Patients monosensitised to Hev b 8 (Hevea brasiliensis latex profilin) may safely undergo major surgery in a normal (non-latex safe) environment.
BACKGROUND
Natural rubber latex allergy is a condition at high risk of anaphylaxis during surgery. However, latex contains several protein allergens and not all of them may show the same clinical relevance.


OBJECTIVE
To investigate the clinical relevance of Hey b 8, the natural rubber latex profilin.


METHODS
Seven patients without a clinical history of latex allergy but identified as being latex hypersensitive by positive SPT (3/7) and or positive latex-specific IgE during routine pre-surgery allergy investigations were studied. All patients were monosensitized to Hev b 8 (Hevea brasiliensis latex profilin) as shown by the detection of specific IgE to recombinant latex allergen components. Ten subjects with a history of latex allergy (urticaria, asthma, and/or rhinitis), sensitised to latex allergens other than profilin were enrolled as controls. Both patients and controls underwent a latex glove-wearing test; in case of a negative test, patients underwent surgery in a normal surgical setting.


RESULTS
All 7 patients scored negative on latex glove wearing test and underwent major surgery (orthopaedic, Caesarean section, pilonidal sinus, vascular, tonsillectomy, uterine revision, and uretral surgery) in a normal (non-latex safe) surgical setting without any consequence. In contrast, 9/10 (90%) controls showed a positive latex glove-wearing test (p < 0.01).


CONCLUSIONS
Latex profilin is either clinically irrelevant or is no longer present in latex products. This study highlights the importance of a component-resolved diagnosis of latex sensitisation as a tool to get a more precise assessment of the risk and to reduce the costs of healthcare.
Quercia
O
O
Servizio di Allergologia, Ospedale di Faenza, Faenza (FO), Italy
Stefanini
G F
GF
Scardovi
A
A
Asero
R
R
D000293:Adolescent; D000328:Adult; D052179:Antigens, Plant / Q000276:immunology*; D002648:Child; D005260:Female; D028482:Hevea / Q000276:immunology*; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D020315:Latex Hypersensitivity / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D051304:Profilins / Q000276:immunology*; D013514:Surgical Procedures, Operative
D052179:Antigens, Plant; C545459:Hev b 8 allergen, Hevea brasiliensis; D051304:Profilins; D007073:Immunoglobulin E