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Immediate hypersensitivity to natural rubber latex (NRL) has become increasingly common during the last 20 years. It is currently one of the most frequently encountered occupational diseases among the healthcare workers and a problem even in other occupations where protective gloves are used.
Several groups at high risk for developing NRL allergy have been defined, including healthcare workers and children with spina bifida or other congenital malformations. However, the majority of NRL allergic patients do not belong to any of these groups but are individuals who usually have atopic background and are frequently in contact with NRL products. The wide spectrum of clinical manifestations of NRL allergy range from contact urticaria and rhinitis to severe systemic reactions—for example, asthma and anaphylaxis. Importantly also, NRL allergens become easily airborne with glove powder and may cause occupational asthma in individuals sensitised to NRL. In addition, a “latex fruit syndrome” has been described implying that, because of alleged allergen cross reactions, NRL allergic patients frequently show allergy to various fruits, such as banana, avocado, chestnut, and kiwi.
NRL, the raw material of natural rubber products, is obtained from the rubber tree Hevea brasiliensis. There is a consensus that proteins or peptides eluting from rubber products are responsible for sensitisation processes in NRL allergy. Knowledge of the causative allergens is required to develop reliable diagnosis of NRL allergy and to develop methods for determination of allergenicity of NRL products. At present, several important NRL allergens have been characterised at the molecular level, but knowledge about the allergens and their concentration in manufactured NRL products is still scanty.
SYMPTOMS OF NRL ALLERGY
The symptoms of immediate hypersensitivity to NRL can vary from mild local reactions to severe systemic reactions. The most frequently reported manifestation of NRL allergy is contact urticaria. Although skin is the most frequently reported site …