title: Latex allergy: low prevalence of immunoglobulin E to highly purified proteins Hev b 2 and Hev b 13.
abstract: BACKGROUND
  Hevea brasiliensis (Hev b) 2 and Hev b 13 have recently been identified as major latex allergens by detecting specific IgE antibodies in >50% of sera from Hev b latex-allergic individuals.
  
  
  OBJECTIVE
  We assessed the prevalence rates for sensitization to extensively purified latex allergens in patients from three diverse geographical areas.
  
  
  METHODS
  Native Hev b 2, Hev b 5, Hev b 6.01 and Hev b 13 were purified by non-denaturating chromatography and were used in ELISAs to assess sera from 215 latex-allergic patients and 172 atopic non-sensitized controls from Finland, Spain and the United States to detect allergen-specific IgE antibodies.
  
  
  RESULTS
  Unexpectedly, even highly purified Hev b 13 contained epitope(s) to which Hev b 6-specific human IgE antibodies bound effectively. Further purification, however, reduced the prevalence of IgE antibody reactivity to low levels: 15%, 5% and 11% for Hev b 2, and 18%, 30% and 27% for Hev b 13 among latex-allergic Finnish, Spanish and American patients, respectively. Interestingly, Finnish patients had a lower prevalence of Hev b 5-specific IgE antibody (28%) as compared with Spanish (49%) and American (71%) patients. The prevalence of Hev b 6.01-specific IgE reactivity was uniformly >50% in all three populations.
  
  
  CONCLUSIONS
  Neither Hev b 2 nor Hev b 13 appear to be major latex allergens when evaluated in serological assays using highly purified allergens. The reason(s) for the observed differences in published sensitization rates in various geographic regions requires further study. The purity of the allergen preparations has a marked impact on the accuracy of latex-specific IgE antibody detection in epidemiological studies and in the serological diagnosis of latex allergy.
authors.affiliation: Laboratory of Immunobiology, National Public Health Institute, Helsinki, Finland. timo.palosuo@ktl.fi
authors.forename: T
authors.initials: T
authors.lastname: Palosuo
authors.forename: M
authors.initials: M
authors.lastname: Lehto
authors.forename: A
authors.initials: A
authors.lastname: Kotovuori
authors.forename: N
authors.initials: N
authors.lastname: Kalkkinen
authors.forename: C
authors.initials: C
authors.lastname: Blanco
authors.forename: P
authors.initials: P
authors.lastname: Poza
authors.forename: T
authors.initials: T
authors.lastname: Carrillo
authors.forename: R G
authors.initials: RG
authors.lastname: Hamilton
authors.forename: H
authors.initials: H
authors.lastname: Alenius
authors.forename: T
authors.initials: T
authors.lastname: Reunala
authors.forename: K
authors.initials: K
authors.lastname: Turjanmaa
mesh_terms: D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000276:immunology*; D052179:Antigens, Plant; D005260:Female; D005387:Finland; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D020315:Latex Hypersensitivity / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D010940:Plant Proteins / Q000276:immunology*; D013030:Spain; D014481:United States
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; D007073:Immunoglobulin E