Karnani
authors.forename: Robert
authors.initials: R
authors.lastname: Hamilton
authors.forename: Karen
authors.initials: K
authors.lastname: Murphy
authors.forename: Cheryl
authors.initials: C
authors.lastname: Bernstein
authors.forename: Siti Arija M
authors.initials: SA
authors.lastname: Arif
authors.forename: Brian
authors.initials: B
authors.lastname: Berendts
authors.forename: H Y
authors.initials: HY
authors.lastname: Yeang
mesh_terms: D000328:Adult; D000368:Aged; D000485:Allergens / Q000276:immunology; D052179:Antigens, Plant; D005260:Female; D006282:Health Personnel; D028482:Hevea / Q000737:chemistry / Q000276:immunology*; D006801:Humans; D007118:Immunoassay; D020315:Latex Hypersensitivity / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D010940:Plant Proteins / Q000276:immunology* / Q000302:isolation & purification; D012882:Skin Tests
chemical_list: D000485:Allergens; D052179:Antigens, Plant; C473106:Hev b 13 allergen, Hevea brasiliensis; C473105:Hev b 2 allergen, Hevea brasiliensis; C097982:Hev b 6.01 protein, Hevea brasiliensis; D010940:Plant Proteins; C101800:allergen Hev b 5