Allergy to latex in health care – what does it have to do with certain fruits?

Latex is the stable dispersion of polymer microparticles in an aqueous medium – a colloidal solution of rubber in the liquid substance. It has been originally extracted from plants and used with a special fondness in pre-Columbian America. Archaeologists claim that the processing of rubber has already begun in 1600 BC. The first medical rubber gloves were created in 1889 at the request of the U.S. surgeon William Halsted. Since then, their use spread throughout the world. The use of latex gloves nowadays is certainly the standard in aseptic procedures.

Latex allergy was first mentioned in 1927. German literature says that the earliest reported case appeared as a serious swelling of the larynx after the exposure to latex during a standard dental procedure. Although in this case one cannot diagnose with all the certainty an allergy to latex, the description clearly suggests the development of such hypersensitivity.

Latex contains the approximate number of 200 proteins, 13 of which have been identified as allergens responsible for the liberation of the hypersensitivity reaction type I (immediate). The highest risk of latex allergy is in healthcare workers who maintain frequent and prolonged contact with medical gloves. It is estimated that hypersensitivity to latex affects around 8% to 12% of healthcare workers. Powdered gloves can be especially dangerous. They increase sensitization as the powder acts as a transport vector for the latex protein. Most frequent symptoms of latex allergy are redness, nausea, vomiting, asthma attacks, and even extremely dangerous anaphylactic shock. In addition to type I hypersensitivity reactions, there may appear a type IV hypersensitivity reaction (the so-called contact allergy). Cracked, itchy and inflamed skin loses its properties as a barrier against germs and pollution – the human body becomes more vulnerable to external factors.

Recent studies indicate a relationship between latex allergy and some food allergies – chitinases have been demonstrated to have a likely impact on the development of food allergy associated with hypersensitivity to latex. Chitinase contained in some plants is a part of their defense system against fungi and insects. It breaks down chitin – a component of insects’ exoskeleton and fungal cell walls. The construction of protein domains of these enzymes is very similar to those occurring in latex, leading to the development of cross-allergic reactions to certain food products. Many latex-allergic patients are also allergic to common plant-derived aeroallergens and foods. Of the people allergic to latex, some have shown an allergy to kiwi fruit (12.2%), avocado (16.3%) and bananas (18.3%). This discovery indicates the possibility of eliminating the products that cross-amplify the hypersensitivity reactions from the diet of allergic to latex individuals.

The vinyl and nitrile gloves are gaining more and more popularity among physicians. They are claimed to be a safe alternative to the highly allergenic latex gloves. Nevertheless, scientists call into question their safety in comparison with the traditional gloves, pointing out the larger pores in the material (which is of great importance in the antiviral prevention) and the significantly higher number of perforations in the course of treatment. The percentage of perforation in latex gloves compared with the percentage in latex-free, according to a survey from 2010, is like 35% to 80%. Damage of the barrier separating the physician and the patient increases the risk of cross-infection.

One sure way of reducing the development of latex allergy among health care workers is using powder – free latex gloves. Their mechanical properties do not differ significantly from the traditional powdered latex gloves. They provide a good insulation from the operating field, and are characterized by a relatively small risk of perforation. Clearly, the risk of hypersensitivity reactions is much smaller due to the lack of allergens transport vector.

Written by: Maria Bilińska

Bibliography:
Latex allergy: Review of Recent Advances Current Allergy and Asthma Reports Volume 1, Issue 1, January 2001, pp. 1932-1938 Levy, David A.; Leynadier, Francisque
The Latex and Food Allergy Connection Journal of the American Dietetic Association, Volume 100, Issue 11, November, 2000, pp. PERKIN 1381-1384, Judy
Latex-Free Gloves: Safer for Whom? The Journal of Arthroplasty Volume 25, Issue 1, January, 2010, pp. 1927-1930 Aldlyami, Ehab; Kulkarni, Ashwin; Reed, Michael R., Muller, Scott D., Partington, Paul F.

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