Latex antigens: identification and use in clinical and experimental studies, including crossreactivity with food and pollen allergens

Learning Objectives: The purpose of this review is to introduce the reader to the range of latex allergens that have been identified by polypeptide sequencing. This knowledge is important for the assessment of clinical latex hypersensitivity, including crossreactivity with food and aeroallergens. Data Sources: Medline search and relevant publications and reviews from the English medical literature since 1989. Results: Of the more than 150 polypeptides in natural latex rubber, 35 or more can act as allergens and are recognized by IgE antibodies in the sera of latex-sensitive subjects. Complete or partial amino acid sequence data have now been obtained for 20 or more allergens, and have facilitated cloning of genes and development of allergen-specific antibodies. In latex-sensitive adults, hevein (Hev b6), rubber elongation factor (Hev b1) and Hev b5 are reported as major allergens, while in children with spina bifida, latex particle proteins are important allergens. Although incomplete, the data for finished latex products indicate that the number as well as diversity of latex antigens are limited compared with the allergen profile of natural rubber latex. Latex allergen sequence data allows epitope mapping, which establishes the molecular basis for understanding crossreactivity between latex, food, and aeroallergens. Conclusion: The identification of latex allergens is paving the way for studying the molecular basis of immunoreactivity to these proteins, including crossreactivity with food and other allergens, The development of reagents to detect and measure antigen-specific responses will increase diagnostic specificity of allergic reactions to latex products.