title: Genetic predisposition to natural rubber latex allergy differs between health care workers and high-risk patients.
abstract: BACKGROUND
  In health care workers, the natural rubber latex (NRL) allergy phenotype has been shown to be associated with promoter polymorphisms in interleukins 13 and 18 (IL13 and IL18) when compared with nonatopic controls. However, it is not known whether high-risk patient populations, such as those born with neural tube defects or genitourinary abnormalities, demonstrate a heightened propensity toward the same genetic/immunologic risk factors that have been reported for health care workers. In this study, we tested the hypothesis that single-nucleotide polymorphisms in genes encoding IL13 and IL18 occur at an increased frequency in NRL allergic patients with spina bifida (SB) or bladder exstrophy (BE).
  
  
  METHODS
  One hundred twenty subjects (40 SB, 40 BE, and 40 control) were screened using a clinical history questionnaire and NRL-specific immunoglobulin E (IgE) antibody measurements in the blood. Genomic DNA was extracted from peripheral blood lymphocytes and analyzed for single-nucleotide polymorphisms in candidate genes of interest. Univariate and multivariate analyses were performed to identify significant variables with significance defined as P < 0.05.
  
  
  RESULTS
  Sensitization (IgE antibody positivity) to NRL allergens was associated with atopic history and number of prior operations and was prevented by the avoidance of NRL beginning at birth. However, unlike health care workers, the NRL allergy phenotype was not significantly associated with promoter polymorphisms in IL13 or IL18 when comparing NRL allergic SB and BE patients with nonsensitized patients and with atopic and nonatopic controls.
  
  
  CONCLUSIONS
  In patients born with SB or BE, environmental factors seem to play a greater role in the development of NRL sensitization and overt allergic symptoms than the IL polymorphisms in IL13 and IL18 previously shown to be associated with NRL allergy in health care workers.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. cmonitt1@jhmi.edu
authors.forename: Constance L
authors.initials: CL
authors.lastname: Monitto
authors.forename: Robert G
authors.initials: RG
authors.lastname: Hamilton
authors.forename: Eric
authors.initials: E
authors.lastname: Levey
authors.forename: Anne E
authors.initials: AE
authors.lastname: Jedlicka
authors.forename: Amanda
authors.initials: A
authors.lastname: Dziedzic
authors.forename: John P
authors.initials: JP
authors.lastname: Gearhart
authors.forename: Simeon A
authors.initials: SA
authors.lastname: Boyadjiev
authors.forename: Robert H
authors.initials: RH
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000235:genetics; D018793:Interleukin-13 / Q000235:genetics / Q000276:immunology; D020382:Interleukin-18 / Q000235:genetics / Q000276:immunology; D020315:Latex Hypersensitivity / Q000235:genetics* / Q000276:immunology; D008297:Male; D016273:Occupational Exposure; D010361:Patients / Q000706:statistics & numerical data*; D011110:Polymorphism, Genetic / Q000235:genetics; D011153:Population; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012306:Risk; D055815:Young Adult
chemical_list: D018793:Interleukin-13; D020382:Interleukin-18