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GIORNALE ITALIANO DI DERMATOLOGIA E VENEREOLOGIA
A Journal on Dermatology and Sexually Transmitted Diseases
Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,014
Giornale Italiano di Dermatologia e Venereologia 2003 October;138(5):385-97
Natural rubber latex allergy. Present knowledge and potential prospects
Nettis E., Pinto L., Colanardi M. C., Ferrannini A., Tursi A.
Cattedra di Allergologia ed Immunologia Università degli Studi di Bari, Bari
Latex is the natural milky rubber sap that is harvested from the rubber tree, Hevea brasiliensis. Three types of reactions can occur in persons using natural latex rubber products: 1) irritant contact dermatitis; 2) allergic contact dermatitis related to rubber additives and latex itself; 3) type I hypersensitivity, which is immunological response mediated by IgE antibodies to latex proteins. Irritant contact dermatitis is the most common reaction to latex products, and to latex gloves, in particular. Latex sensitisation occurs as a result of repeated contacts with natural rubber latex (NRL) containing products or by inhalation of latex aeroallergens. Individuals in the health care professions (2.8% to 12.1%) and children with spina bifida (18% to 72%) have the highest prevalence rates for latex hypersensitivity. Diagnosis of latex allergy is made from clinical history and diagnostic tests. These include both in vitro (CAP RAST and AlaSTAT are the most commonly used), and in vivo tests (skin prick test and challenge test). The provocation tests, especially glove use test and bronchial inhalation challenge which ensure a whole allergenic spectrum of NRL, have been considered to be decisive for the diagnosis of NRL allergy. Curative treatment inducing immunologic tolerance in formerly sensitised patients is experimental and not yet generally available. Therefore, preventive measures are needed to decrease the incidence of NRL sensitisation. It means avoidance of exposure by the non-sensitized individuals, that is virtually impossible, given the large number of latex products we encounter from childhood. Secondary prevention consists of identification of latex hypersensitivity at an early stage and to avoid exposure to latex devices in sensitized subjects in order to minimize long-term impairment and disability.