PMID- 8145008
OWN - NLM
STAT- MEDLINE
DCOM- 19940505
LR  - 20071114
IS  - 0022-2143 (Print)
IS  - 0022-2143 (Linking)
VI  - 123
IP  - 4
DP  - 1994 Apr
TI  - Serologic methods in the laboratory diagnosis of latex rubber allergy: study of 
      nonammoniated, ammoniated latex, and glove (end-product) extracts as allergen 
      reagent sources.
PG  - 594-604
AB  - In the absence of approved natural rubber latex skin testing reagents, serologic 
      methods for the detection of latex-specific immunoglobulin E (IgE) antibody are 
      useful in the definitive diagnosis of latex allergy. In this study we examined 
      extracts from two nonammoniated latex (NAL), two ammoniated latex (AL), and three 
      diverse latex rubber gloves as sources of allergen for their utility in solid 
      phase radioimmunoassays (SPRIAs) for latex-specific IgE. Serum samples were 
      collected from 46 healthcare workers (HCWs), one beautician, two clerks, and 
      seven children with spina bifida who exhibited clinical evidence of 
      latex-associated contact dermatitis (CD, n = 8), contact urticaria (CU) with or 
      without CD (n = 15), or systemic reactions involving respiratory symptoms with or 
      without anaphylaxis (n = 33) and from 10 latex-exposed HCW control subjects with 
      no latex allergy symptoms. Serum samples were coded and analyzed in a blinded 
      manner in two laboratories by three particulate and four nonparticulate SPRIAs 
      with different latex extracts on the allergosorbent. Intraassay coefficient of 
      variation as assessed with 44 split, randomized, blinded serum specimens was < 
      20%. Agreement within a source of latex (e.g., NAL, AL, or gloves) and between 
      laboratories was > 90% concordant for Glove 1/Glove 2 and NAL1/2. Specific IgE 
      antilatex was detected in one of 10 latex-exposed control serum samples by five 
      of the seven SPRIAs, despite a lack of clinical evidence for latex allergy in 
      this otherwise atopic individual. Latex-specific IgE was detected in the serum of 
      22% of subjects with CU with or without CD, suggesting that IgE antibody may not 
      be the primary factor involved in the induction of these local reactions. 
      Approximately two thirds of the systemic reactor group had detectable 
      latex-specific IgE in their serum, with levels ranging from 0.7 to 338 ng/ml. The 
      predictive characteristics of these assays will await future provocation testing. 
      We conclude that glove extracts contain as complete a repertoire of allergens as 
      the NAL and AL. Of the three source latex materials, NAL and glove extracts 
      provided the most sensitive and greatest consistency of IgE antibody results 
      between laboratories.
FAU - Hamilton, R G
AU  - Hamilton RG
AD  - Division of Allergy and Clinical Immunology, Johns Hopkins Asthma and Allergy 
      Center, Johns Hopkins University School of Medicine, Baltimore, MD 21224.
FAU - Charous, B L
AU  - Charous BL
FAU - Adkinson, N F Jr
AU  - Adkinson NF Jr
FAU - Yunginger, J W
AU  - Yunginger JW
LA  - eng
GR  - U01-AI31867/AI/NIAID NIH HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - J Lab Clin Med
JT  - The Journal of laboratory and clinical medicine
JID - 0375375
RN  - 0 (Allergens)
RN  - 37341-29-0 (Immunoglobulin E)
RN  - 7664-41-7 (Ammonia)
RN  - 9006-04-6 (Rubber)
SB  - IM
MH  - Adult
MH  - Allergens/*immunology
MH  - Ammonia/*immunology
MH  - Child
MH  - Dermatitis, Allergic Contact/*immunology
MH  - Gloves, Protective/*adverse effects
MH  - Humans
MH  - Immunoassay
MH  - Immunoglobulin E/*blood
MH  - Occupational Diseases/immunology
MH  - Predictive Value of Tests
MH  - Rubber/*adverse effects
MH  - Spinal Dysraphism/immunology
EDAT- 1994/04/01 00:00
MHDA- 2001/03/28 10:01
CRDT- 1994/04/01 00:00
PHST- 1994/04/01 00:00 [pubmed]
PHST- 2001/03/28 10:01 [medline]
PHST- 1994/04/01 00:00 [entrez]
PST - ppublish
SO  - J Lab Clin Med. 1994 Apr;123(4):594-604.