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Farret MM. Orthodontic biomechanics with intermaxillary elastics. Dental Press J Orthod 2023; 28:e23spe3. [PMID: 37493850 PMCID: PMC10365070 DOI: 10.1590/2177-6709.28.3.e23spe3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 05/29/2023] [Indexed: 07/27/2023] Open
Abstract
INTRODUCTION Intermaxillary elastics are orthodontic resources widely used in various malocclusions. Their main advantages are low cost, easy insertion and removal by patients, and application versatility. As main disadvantages, we can highlight the need for cooperation from patients and the side effects normally present in treatments with this resource. Knowledge of the biomechanics involved in the use of intermaxillary elastics is essential to take full advantage of the desired effects and avoid unwanted effects in their use. OBJECTIVE Therefore, the objective of this article is to describe the anchorage preparation, connection methods, time and force of use, and side effects involved in the use of intermaxillary elastics for the treatment of anteroposterior, vertical and transverse problems. For that, clinical cases and biomechanics schemes will be presented, in which all these details will be described.
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Affiliation(s)
- Marcel Marchiori Farret
- Centro de Estudos Odontológicos Meridional (CEOM), Especialização em Ortodontia (Passo Fundo/RS, Brazil)
- Private practice (Santa Maria/RS, Brazil)
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2
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De Amici M, Barocci F, Barzaghi CE, Sacchi L, De Silvestri A, Licari A, Caimmi S, Marseglia A, Testa G, Torre C, Marseglia GL. Impact of individual molecular components in determining primary sensitization to latex. Immunobiology 2023; 228:152320. [PMID: 36621307 DOI: 10.1016/j.imbio.2022.152320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/01/2022] [Accepted: 12/26/2022] [Indexed: 01/01/2023]
Abstract
Allergy to natural rubber latex emerged as one of the main allergies at the beginning among some professional groups and the general population. Sensitization and development of latex allergy have been attributed to exposure to products containing residual latex proteins. The prevailing cross-reactivity of latex proteins with other food allergens is of great concern. Numerous purified allergens are currently available, which greatly help in patient management, thus determining their specific profile. We conducted a multicenter study to investigate changes, from the ROC analysis, in the characteristics of patients with latex allergy by measuring its major protein components. Sensitization to latex proteins is crucial because it highlights the cross reactivity to inhalants (pollen) and food (fruit). It is very essential in an accurate and specific clinical setting.
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Affiliation(s)
- M De Amici
- Immuno-Allergology Laboratory of Clinical Chemistry and Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - F Barocci
- Medicine Unit Laboratory, ASST Rhodense Garbagnate Milanese, Rho, Italy.
| | - C E Barzaghi
- Allergology Clinic, ASST Rhodense Garbagnate Milanese, Rho, Italy
| | - L Sacchi
- Laboratory for Biomedical Informatics "Mario Stefanelli", Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Italy
| | - A De Silvestri
- Servizio di Epidemiologia Clinica e Biometria Direzione Scientifica - Fondazione IRCCS Policlinico san Matteo, Pavia, Italy
| | - A Licari
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Italy; Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - S Caimmi
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - A Marseglia
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - G Testa
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - C Torre
- Laboratory of Clinical Chemistry, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - G L Marseglia
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Italy; Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Content of Asthmagen Natural Rubber Latex Allergens in Commercial Disposable Gloves. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 921:37-44. [PMID: 27241513 DOI: 10.1007/5584_2016_227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The use of natural rubber latex (NRL) gloves in many occupations may lead to latex sensitization, allergic asthma, and skin reactions. Due to their good properties and environmental safety NRL gloves are still being used in the healthcare setting, but also in the food industry, by hairdressers, cleaners, etc. The aim of our study was to assess the protein and NRL allergen content in commercial gloves by different methods, including a new assay. Twenty commercially available NRL gloves were analyzed. Protein extraction was performed according to the international standard ASTM D-5712. Total protein content was measured with a modified Lowry method, NRL content with the CAP Inhibition Assay, the Beezhold ELISA Inhibition Assay, and an innovative ELISA with IgY-antibodies extracted from eggs of NRL-immunized hens (IgY Inhibition Assay). We found a high protein content in a range of 215.0-1304.7 μg/g in 8 out of the 20 NRL gloves. Seven of the 20 gloves were powdered, four of them with a high protein content. In gloves with high protein content, the immunological tests detected congruently high levels of NRL allergen. We conclude that a high percentage of commercially available NRL gloves still represent a risk for NRL allergy, including asthma. The modified Lowry Method allows to infer on the latex allergen content.
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Development of an Economical Method to Reduce the Extractable Latex Protein Levels in Finished Dipped Rubber Products. BIOMED RESEARCH INTERNATIONAL 2017; 2017:9573021. [PMID: 28706952 PMCID: PMC5494553 DOI: 10.1155/2017/9573021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 05/07/2017] [Indexed: 11/24/2022]
Abstract
Natural rubber latex (NRL) allergy is caused by the extractable latex proteins in dipped rubber products. It is a major concern for the consumers who are sensitive to the allergenic extractable proteins (EP) in products such as NRL gloves. Objective of this research was to develop an economical method to reduce the EP in finished dipped NRL products. In order to reduce the EP levels, two natural proteases, bromelain from pineapple and papain from papaya, were extracted and partially purified using (NH4)2SO4. According to the newly developed method, different glove samples were treated with a 5% solution of each partially purified enzyme, for 2 hours at 60°C. Residual amounts of in treated samples were quantified using the modified Lowry assay (ASTM D5712-10). Bromelain displayed a 54 (±11)% reduction of the EP from the dipped rubber products, whereas it was 58 (±8)% with papain. These results clearly indicate that the selected natural proteases, bromelain, and papain contribute significantly towards the reduction of the total EP in finished NRL products. Application of bromelain enzyme for the aforementioned purpose has not been reported up to date, whereas papain has been used to treat raw NRL towards reducing the EP.
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Bittner C, Velasco Garrido M, Krach LH, Harth V. Content of Asthmagen Natural Rubber Latex Allergens in Commercial Disposable Gloves. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016. [PMID: 27469013 DOI: 10.1007/5584_2016_241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The use of natural rubber latex (NRL) gloves in many occupations may lead to latex sensitization, allergic asthma, and skin reactions. Due to their good properties and environmental safety NRL gloves are still being used in the healthcare setting, but also in the food industry, by hairdressers, cleaners, etc. The aim of our study was to assess the protein and NRL allergen content in commercial gloves by different methods, including a new assay. Twenty commercially available NRL gloves were analyzed. Protein extraction was performed according to the international standard ASTM D-5712. Total protein content was measured with a modified Lowry method, NRL content with the CAP Inhibition Assay, the Beezhold ELISA Inhibition Assay, and an innovative ELISA with IgY-antibodies extracted from eggs of NRL-immunized hens (IgY Inhibition Assay). We found a high protein content in a range of 215.0-1304.7 μg/g in 8 out of the 20 NRL gloves. Seven of the 20 gloves were powdered, four of them with a high protein content. In gloves with high protein content, the immunological tests detected congruently high levels of NRL allergen. We conclude that a high percentage of commercially available NRL gloves still represent a risk for NRL allergy, including asthma. The modified Lowry Method allows to infer on the latex allergen content.
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Affiliation(s)
- C Bittner
- Division of Clinical Occupational Medicine, Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, 10 Seewartenstraße, 20459, Hamburg, Germany.
| | - Marcial Velasco Garrido
- Division of Clinical Occupational Medicine, Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, 10 Seewartenstraße, 20459, Hamburg, Germany
| | - L H Krach
- Division of Clinical Occupational Medicine, Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, 10 Seewartenstraße, 20459, Hamburg, Germany
| | - V Harth
- Division of Clinical Occupational Medicine, Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, 10 Seewartenstraße, 20459, Hamburg, Germany
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Higgins CL, Palmer AM, Cahill JL, Nixon RL. Occupational skin disease among Australian healthcare workers: a retrospective analysis from an occupational dermatology clinic, 1993-2014. Contact Dermatitis 2016; 75:213-22. [PMID: 27436328 DOI: 10.1111/cod.12616] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 04/17/2016] [Accepted: 04/19/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Healthcare workers (HCWs) are at risk of developing occupational skin disease (OSD). OBJECTIVES To ascertain the causes of OSD in Australian HCWs in a tertiary referral clinic. METHODS A retrospective review was performed of patients assessed at the Occupational Dermatology Clinic in Melbourne from 1993 to 2014. RESULTS Of 685 HCWs assessed in the clinic over a period of 22 years, 555 (81.0%) were diagnosed with OSD. The most common diagnosis was irritant contact dermatitis (ICD) (79.1%), followed by allergic contact dermatitis (ACD) (49.7%). Natural rubber latex allergy was also relatively frequent (13.0%). The major substances causing ACD were rubber glove chemicals (thiuram mix and tetraethylthiuram disulfide), preservatives (formaldehyde, formaldehyde releasers, and isothiazolinones), excipients in hand cleansers, which are hard-to-avoid weak allergens, and antiseptics. ACD caused by commercial hand cleansers occurred more frequently than ACD caused by alcohol-based hand rubs (ABHRs). Occupational ICD was mostly caused by water/wet work and hand cleansers, and environmental irritants such as heat and sweating. CONCLUSIONS Understanding the causes of OSD in HCWs is important in order to develop strategies for prevention. We suggest that skin care advice should be incorporated into hand hygiene education. The use of ABHRs should be encouraged, weak allergens in skin cleansers should be substituted, and accelerator-free gloves should be recommended for HCWs with OSD.
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Affiliation(s)
- Claire L Higgins
- Occupational Dermatology Research and Education Centre, Skin and Cancer Foundation Inc., Carlton, Victoria, 3053, Australia.
| | - Amanda M Palmer
- Occupational Dermatology Research and Education Centre, Skin and Cancer Foundation Inc., Carlton, Victoria, 3053, Australia
| | - Jennifer L Cahill
- Occupational Dermatology Research and Education Centre, Skin and Cancer Foundation Inc., Carlton, Victoria, 3053, Australia
| | - Rosemary L Nixon
- Occupational Dermatology Research and Education Centre, Skin and Cancer Foundation Inc., Carlton, Victoria, 3053, Australia
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Differentiating of cross-reactions in patients with latex allergy with the use of ISAC test. Postepy Dermatol Alergol 2016; 33:120-7. [PMID: 27279821 PMCID: PMC4884780 DOI: 10.5114/ada.2016.59154] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 12/25/2014] [Indexed: 12/03/2022] Open
Abstract
Introduction Differentiating between cross-reactivity and double sensitization is still a challenging issue in allergology. Aim To differentiate cross-reactions accompanying latex allergy with the use of the ISAC test. Material and methods Thirty-nine patients reporting immediate allergic reactions to latex were enrolled into the study (group A). The control group was comprised of 41 patients with allergic diseases not associated with latex (group B) and 20 healthy individuals (group C). Their history was recorded and skin prick tests were performed with latex, airborne and food allergens. Specific IgE against food allergens, latex (k82) and recombined latex allergens were determined. ImmunoCAP ISAC test was performed with 103 molecules. Results Sensitization to latex was found by means of skin tests in 16 cases and sIgE against latex was revealed in 12 cases (including 10 positive in both SPT and sIgE). In the ISAC test antibodies against recombined latex allergens were found in 8 patients with rHev b 6 as the most common. All the patients positive for rHev b 1, 5, 6, 8 had allergy or asymptomatic sensitization to food allergens cross-reacting with latex. Some reactions could not have been differentiated due to the lack of allergens in the ISAC test. Others, not related to latex-fruits syndrome were explained by cross-reactivity with other profilins or PR-10 proteins. Conclusions ImmunoCAP ISAC test could be useful in differentiating between cross-reactions and double sensitizations. However, in the case of latex its advantages are limited due to a small panel of allergens.
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Matricardi PM, Kleine-Tebbe J, Hoffmann HJ, Valenta R, Hilger C, Hofmaier S, Aalberse RC, Agache I, Asero R, Ballmer-Weber B, Barber D, Beyer K, Biedermann T, Bilò MB, Blank S, Bohle B, Bosshard PP, Breiteneder H, Brough HA, Caraballo L, Caubet JC, Crameri R, Davies JM, Douladiris N, Ebisawa M, EIgenmann PA, Fernandez-Rivas M, Ferreira F, Gadermaier G, Glatz M, Hamilton RG, Hawranek T, Hellings P, Hoffmann-Sommergruber K, Jakob T, Jappe U, Jutel M, Kamath SD, Knol EF, Korosec P, Kuehn A, Lack G, Lopata AL, Mäkelä M, Morisset M, Niederberger V, Nowak-Węgrzyn AH, Papadopoulos NG, Pastorello EA, Pauli G, Platts-Mills T, Posa D, Poulsen LK, Raulf M, Sastre J, Scala E, Schmid JM, Schmid-Grendelmeier P, van Hage M, van Ree R, Vieths S, Weber R, Wickman M, Muraro A, Ollert M. EAACI Molecular Allergology User's Guide. Pediatr Allergy Immunol 2016; 27 Suppl 23:1-250. [PMID: 27288833 DOI: 10.1111/pai.12563] [Citation(s) in RCA: 500] [Impact Index Per Article: 62.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The availability of allergen molecules ('components') from several protein families has advanced our understanding of immunoglobulin E (IgE)-mediated responses and enabled 'component-resolved diagnosis' (CRD). The European Academy of Allergy and Clinical Immunology (EAACI) Molecular Allergology User's Guide (MAUG) provides comprehensive information on important allergens and describes the diagnostic options using CRD. Part A of the EAACI MAUG introduces allergen molecules, families, composition of extracts, databases, and diagnostic IgE, skin, and basophil tests. Singleplex and multiplex IgE assays with components improve both sensitivity for low-abundance allergens and analytical specificity; IgE to individual allergens can yield information on clinical risks and distinguish cross-reactivity from true primary sensitization. Part B discusses the clinical and molecular aspects of IgE-mediated allergies to foods (including nuts, seeds, legumes, fruits, vegetables, cereal grains, milk, egg, meat, fish, and shellfish), inhalants (pollen, mold spores, mites, and animal dander), and Hymenoptera venom. Diagnostic algorithms and short case histories provide useful information for the clinical workup of allergic individuals targeted for CRD. Part C covers protein families containing ubiquitous, highly cross-reactive panallergens from plant (lipid transfer proteins, polcalcins, PR-10, profilins) and animal sources (lipocalins, parvalbumins, serum albumins, tropomyosins) and explains their diagnostic and clinical utility. Part D lists 100 important allergen molecules. In conclusion, IgE-mediated reactions and allergic diseases, including allergic rhinoconjunctivitis, asthma, food reactions, and insect sting reactions, are discussed from a novel molecular perspective. The EAACI MAUG documents the rapid progression of molecular allergology from basic research to its integration into clinical practice, a quantum leap in the management of allergic patients.
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Affiliation(s)
- P M Matricardi
- Paediatric Pneumology and Immunology, Charitè Medical University, Berlin, Germany
| | - J Kleine-Tebbe
- Allergy & Asthma Center Westend, Outpatient Clinic Ackermann, Hanf, & Kleine-Tebbe, Berlin, Germany
| | - H J Hoffmann
- Department of Respiratory Diseases and Allergy, Institute of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - R Valenta
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - C Hilger
- Department of Infection & Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - S Hofmaier
- Paediatric Pneumology and Immunology, Charitè Medical University, Berlin, Germany
| | - R C Aalberse
- Sanquin Research, Department of Immunopathology, Amsterdam, The Netherlands
- Landsteiner Laboratory, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - I Agache
- Department of Allergy and Clinical Immunology, Faculty of Medicine, Transylvania University of Brasov, Brasov, Romania
| | - R Asero
- Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Italy
| | - B Ballmer-Weber
- Allergy Unit, Department of Dermatology, University Hospital Zürich, Zürich, Switzerland
| | - D Barber
- IMMA-School of Medicine, University CEU San Pablo, Madrid, Spain
| | - K Beyer
- Paediatric Pneumology and Immunology, Charitè Medical University, Berlin, Germany
| | - T Biedermann
- Department of Dermatology and Allergology, Technical University Munich, Munich, Germany
| | - M B Bilò
- Allergy Unit, Department of Internal Medicine, University Hospital Ospedali Riuniti di Ancona, Ancona, Italy
| | - S Blank
- Center of Allergy and Environment (ZAUM), Helmholtz Center Munich, Technical University of Munich, Munich, Germany
| | - B Bohle
- Division of Experimental Allergology, Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology & Immunology, Medical University of Vienna, Vienna, Austria
| | - P P Bosshard
- Allergy Unit, Department of Dermatology, University Hospital Zürich, Zürich, Switzerland
| | - H Breiteneder
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - H A Brough
- Paediatric Allergy, Department of Asthma, Allergy and Respiratory Science, King's College London, Guys' Hospital, London, UK
| | - L Caraballo
- Institute for Immunological Research, The University of Cartagena, Cartagena de Indias, Colombia
| | - J C Caubet
- Pediatric Allergy Unit, Department of Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland
| | - R Crameri
- Swiss Institute of Allergy and Asthma Research, University of Zürich, Davos, Switzerland
| | - J M Davies
- School of Biomedical Sciences, Institute of Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia
| | - N Douladiris
- Allergy Unit, 2nd Paediatric Clinic, National & Kapodistrian University, Athens, Greece
| | - M Ebisawa
- Department of Allergy, Clinical Research Center for Allergology and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan
| | - P A EIgenmann
- Pediatric Allergy Unit, Department of Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland
| | - M Fernandez-Rivas
- Allergy Department, Hospital Clinico San Carlos IdISSC, Madrid, Spain
| | - F Ferreira
- Division of Allergy and Immunology, Department of Molecular Biology, University of Salzburg, Salzburg, Austria
| | - G Gadermaier
- Division of Allergy and Immunology, Department of Molecular Biology, University of Salzburg, Salzburg, Austria
| | - M Glatz
- Allergy Unit, Department of Dermatology, University Hospital Zürich, Zürich, Switzerland
- Christine Kühne Center for Allergy Research and Education CK-CARE, Davos, Switzerland
| | - R G Hamilton
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - T Hawranek
- Department of Dermatology, Paracelsus Private Medical University, Salzburg, Austria
| | - P Hellings
- Department of Otorhinolaryngology, Academic Medical Center (AMC), Amsterdam, The Netherlands
- Department of Otorhinolaryngology, University Hospitals Leuven, Leuven, Belgium
| | - K Hoffmann-Sommergruber
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - T Jakob
- Department of Dermatology and Allergology, University Medical Center Giessen and Marburg, Justus Liebig University Giessen, Giessen, Germany
| | - U Jappe
- Division of Clinical and Molecular Allergology, Research Centre Borstel, Airway Research Centre North (ARCN), Member of the German Centre for Lung Research (DZL), Borstel, Germany
- Interdisciplinary Allergy Division, Department of Pneumology, University of Lübeck, Lübeck, Germany
| | - M Jutel
- Department of Clinical Immunology, 'ALL-MED' Medical Research Institute, Wrocław Medical University, Wrocław, Poland
| | - S D Kamath
- Molecular Allergy Research Laboratory, Centre for Biodiscovery and Molecular Development of Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Townsville City, Qld, Australia
| | - E F Knol
- Departments of Immunology and Dermatology/Allergology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - P Korosec
- University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia
| | - A Kuehn
- Department of Infection & Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - G Lack
- King's College London, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
- Division of Asthma, Allergy and Lung Biology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - A L Lopata
- Department of Clinical Immunology, 'ALL-MED' Medical Research Institute, Wrocław Medical University, Wrocław, Poland
| | - M Mäkelä
- Skin and Allergy Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - M Morisset
- National Service of Immuno-Allergology, Centre Hospitalier Luxembourg (CHL), Luxembourg, UK
| | - V Niederberger
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
| | - A H Nowak-Węgrzyn
- Pediatric Allergy and Immunology, Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - N G Papadopoulos
- Centre for Paediatrics and Child Health, Institute of Human Development, University of Manchester, Manchester, UK
| | - E A Pastorello
- Unit of Allergology and Immunology, Niguarda Ca' Granda Hospital, Milan, Italy
| | - G Pauli
- Service de Pneumologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - T Platts-Mills
- Department of Microbiology & Immunology, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - D Posa
- Paediatric Pneumology and Immunology, Charitè Medical University, Berlin, Germany
| | - L K Poulsen
- Allergy Clinic, Copenhagen University Hospital, Copenhagen, Denmark
| | - M Raulf
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Ruhr-University Bochum (IPA), Bochum, Germany
| | - J Sastre
- Allergy Division, Fundación Jimenez Díaz, Madrid, Spain
| | - E Scala
- Experimental Allergy Unit, IDI-IRCCS, Rome, Italy
| | - J M Schmid
- Department of Respiratory Diseases and Allergy, Institute of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - P Schmid-Grendelmeier
- Allergy Unit, Department of Dermatology, University Hospital Zürich, Zürich, Switzerland
- Christine Kühne Center for Allergy Research and Education CK-CARE, Davos, Switzerland
| | - M van Hage
- Department of Medicine Solna, Clinical Immunology and Allergy Unit, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - R van Ree
- Departments of Experimental Immunology and of Otorhinolaryngology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - S Vieths
- Department of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - R Weber
- School of Medicine, University of Colorado, Denver, CO, USA
- Department of Medicine, National Jewish Health Service, Denver, CO, USA
| | - M Wickman
- Sachs' Children's Hospital, Karolinska Institutet, Stockholm, Sweden
| | - A Muraro
- The Referral Centre for Food Allergy Diagnosis and Treatment Veneto Region, Department of Mother and Child Health, University of Padua, Padua, Italy
| | - M Ollert
- Department of Infection & Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
- Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis, University of Southern Denmark, Odense, Denmark
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Shimomura S, Matsuno H, Ohta T, Kawahara S, Tanaka K. Initial Adhesion of Fibroblasts on Thin Rubber Scaffolds. CHEM LETT 2016. [DOI: 10.1246/cl.160061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
| | | | | | - Seiichi Kawahara
- Department of Materials Science and Technology, Nagaoka University of Technology
| | - Keiji Tanaka
- Department of Applied Chemistry, Kyushu University
- International Institute for Carbon-Neutral Energy Research (WPI-I2CNER), Kyushu University
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11
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Goldberg H, Aharony S, Levy Y, Sivan B, Baniel J, Ben Meir D. Low prevalence of latex allergy in children with spinal dysraphism in non-latex-free environment. J Pediatr Urol 2016; 12:52.e1-5. [PMID: 26388261 DOI: 10.1016/j.jpurol.2015.07.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 07/17/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Studies in the past have shown that children with spinal dysraphism have highly prevalent latex allergy. These children have a spectrum of congenital spinal anomalies, caused by defects in neural tube closure, with an incidence of 1 in 1000 births. Proposed risk factors for latex allergy include multiple surgeries since birth, including an insertion of a ventriculoperitoneal shunt, elevated IgE titers, repeat multiple catheterizations, and atopy. In the 1990 s, studies published in the United States and Europe showed a latex allergy prevalence of over 70% in these patients. On the other hand, studies published years later in other countries showed a declining prevalence of no more than 17%. OBJECTIVE Our goal was to prospectively assess the prevalence of latex allergy in children with spinal dysraphism in our non-latex free environment center compared with a control group. STUDY DESIGN The study group included 58 children with spinal dysraphism attending our center between 2010 and 2013. Findings were compared to 65 children referred for evaluation of allergic diseases. The parents completed questionnaires assessing personal and familial history of allergic diseases. All children were tested for blood latex IgE-specific antibodies (IMMULITE 2000). RESULTS The mean age was 120.9 (67.6) months in the study group and 129.5 (68.5) months in the control group (p = 0.27). The corresponding median number of surgical procedures was 2 (range 0-10) and 0 (range 0-4), and mean duration of clean intermittent catheterization was 52 (72.2) months in the study group. Positive IgE antibodies and clinical allergic reactions were low with very similar prevalence in both groups (Figure). DISCUSSION Our results show considerable lower latex allergy and sensitization than studies published in the United States and Europe in the past, despite the fact that our center utilizes minimal avoidance measures for latex allergy. Study limitations include the relatively small number of patients in our single-center study. Moreover, our control group could not include normal volunteering healthy children due to institutional review board refusal. CONCLUSIONS Children with spinal dysraphism in our center have a low prevalence of latex allergy. Possible explanations include low latex protein content gloves and catheters used worldwide, including our center, lower number of surgeries, or a disease associated propensity for latex sensitization with a geographically variable genetic association. More studies are needed to validate our conclusion that using minimal avoidance measures, without maintaining a strict latex free environment, seems sufficient to prevent clinical latex allergy, at least in the Mediterranean region.
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Affiliation(s)
- Hanan Goldberg
- Urology Unit, Schneider Children's Medical Center of Israel, and Sackler School of Medicine, Tel Aviv University, Israel.
| | - Shachar Aharony
- Urology Unit, Schneider Children's Medical Center of Israel, and Sackler School of Medicine, Tel Aviv University, Israel
| | - Yael Levy
- Kipper Institute of Immunology & Allergy, Schneider Children's Medical Center of Israel, and Sackler School of Medicine, Tel Aviv University, Israel
| | - Bezalel Sivan
- Urology Unit, Schneider Children's Medical Center of Israel, and Sackler School of Medicine, Tel Aviv University, Israel
| | - Jack Baniel
- Urology Unit, Schneider Children's Medical Center of Israel, and Sackler School of Medicine, Tel Aviv University, Israel
| | - David Ben Meir
- Urology Unit, Schneider Children's Medical Center of Israel, and Sackler School of Medicine, Tel Aviv University, Israel
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Suksaeree J, Pichayakorn W, Monton C, Sakunpak A, Chusut T, Saingam W. Rubber Polymers for Transdermal Drug Delivery Systems. Ind Eng Chem Res 2014. [DOI: 10.1021/ie403619b] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Jirapornchai Suksaeree
- Faculty
of Pharmacy, Rangsit University, Pathum Thani 12000, Thailand
- Sino-Thai
Traditional Medicine Research Center (Cooperation between Rangsit
University, Harbin Institute of Technology, and Heilongjiang University
of Chinese Medicine), Rangsit University, Pathum Thani 12000, Thailand
| | | | - Chaowalit Monton
- Faculty
of Pharmacy, Rangsit University, Pathum Thani 12000, Thailand
- Sino-Thai
Traditional Medicine Research Center (Cooperation between Rangsit
University, Harbin Institute of Technology, and Heilongjiang University
of Chinese Medicine), Rangsit University, Pathum Thani 12000, Thailand
| | - Apirak Sakunpak
- Faculty
of Pharmacy, Rangsit University, Pathum Thani 12000, Thailand
- Sino-Thai
Traditional Medicine Research Center (Cooperation between Rangsit
University, Harbin Institute of Technology, and Heilongjiang University
of Chinese Medicine), Rangsit University, Pathum Thani 12000, Thailand
| | - Tun Chusut
- Faculty
of Pharmacy, Rangsit University, Pathum Thani 12000, Thailand
- Sino-Thai
Traditional Medicine Research Center (Cooperation between Rangsit
University, Harbin Institute of Technology, and Heilongjiang University
of Chinese Medicine), Rangsit University, Pathum Thani 12000, Thailand
| | - Worawan Saingam
- Faculty
of Pharmacy, Rangsit University, Pathum Thani 12000, Thailand
- Sino-Thai
Traditional Medicine Research Center (Cooperation between Rangsit
University, Harbin Institute of Technology, and Heilongjiang University
of Chinese Medicine), Rangsit University, Pathum Thani 12000, Thailand
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Suksaeree J, Charoenchai L, Monton C, Chusut T, Sakunpak A, Pichayakorn W, Boonme P. Preparation of a Pseudolatex-Membrane for Ketoprofen Transdermal Drug Delivery Systems. Ind Eng Chem Res 2013. [DOI: 10.1021/ie402345a] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Jirapornchai Suksaeree
- Faculty
of Pharmacy, Rangsit University, Pathum Thani 12000, Thailand
- Sino-Thai
Traditional Medicine Research Center (Cooperation between Rangsit University, Harbin Institute of Technology, and Heilongjiang University of Chinese Medicine), Rangsit University, Pathum Thani 12000, Thailand
| | - Laksana Charoenchai
- Faculty
of Pharmacy, Rangsit University, Pathum Thani 12000, Thailand
- Sino-Thai
Traditional Medicine Research Center (Cooperation between Rangsit University, Harbin Institute of Technology, and Heilongjiang University of Chinese Medicine), Rangsit University, Pathum Thani 12000, Thailand
| | - Chaowalit Monton
- Faculty
of Pharmacy, Rangsit University, Pathum Thani 12000, Thailand
- Sino-Thai
Traditional Medicine Research Center (Cooperation between Rangsit University, Harbin Institute of Technology, and Heilongjiang University of Chinese Medicine), Rangsit University, Pathum Thani 12000, Thailand
| | - Tun Chusut
- Faculty
of Pharmacy, Rangsit University, Pathum Thani 12000, Thailand
- Sino-Thai
Traditional Medicine Research Center (Cooperation between Rangsit University, Harbin Institute of Technology, and Heilongjiang University of Chinese Medicine), Rangsit University, Pathum Thani 12000, Thailand
| | - Apirak Sakunpak
- Faculty
of Pharmacy, Rangsit University, Pathum Thani 12000, Thailand
- Sino-Thai
Traditional Medicine Research Center (Cooperation between Rangsit University, Harbin Institute of Technology, and Heilongjiang University of Chinese Medicine), Rangsit University, Pathum Thani 12000, Thailand
| | - Wiwat Pichayakorn
- Faculty
of Pharmaceutical Sciences, Prince of Songkla University, Songkhla 90112, Thailand
| | - Prapaporn Boonme
- Faculty
of Pharmaceutical Sciences, Prince of Songkla University, Songkhla 90112, Thailand
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Systemic Toxicity and Hypersensitivity. Biomater Sci 2013. [DOI: 10.1016/b978-0-08-087780-8.00047-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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Abstract
ABSTRACT
Dentists, as well as other dental personnel are constantly exposed to a number of specific occupational hazards. These cause the appearance of various ailments, specific to the profession, which develop and intensify with years. Despite numerous technical advances in recent years, many occupational health problems still persist in modern dentistry. These include percutaneous exposure incidents (PEI), exposure to infectious diseases, radiation, dental materials, musculoskeletal disorders (MSD), dermatitis, respiratory disorders, eye injuries and psychological problems. PEI remains a particular concern, as there is an almost constant risk of exposure to serious infectious agents. Aside from biological hazards, dentists continue to suffer a high prevalence of MSD, especially of the back, neck and shoulders. Awareness regarding these occupational hazards and implementation of preventive strategies can provide a safe working environment for all the dental personnel. There is also a need for continuing dental education programs in dentistry so that dentists can update themselves with the latest and newer techniques and materials.
How to cite this article
Mohammed NS, Shaik MA. Occupational Hazards in Modern Dentistry. Int J Experiment Dent Sci 2013;2(1):33-40.
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Sivakumar I, Arunachalam KS, Solomon EGR. Occupational health hazards in a prosthodontic practice: review of risk factors and management strategies. J Adv Prosthodont 2012; 4:259-65. [PMID: 23236581 PMCID: PMC3517967 DOI: 10.4047/jap.2012.4.4.259] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Revised: 10/22/2012] [Accepted: 11/06/2012] [Indexed: 11/17/2022] Open
Abstract
The intent of this article was to analyze the potential hazards and risks involved in persons exposed to prosthodontic practice. These risks include exposure to physical and chemical hazards, dental materials, infectious environment, inappropriate working pattern and psychosocial stress. The potential harm of these hazards and its prevention is highlighted. Prosthodontists, students, dental technicians, and others working in the prosthodontic clinics and laboratory should be aware of the specific risk factors and take measures to prevent and overcome these hazards.
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Affiliation(s)
| | | | - EGR Solomon
- Department of Prosthodontics, Satyabahma University Dental College and Hospital, Chennai, India
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Pichayakorn W, Suksaeree J, Boonme P, Amnuaikit T, Taweepreda W, Ritthidej GC. Deproteinized natural rubber film forming polymeric solutions for nicotine transdermal delivery. Pharm Dev Technol 2012; 18:1111-21. [PMID: 22881292 DOI: 10.3109/10837450.2012.705297] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Film forming polymeric solutions were prepared from DNRL blended with MC, PVA, or SAG, together with dibutylphthalate or glycerine used as plasticizers. These formulations were easily prepared by simple mixing. In a preliminary step, in situ films were prepared by solvent evaporation in a Petri-dish. Their mechanical and physicochemical properties were determined. The in vitro release and skin permeation of nicotine dissolved in these blended polymers were investigated by a modified Franz diffusion cell. The formulations had a white milky appearance, and were homogeneous and smooth in texture. Their pH was suitable for usage in skin contact. The mechanical property of in situ films depended on the ingredients but all compatible films were in an amorphous phase. The DNRL/PVA was shown to be the most suitable mixture to form completed films. The in vitro release and skin permeation studies demonstrated a biphasic release that provided an initial rapid release followed by a constant release rate that fitted the Higuchi's model. Nicotine loaded DNRL/PVA series were selected for the stability test for 3 months. These formulations needed to be kept at 4°C in tight fitting containers. In conclusion, film forming polymeric solutions could be developed for transdermal nicotine delivery systems.
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Affiliation(s)
- Wiwat Pichayakorn
- Department of Pharmaceutical Technology, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Songkhla, Thailand.
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Santos RLD, Pithon MM, Martins FO, Romanos MTV. Cytotoxicity of separation orthodontic elastics. Dental Press J Orthod 2012. [DOI: 10.1590/s2176-94512012000400021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE: To test the hypothesis that there is no difference in cytotoxicity between separating elastics of different manufacturers. METHODS: The present article compared latex elastics (4.0 mm, 4.4 mm and 4.8 mm) of four different manufacturers. The sample was allocated to seven groups of 9 elastics: Group A (American Orthodontics, green color, modules), Groups M1 and M2 (Morelli, blue color, modules and free in pack respectively), Groups M3 and M4 (Morelli, green color, modules and free in pack respectively), Group U (Uniden, blue color, free in pack) and Group T (Tecnident, blue color, free in pack) regarding their possible cytotoxic effects on oral tissues. Cytotoxicity assays were performed using cell culture medium containing epithelioid-type cells (Hep-2 line) derived from human laryngeal carcinoma and submitted to the methods for evaluating the cytotoxicity by the "dye-uptake" test, at time intervals 24, 48, 72 and 168 h. Data were compared by analysis of variance (ANOVA) and Tukey's test (p < 0.05). RESULTS: Results showed statistically significant difference (p < 0.05) between group U and all the other Groups (A, M1, M2, M3, M 4 and T) at 24 and 48 hours. CONCLUSIONS: Uniden elastics evoked more cell lysis at 24 and 48 h, although, all brands showed biocompatibility from 72 h onwards.
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Wrangsjö K, Boman A, Lidén C, Meding B. Primary prevention of latex allergy in healthcare-spectrum of strategies including the European glove standardization. Contact Dermatitis 2012; 66:165-71. [PMID: 22404191 DOI: 10.1111/j.1600-0536.2012.02057.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
IgE-mediated allergy to natural rubber latex was first noted from rubber gloves in 1979. The initial reports in dermatological journals described contact urticarial reactions; later, severe generalized allergic reactions and asthma were documented. A considerable proportion of the people involved in medical and dental care were found to be sensitized to latex. This article describes and surveys a broad range of primary prevention measures at the local and national levels. Examples are given from paediatrics, dental education, and medical care. National strategies and position papers on latex allergy are presented in which medical professionals, manufacturers and public authorities have cooperated. Special reference is paid to the European work to standardize medical gloves, which led to document EN 455:3.
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Affiliation(s)
- Karin Wrangsjö
- Unit of Occupational and Environmental Dermatology, Institute of Environmental Medicine, Karolinska Institutet, SE-17177 Stockholm, Sweden.
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Lacerda Dos Santos R, Pithon MM, Romanos MTV. The influence of pH levels on mechanical and biological properties of nonlatex and latex elastics. Angle Orthod 2011; 82:709-14. [PMID: 22149622 DOI: 10.2319/082811-552.1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the influence of pH levels on interarch elastics with regard to force decay and cytotoxicity. MATERIALS AND METHODS One nonlatex (NLAO) group and one latex (LAO) group were tested (n = 10). Elastics were stretched to 25 mm and were held for 1, 6, 12, and 24 hours in artificial saliva solutions with pH levels of 5.0, 6.0, and 7.5. Force magnitudes were measured at 25 mm of activation. The cytotoxicity assay was performed using cell cultures (L929 mouse fibroblast cell line), which were subjected to the cell viability test with neutral red ("dye-uptake"). Force decay and cytotoxicity were assessed using analysis of variance, the Sidak method, and a Tukey's test. RESULTS The interactions between group, pH, and time showed no statistically significant differences (P = .29). When pH per time (P = .032) and group per time (P = .0009) were considered, these interactions showed statistically significant differences (P < .05). The pH did not interfere directly in the degradation results of the tested elastics. The cytotoxicity test showed that group LAO presented lower cell viability when compared with group NLAO over the course of the entire experiment. There was a gradual reduction in cell viability from 1 hour to 24 hours. A significant difference (P < .05) was found between the interactions group pH and the control group of cells, except between group NLAO at the time point of 1 hour at different pH values and at the time points of 6 and 12 hours with pH 5 (P > .05). CONCLUSIONS No significant correlation between pH, force decay, and cytotoxicity was observed.
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Palosuo T, Antoniadou I, Gottrup F, Phillips P. Latex medical gloves: time for a reappraisal. Int Arch Allergy Immunol 2011; 156:234-46. [PMID: 21720169 DOI: 10.1159/000323892] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Many hospitals have implemented policies to restrict or ban the use of devices made of natural rubber latex (NRL) in healthcare as precautionary measures against the perceived risk of NRL allergy. Changes in glove technology, progress in measuring the specific allergenic potential of gloves and a dramatic decrease in the prevalence of NRL allergies after interventions and education prompted us to revisit the basis for justifiable glove selection policies. The published Anglophone literature from 1990 to 2010 was reviewed for original articles and reviews dealing with the barrier and performance properties of NRL and synthetic gloves and the role of glove powder. The review shows that NRL medical gloves, when compared with synthetic gloves, tend to be stronger, more flexible and better accepted by clinicians. The introduction of powder-free gloves has been associated with reductions in protein content and associated allergies. Recently, new methods to quantify clinically relevant NRL allergens have enabled the identification of gloves with low allergenic potential. The use of low-protein, low-allergenic, powder-free gloves is associated with a significant decrease in the prevalence of type I allergic reactions to NRL among healthcare workers. Given the excellent barrier properties and operating characteristics, dramatically reduced incidences of allergic reactions, availability of specific tests for selection of low-allergen gloves, competitive costs and low environmental impact, the use of NRL gloves within the hospital environment warrants reappraisal.
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Affiliation(s)
- Timo Palosuo
- Department of Vaccination and Immune Protection, National Institute for Health and Welfare, Helsinki, Finland.
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Sontimuang C, Suedee R, Canyuk B, Phadoongsombut N, Dickert FL. Development of a rubber elongation factor, surface-imprinted polymer–quartz crystal microbalance sensor, for quantitative determination of Hev b1 rubber latex allergens present in natural rubber latex products. Anal Chim Acta 2011; 687:184-92. [DOI: 10.1016/j.aca.2010.12.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2010] [Revised: 12/13/2010] [Accepted: 12/14/2010] [Indexed: 11/25/2022]
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Abstract
Natural rubber latex represents a potent allergen, which for many years had an important impact on occupational health problems but especially on certain risk groups such as spina bifida. Luckily, these problems decreased when powder-free, latex-poor gloves were introduced. Latest data show that in children with spina bifida, who grew up completely latex-free from birth on, sensitization to NRL as well as clinical relevant allergy significantly decreased. Furthermore, sensitization to aeroallergens also went down and even the prevalence of allergic diseases decreased significantly to rates of the general population. This new data clearly indicates that potent allergens (such as latex) in high-risk groups (such as spina bifida) can induce sensitization spreading, and corresponding avoidance can reverse this development. In conclusion, it can be stated that 'new' allergies can suddenly arise, there are allergen-specific risk groups, local IgE-production is also possible in the CNS, allergen avoidance can be very effective in terms of primary prevention, sensitization spreading can be made reversible by effective prevention, and finally, certain allergies can luckily become history within a relatively short period of time. Furthermore, these new findings clearly end the debate about whether patients with spina bifida have a disease-inherited risk for allergy to NRL and show that the cause is the meningi and the multiple surgical interventions - and therefore sequelae can be reversed by implementing preventive measures.
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Affiliation(s)
- Bodo Niggemann
- Pediatric Allergology and Pneumology, German Red Cross Clinic Westend, Berlin, Germany.
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In vitro cytotoxicity evaluation of natural rubber latex film surface coated with PMMA nanoparticles. Colloids Surf B Biointerfaces 2010; 78:328-33. [DOI: 10.1016/j.colsurfb.2010.03.025] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2009] [Revised: 02/03/2010] [Accepted: 03/22/2010] [Indexed: 11/22/2022]
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YAGAMI TAKESHI. Features and Mode of Action of Cross-reactive Plant Allergens Relevant to Latex-fruit Syndrome. FOOD AGR IMMUNOL 2010. [DOI: 10.1080/0954010021000096382] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- TAKESHI YAGAMI
- a Division of Medical Devices , National Institute of Health Sciences , Kamiyoga 1-18-1, Setagaya-ku, Tokyo , 158-8501 , Japan
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dos Santos RL, Pithon MM, Martins FO, Romanos MTV, de Oliveira Ruellas AC. Evaluation of the cytotoxicity of latex and non-latex orthodontic separating elastics. Orthod Craniofac Res 2010; 13:28-33. [PMID: 20078792 DOI: 10.1111/j.1601-6343.2009.01469.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To test the hypothesis that a difference in cytotoxicity exists between latex and non-latex orthodontic separating elastics. MATERIAL AND METHODS Five intra-oral separating elastics from different manufactures (four latex and one non-latex) were divided into five groups of 15 elastics each: Group MA (non-latex elastics, Masel), Group MO (natural latex, Morelli), Group DE (natural latex, Dentaurum), Group TP (natural latex, TP Orthodontics) and Group UN (natural latex, Unitek). The cytotoxicity assay was performed using cell cultures (epithelial HEp-2 cells originating from human laryngeal carcinoma) that were submitted to the cell viability test with neutral red (dye-uptake) at 24, 48, 72 and 168 h. Analysis of variance (anova) with multiple comparisons and Tukey's test were employed (p < 0.05). RESULTS The results showed no statistically significant differences between groups MA, DE, TP and UN in relation to Group CC (cell control) for experimental times of 24, 48 and 168 h (p > 0.05). Morelli, Dentaurum, TP Orthodontics and Unitek elastics induced a great amount of cell lyses at 72 h. CONCLUSION One can demonstrate that the Masel elastic induced less cell lysis compared with other elastics, but all trademarks were found to be clinically biocompatible. CLINICAL RELEVANCE Separating orthodontic elastics are used in the interdental subgingival region with the aim to separate the teeth for placement of orthodontic bands. However, latex has been known to cause allergy. As these materials are widely used in clinical orthodontics, care regarding the cytotoxicity of orthodontic elastics should be taken. Thus, clinically proven biocompatible materials should be acquired whenever possible.
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Affiliation(s)
- R L dos Santos
- Department of Orthodontics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
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Santos RLD, Pithon MM, Martins FO, Romanos MTV, Ruellas ACDO. Cytotoxicity of latex and non-latex orthodontic elastomeric ligatures on L929 mouse fibroblasts. Braz Dent J 2010; 21:205-10. [PMID: 21203701 DOI: 10.1590/s0103-64402010000300005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Accepted: 06/22/2010] [Indexed: 11/22/2022] Open
Abstract
This study investigated the cytotoxicity exists between latex and non-latex Orthodontic elastomeric ligatures. Six elastomeric ligatures (1 latex, 2 latex-free and 3 polyurethane) from different manufacturers were divided into 6 groups of 15 elastics each: A (Latex-free, American Orthodontics), M (Polyurethane, Morelli), G (Polyurethane,GAC International), Te (Polyurethane, Tecnident), TP (Natural latex,TP Orthodontics) and U (Latex-free,3M Unitek). The cytotoxicity assay was performed using cell cultures (L929 mouse fibroblast cell line), which were subjected to the cell viability test with neutral red ("dye-uptake") at 1, 2, 3, 7 and 28 days. Data were analyzed statistically by ANOVA and Tukey's test (α=0.05). No statistically significant differences (p>0.05) were observed between Groups M and Te in all experimental periods, except at 2 days. No significant differences (p>0.05) in cell viability were found either among Groups A, G, TP and U or between Groups M and Te at 24 h or among Groups CC, A, G, TP and U at 2 and 28 days. It may be concluded that latex-free elastomeric ligatures from American Orthodontics and Unitek trademarks induced less cell lysis compared to latex and polyurethane ligatures.
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Dos Santos RL, Pithon MM, Da Silva Mendes G, Romanos MTV, De Oliveira Ruellas AC. Cytotoxicity of intermaxillary orthodontic elastics of different colors: an in vitro study. J Appl Oral Sci 2009; 17:326-9. [PMID: 19668992 PMCID: PMC4327649 DOI: 10.1590/s1678-77572009000400010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2008] [Accepted: 11/15/2008] [Indexed: 11/28/2022] Open
Abstract
Objectives: Natural latex does not fall into the category of materials known to be entirely inoffensive. The purpose of this in vitro study was to test the hypothesis that there is no difference in the cytotoxicity between elastics of different colors and those from different manufacturers. Material and Methods: Different latex intraoral elastics of different colors (5/16 = 7.9 mm, mean load) were compared. The sample was divided into 7 groups of 24 elastics each: Group T (TP Orthodontics, natural latex elastics, control); Groups U1, U2, U3, U4, U5 and U6 (Uniden, natural latex elastics and colored elastics, namely, green, pink, yellow, red and purple, respectively). Cytotoxicity assays were performed by using cell culture medium containing epithelioid-type cells (Hep-2 line) derived from human laryngeal carcinoma. The cytotoxicity was evaluated by using the "dye-uptake" test, which was employed at two different moments (0 and 24 h). Data were compared by analysis of variance (ANOVA) and Tukey's test (p<0.05). Results: There was statistically significant difference (p<0.05) between Group T and all other groups (U1, U2, U3, U4, U5 and U6) at 0 and 24 h. No statistically significant difference (p<0.05) was found between Groups U1 and U5, U1 and U6, U2 and U3, U2 and U4, U2 and U5, U2 and U6, U3 and U4, U3 and U5, U3 and U6, U4 and U5, U4 and U6, and U5 and U6 at 0 and 24 h. Conclusions: The TP Orthodontics elastics promoted less cell lysis compared to the Uniden elastics regardless of their color.
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Marchetti-Deschmann M, Allmaier G. Allergenic compounds on the inner and outer surfaces of natural latex gloves: MALDI mass spectrometry and imaging of proteinous allergens. JOURNAL OF MASS SPECTROMETRY : JMS 2009; 44:61-70. [PMID: 18720446 DOI: 10.1002/jms.1471] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Natural latex gloves are the cause of a severe health problem to an increasing number of healthcare workers or patients due to the presence of protein allergens as Hevein or Rubber Elongation Factor (REF). One of the most challenging problems is the in situ localization of theses allergens in, e.g. gloves, to estimate the allergenic potential of the latex material. A sample preparation protocol applying a binary matrix-assisted laser desorption/ionization(MALDI) matrix containing alpha-cyano-4-hydroxy cinnamic acid (CHCA) and 2,5-dihydroxy benzoic acid (DHB) on trifluoro acetic acid (TFA) etched latex glove surfaces allowed the direct determination (exact molecular weight) of Hevein, REF and a truncated form of REF (tREF) within nine different brands of natural latex gloves by means of MALDI-TOF-MS in the linear mode. MALDI mass spectrometry demonstrated that Hevein, tREF and REF were present on the inner surfaces (in direct contact with the skin) of many, but not all, investigated gloves without any prior extraction procedure. Additionally, different isoforms of the allergen Hevein were detected (exhibiting ragged C-termini). tREF and REF could always be detected beside each other, but were not observed on every latex glove sample, which contained Hevein. It was also demonstrated that there is a significant difference in terms of proteins and polymers between inner and outer surfaces of gloves, which helps to explain the different allergenic potential of these.MALDI imaging allowed for the first time the unambiguous localization of all three allergens in parallel and showed that Hevein was present on 36% of the investigated area of a latex glove with a certain localization, whereupon, tREF and REF were only found on 25% of the investigated material.
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Ocek Z, Soyer MT, Aksan AD, Hassoy H, Manavgat SS. Risk perception of occupational hazards among dental health care workers in a dental hospital in Turkey. Int Dent J 2008; 58:199-207. [DOI: 10.1111/j.1875-595x.2008.tb00349.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Turjanmaa K. Diagnosis of latex allergy. Allergy 2008. [DOI: 10.1034/j.1398-9995.2001.00011.x-i1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Williams J, Lee A, Matheson M, Frowen K, Noonan A, Nixon R. Occupational contact urticaria: Australian data. Br J Dermatol 2008; 159:125-31. [DOI: 10.1111/j.1365-2133.2008.08583.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lee MF, Tsai JJ, Hwang GY, Lin SJ, Chen YH. Identification of immunoglobulin E (IgE)-binding epitopes and recombinant IgE reactivities of a latex cross-reacting Indian jujube Ziz m 1 allergen. Clin Exp Immunol 2008; 152:464-71. [PMID: 18435802 DOI: 10.1111/j.1365-2249.2008.03661.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Ziz m 1 is a major Indian jujube (Zizyphus mauritiana) allergen involved in latex-fruit syndrome, and cDNA of the allergen has been cloned, sequenced and expressed in yeast by our laboratory previously. In this study, we performed an immunoglobulin E (IgE)-binding epitope analysis of Ziz m 1 using overlapping recombinant fragments. Eight overlapping recombinant fragments were generated from the recombinant Ziz m 1 allergen. The fragments were expressed in Escherichia coli and IgE-binding activities were evaluated by sera of latex-Indian jujube-allergic subjects and normal subjects using immunoblotting. Human allergic sera are not able to recognize fragments consisting of amino acid sequences 26-71, 119-280 and 119-291. However, residues at positions 26-199, 26-105, 26-86, 119-320 and 238-330 were found relevant in the IgE-binding. Our results indicate that (72)NISGHCSDCTFLGEE(86) and (292)VWNRYYDLKTNYSSSIILEYVNSGTKYLP(320) of Ziz m 1 are the sequences required for human IgE binding. Four corresponding peptides, (72)NISGHCSDCTE(86), (292)VWNRYYDLKT(301), (300)KTNYSSSIILEY(311) and (309)LEYVNSGTKYLP(320), were synthesized, and these peptides reacted with 70%, 100%, 70% and 70% of 10 allergic sera tested, as revealed by enzyme-linked immunosorbent assay. Sensitization to (292)VWNRYYDLKT(301) correlated significantly with the presence of allergic symptoms (P < 0.001). These findings will be useful in designing diagnostic and therapeutic approaches, thereby contributing to the development of specific immunotherapy for subjects with latex-fruit syndrome.
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Affiliation(s)
- M F Lee
- Department of Education and Research, Taichung Veterans General Hospital, Taichung, Taiwan
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35
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Palosuo T, Lehto M, Kotovuori A, Kalkkinen N, Blanco C, Poza P, Carrillo T, Hamilton RG, Alenius H, Reunala T, Turjanmaa K. Latex allergy: low prevalence of immunoglobulin E to highly purified proteins Hev b 2 and Hev b 13. Clin Exp Allergy 2007; 37:1502-11. [PMID: 17850383 DOI: 10.1111/j.1365-2222.2007.02810.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Hevea brasiliensis (Hev b) 2 and Hev b 13 have recently been identified as major latex allergens by detecting specific IgE antibodies in >50% of sera from Hev b latex-allergic individuals. OBJECTIVE We assessed the prevalence rates for sensitization to extensively purified latex allergens in patients from three diverse geographical areas. METHODS Native Hev b 2, Hev b 5, Hev b 6.01 and Hev b 13 were purified by non-denaturating chromatography and were used in ELISAs to assess sera from 215 latex-allergic patients and 172 atopic non-sensitized controls from Finland, Spain and the United States to detect allergen-specific IgE antibodies. RESULTS Unexpectedly, even highly purified Hev b 13 contained epitope(s) to which Hev b 6-specific human IgE antibodies bound effectively. Further purification, however, reduced the prevalence of IgE antibody reactivity to low levels: 15%, 5% and 11% for Hev b 2, and 18%, 30% and 27% for Hev b 13 among latex-allergic Finnish, Spanish and American patients, respectively. Interestingly, Finnish patients had a lower prevalence of Hev b 5-specific IgE antibody (28%) as compared with Spanish (49%) and American (71%) patients. The prevalence of Hev b 6.01-specific IgE reactivity was uniformly >50% in all three populations. CONCLUSION Neither Hev b 2 nor Hev b 13 appear to be major latex allergens when evaluated in serological assays using highly purified allergens. The reason(s) for the observed differences in published sensitization rates in various geographic regions requires further study. The purity of the allergen preparations has a marked impact on the accuracy of latex-specific IgE antibody detection in epidemiological studies and in the serological diagnosis of latex allergy.
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Affiliation(s)
- T Palosuo
- Laboratory of Immunobiology, National Public Health Institute, Helsinki, Finland.
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Palosuo T, Reinikka-Railo H, Kautiainen H, Alenius H, Kalkkinen N, Kulomaa M, Reunala T, Turjanmaa K. Latex allergy: the sum quantity of four major allergens shows the allergenic potential of medical gloves. Allergy 2007; 62:781-6. [PMID: 17573726 DOI: 10.1111/j.1398-9995.2007.01411.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Assessment of allergenic potential of medical devices made of natural rubber latex (NRL) requires the measurement of concentrations of specific allergenic proteins or polypeptides eluting from rubber. METHODS Four NRL allergens (Hev b 1, 3, 5, and 6.02) were quantified in all medical glove brands marketed in Finland in 1999, 2001, and 2003 (n = 208) by a capture enzyme immunoassay. The results were compared with those obtained from previous nationwide market surveys, using a skin prick test-validated human IgE-based ELISA-inhibition method. RESULTS A high overall correlation (r = 0.87, 95% CI 0.83-0.90) emerged between the sum values of the four allergens(microg/g glove) and IgE-ELISA inhibition (allergen units, AU/ml, 1 : 5 diluted glove extract). The sum of four allergens when set at 0.15 microg/g discriminated 'low allergenic' (<10 AU/ml) from 'moderate- to high-allergenic' (>/=10 AU/ml) gloves at a sensitivity of 0.93 (95% CI 0.85-0.98) and specificity of 0.90 (95% CI 0.83-0.94). When the sum was below the detection limit (0.03 microg/g) all gloves belonged to the previously defined low-allergen category. CONCLUSIONS By comparing the sum concentration of four selected NRL allergens with results obtained in human IgE-ELISA inhibition, it was possible set a cut-off level (0.15 microg/g) below which virtually all gloves contain low or insignificant amounts of allergens, and can be considered as low allergenic. At different cut-off-points, one could calculate the likelihood of a given glove to belong to the previously defined low, moderate or high allergen categories.
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Affiliation(s)
- T Palosuo
- Laboratory of Immunobiology, National Public Health Institute, Helsinki, Finland
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Yeang HY, Hamilton RG, Bernstein DI, Arif SAM, Chow KS, Loke YH, Raulf-Heimsoth M, Wagner S, Breiteneder H, Biagini RE. Allergen concentration in natural rubber latex. Clin Exp Allergy 2007; 36:1078-86. [PMID: 16911364 DOI: 10.1111/j.1365-2222.2006.02531.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Hevea brasiliensis latex serum is commonly used as the in vivo and in vitro reference antigen for latex allergy diagnosis as it contains the full complement of latex allergens. OBJECTIVE This study quantifies the concentrations of the significant allergens in latex serum and examines its suitability as an antigen source in latex allergy diagnosis and immunotherapy. METHODS The serum phase was extracted from centrifuged latex that was repeatedly freeze-thawed or glycerinated. Quantitation of latex allergens was performed by two-site immunoenzymetric assays. The abundance of RNA transcripts of the latex allergens was estimated from the number of their clones in an Expressed Sequence Tags library. RESULTS The latex allergens, Hev b 1, 2, 3, 4, 5, 6, 7 and 13, were detected in freeze-thawed and glycerinated latex serum at levels ranging from 75 (Hev b 6) to 0.06 nmol/mg total proteins (Hev b 4). Hev b 6 content in the latex was up to a thousand times higher than the other seven latex allergens, depending on source and/or preparation procedure. Allergen concentration was reflected in the abundance of mRNA transcripts. When used as the antigen, latex serum may bias the outcome of latex allergy diagnostic tests towards sensitization to Hev b 6. Tests that make use of latex serum may fail to detect latex-specific IgE reactivity in subjects who are sensitized only to allergens that are present at low concentrations. CONCLUSION Latex allergy diagnostics and immunotherapy that use whole latex serum as the antigen source may not be optimal because of the marked imbalance of its constituent allergens.
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Affiliation(s)
- H-Y Yeang
- Biotechnology and Strategic Research Unit, Rubber Research Institute of Malaysia, Malaysian Rubber Board, Malaysia
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Krakowiak A, Wiszniewska M, Krawczyk P, Szulc B, Wittczak T, Walusiak J, Pałczynski C. Risk factors associated with airway allergic diseases from exposure to laboratory animal allergens among veterinarians. Int Arch Occup Environ Health 2006; 80:465-75. [PMID: 17021840 DOI: 10.1007/s00420-006-0153-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2006] [Accepted: 09/04/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Investigate the risk factors for the development of occupational airway allergy (OAA) from exposure to laboratory animal allergens (LAA) among Polish veterinarians. METHODS Two hundred veterinarians responded to the questionnaire and were subjected to skin prick test (SPT) to common allergens and LAA (rat, mouse, hamster, guinea pig, rabbit). Evaluation of total serum IgE level and specific IgE against occupational allergens was performed. In addition, bronchial hyperreactivity (BHR) and peak expiratory flow rate (PEFR) were measured before and after specific challenge testing (SCT) only in the subjects with work-related symptoms suggestive of occupational asthma (OA). RESULTS The prevalence of asthmatic and ocular symptoms was statistically more prevalent in the group of veterinarians sensitised to LAA versus non-sensitised subjects. The most frequent occupational allergens of skin and serum reactivity were LAA (44.5 and 31.5%, respectively). In 41 (20.5%) and in 22 (11%) subjects out of 200 veterinarians, serum specific IgE to natural rubber latex (NRL) allergens and disinfectants was also found. Serum sensitisation to cat allergens and daily contact with laboratory animals (LA) increased the risk for developing isolated occupational rhinitis. Furthermore, working time of more than 10 years and daily contact with LA were also significant risk factors for the development of OAA. Measuring PEFR and BHR before and after SCT is a useful method to confirm the presence of OA. CONCLUSIONS Allergy to LAA is an important health problem among veterinary medicine practitioners in Poland.
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Affiliation(s)
- Anna Krakowiak
- Department of Occupational Diseases, Nofer Institute of Occupational Medicine, 8 Teresy Street, 91-348 Lodz, Poland.
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Sastre J, Quirce S. Immunotherapy: an option in the management of occupational asthma? Curr Opin Allergy Clin Immunol 2006; 6:96-100. [PMID: 16520672 DOI: 10.1097/01.all.0000216851.10571.64] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW To review clinical data on immunotherapy applied to occupational asthma. RECENT FINDINGS There are very few studies on immunotherapy in occupational asthma. The best documented use of immunotherapy in this disorder corresponds to latex allergy among healthcare workers. There are anecdotic reports of non-well controlled studies using immunotherapy with wheat flour, African maple wood, sea squirt and rat epithelium extracts. Subcutaneous immunotherapy with natural rubber latex extract, at adequate doses, seems to be a useful treatment in reducing cutaneous and respiratory symptoms, but it should be considered as a high-risk treatment due to the appearance of systemic reactions. SUMMARY At present, subcutaneous immunotherapy with latex extract can only be considered experimental and must be administered by experienced allergists in a hospital setting, similarly to venom immunotherapy. Nevertheless, systemic reactions responded well to treatment. Further clinical trials on efficacy, safety and long-term effectiveness in immunoglobulin E-mediated occupational rhinitis and asthma are clearly needed. Since allergen avoidance is not always possible, no other etiologic treatment but immunotherapy can be offered to patients with occupational rhinitis/asthma.
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Affiliation(s)
- Joaquín Sastre
- Fundación Jiménez Díaz, Allergy Department, Universidad Autónoma de Madrid, Madrid, Spain.
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Crippa M, Belleri L, Mistrello G, Tedoldi C, Alessio L. Prevention of latex allergy among health care workers and in the general population: latex protein content in devices commonly used in hospitals and general practice. Int Arch Occup Environ Health 2006; 79:550-7. [PMID: 16468057 DOI: 10.1007/s00420-005-0080-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2004] [Accepted: 12/14/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND In this study the latex protein content in devices commonly used in hospitals and general practice were investigated. The main aim was to acquire information for preventing latex allergy in health care workers and in the general population. METHODS About 22 different types of medical devices and 23 devices commonly used in general practice were examined evaluating the total allergenic potency by a modified RAST-inhibition assay and quantitative determination of single allergens (Hev b1, Hev b5 and Hev b6.02) by using commercial ELISA kit. RESULTS A high level of inhibition was found in medical devices, such as elastic bandage (81.57%), tourniquet (74.09%), Foley urinary catheter (68.35%), Penrose drainage (67.25%) and taping (39.6%), and in common devices, such as rubber inner-sole (84.20%), toy balloon (78.62%), latex mattress (74.27%), household rubber gloves (49.10%), working gloves (38.25%), inflatable floating mattress (32.10%). Concentrations of latex extractable proteins and Hev b1, Hev b5 and Hev b6.02 antigens were high in some medical and general devices. CONCLUSIONS Latex exposure sources were found in hospitals and the home. These findings, though only preliminary and far from conclusive, could enable sensitized persons to avoid risky exposures and prevent allergic reactions. From the point of view of prevention, the time may come when every natural rubber object could be systematically labelled as "containing latex" together with the warning that "this item may cause allergic reactions in sensitized subjects."
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Affiliation(s)
- Michela Crippa
- Institute of Occupational Health, University of Brescia, Regional hospital Sp. Civili of Brescia, Brescia, Italy.
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Guillet G, Guillet MH, Dagregorio G. Allergic contact dermatitis from natural rubber latex in atopic dermatitis and the risk of later Type I allergy. Contact Dermatitis 2005; 53:46-51. [PMID: 15982232 DOI: 10.1111/j.0105-1873.2005.00634.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The aims of the study were to assess whether contact dermatitis in children could be due to a delayed hypersensitivity reaction to natural rubber latex (NRL) and to define risk factors for later occurrence of Type I hypersensitivity to this allergen. Among 1800 children investigated for contact dermatitis, 55 were referred on suspicion of rubber allergy and had patch tests to NRL, as well as prick tests and blood tests for specific immunoglobulin E (IgE). A 2-year follow-up was then carried out. Delayed hypersensitivity to NRL was confirmed in 32 children. Patch testing with NRL proved to be positive, and clinical improvement confirmed the diagnosis and relevance of patch tests. 30 of these 32 patients had associated atopic dermatitis (AD). Prick tests and blood tests for specific IgE to latex were negative at the time of diagnosis. A 2-year follow-up showed that 10 of 27 patients presenting initially with a positive patch test without associated Type I sensitization later developed immediate hypersensitivity. Children with AD are at high risk for allergy to NRL protein. Exclusion of this allergen should be strongly advised in atopics because of the dual risk of dermatitis and later evolution into severe Type I hypersensitivity.
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Affiliation(s)
- G Guillet
- Department of Dermatology and Venereology, Centre Hospitalo-Universitaire de Poitiers, Poitiers, France
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Abstract
The highest rates of anaphylaxis in humans occur in early childhood associated with food allergy. Latex allergy, pharmaceutical drugs, and stinging insect reactions are important later in childhood, with drug allergy peaking in adult populations. Knowledge about diagnosis and therapy of anaphylaxis is critical, because a large percentage of subjects are not previously known to be at risk at the time of initial reactions. This article summarizes the basic clinical knowledge of anaphylaxis in childhood.
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Affiliation(s)
- Asriani M Chiu
- Division of Allergy and Immunology, Medical College of Wisconsin, 9000 West Wisconsin, Suite 411, Milwaukee, WI 53226, USA.
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Abstract
Latex allergy has become an increasing cause of morbility in the last few years and is now recognized as an international health problem. The prevalence of latex sensitization among the general population is less than 1 %. The groups at highest risk include healthcare workers, rubber industry workers, patients with a history of multiple surgical procedures, particularly children with spina bifida and urogenital abnormalities, atopic individuals, and patients with certain fruit allergies (especially kiwi, avocado, chestnut and banana). The molecular and immunological characteristics of several natural latex allergens have been identified. Symptoms range from contact urticaria to anaphylaxis. Diagnosis is based on clinical history and is confirmed by skin prick tests. Measurement of serum specific IgE to latex can also be useful. The best treatment is latex avoidance and substitution by other materials. However, because latex products are ubiquitous in medical and nonmedical devices of daily use, a latex-free environment is not easy to achieve. In some patients, immunotherapy could be an alternative.
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Affiliation(s)
- A Valls
- Servicio de Alergología, Hospital Universitario La Paz, Castellana 261, 28046 Madrid, Spain
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Johar A, Lim DL, Arif SAM, Hawarden D, Toit GD, Weinberg EG, Motala C, Fieggen G, Yeang HY, Potter PC. Low prevalence of latex sensitivity in South African spina bifida children in Cape Town. Pediatr Allergy Immunol 2005; 16:165-70. [PMID: 15787875 DOI: 10.1111/j.1399-3038.2005.00221.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Spina bifida children have a high prevalence of latex allergy in studies reported from Europe and the USA. This study investigated the prevalence of latex allergy in a cohort of 24 spina bifida children at the Red Cross Children's Hospital from Cape Town, South Africa. The children were investigated using a detailed questionnaire, skin prick tests (ALK-Abello), ImmunoCap RASTs, Western blotting and ELISA, using the purified latex proteins Hev b1 and Hev b3 and whole latex preparation. A low overall prevalence of latex sensitization of 16.7% was found in the children. Children who were sensitive reacted to water insoluble to Hev b1 and Hev b3 proteins. The low prevalence of latex sensitization in the South African children may not be entirely explained by stringent latex avoidance. The children were from a low socioeconomic social status and 'hygiene' and other factors should be considered.
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Affiliation(s)
- Asmah Johar
- Department of Dermatology, Hospital Kuala Lumpur, Malaysia
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Ahmed SM, Aw TC, Adisesh A. Toxicological and immunological aspects of occupational latex allergy. ACTA ACUST UNITED AC 2005; 23:123-34. [PMID: 15578865 DOI: 10.2165/00139709-200423020-00005] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Latex allergy continues to be an important occupational health problem as latex products are used increasingly worldwide, particularly in healthcare. Although there are few epidemiological studies on the incidence of latex allergy, there has been an increase in the number of case reports over the last 10 years and, based on skin-prick tests, estimates of prevalence of latex allergy in healthcare workers range from 2% to 17%. The allergic health effects arise either from the latex proteins, generally causing a type I immediate hypersensitivity reaction, or from the chemicals added to latex during processing, causing a type IV delayed hypersensitivity reaction. Clinical manifestations of latex allergy depend on the route of exposure and occur by direct contact either with skin or mucosa, or by inhalation. The diagnosis of latex allergy is based on the history, skin tests, serological tests and challenge tests. Thirteen latex allergens have been identified and isolated so far from natural rubber latex. They differ in their potential to elicit immunological responses in individuals allergic to latex and thus have been designated as major or minor allergens. In latex gloves, cornstarch powder used as a donning agent carries latex proteins, thereby increasing inhalational and mucosal exposure to latex proteins. There also appears to be a positive correlation between protein content and allergenicity of gloves. The use of powder-free, low-protein gloves is effective in reducing symptoms and markers of sensitisation. Alternatives to latex gloves, such as nitrile or vinyl gloves are available but may be inferior in respect to manual dexterity and biological impermeability.
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Affiliation(s)
- Syed M Ahmed
- Occupational Health Department, Kent and Canterbury Hospital, Canterbury, Kent, UK
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de Silva HD, Gardner LM, Drew AC, Beezhold DH, Rolland JM, O'Hehir RE. The hevein domain of the major latex-glove allergen Hev b 6.01 contains dominant T cell reactive sites. Clin Exp Allergy 2004; 34:611-8. [PMID: 15080815 DOI: 10.1111/j.1365-2222.2004.1919.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Sensitization to natural rubber latex (Hevea brasiliensis) is a major cause of occupational asthma and rhinitis affecting frequent latex-glove users. Hev b 6.01, a known major latex allergen, is cleaved naturally into hevein (4.7 kDa) and a C-terminal fragment (14 kDa). Hevein is an abundant protein in latex-glove extracts. As the immune response to allergens is initiated by activation of allergen-specific CD4(+) T cells, identification of dominant T cell epitopes is crucial for the development of specific immunotherapy. OBJECTIVE To identify dominant T cell epitopes of Hev b 6.01 in latex-allergic glove users. METHODS Ten latex-allergic frequent glove users and six non-latex-allergic atopic control subjects were selected, based on clinical symptoms and positive latex-specific serum IgE. Serum IgE reactivity to glove extract and recombinant Hev b 6.01 (rHev b 6.01) were analysed by ELISA. Latex-specific short-term oligoclonal T cell lines were generated from peripheral blood of latex-allergic subjects. These lines were tested for proliferative responses to overlapping 20-mer peptides of the Hev b 6.01 molecule. CD4(+) T cell intracellular cytokines, IL-4 and IFN-gamma were assessed following stimulation with immobilized anti-CD3 in the presence of IL-2. RESULTS All ten of the latex-allergic patients showed serum IgE binding to glove extract while eight of these also showed IgE binding to rHev b 6.01 by ELISA. Western blotting confirmed reactivity with rHev b 6.01 at around 20 kDa. T cell proliferation assays showed that latex-specific T cell lines from all subjects responded to one or more peptides, with greatest frequency of reactivity to peptides Hev b 6.01 p(10-29) and Hev b 6.01 p(19-38) in the hevein domain. An allergic-type cytokine profile with considerable IL-4 in addition to IFN-gamma was evident from intracellular cytokine staining. CONCLUSION Hevein is an important T cell as well as B cell immunogen and contains dominant T cell reactive sites.
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Affiliation(s)
- H D de Silva
- Co-operative Research Centre for Asthma, Sydney, Australia
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48
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Raulf-Heimsoth M, Rozynek P, Brüning T, Rihs HP. Characterization of B- and T-cell responses and HLA-DR4 binding motifs of the latex allergen Hev b 6.01 (prohevein) and its post-transcriptionally formed proteins Hev b 6.02 and Hev b 6.03. Allergy 2004; 59:724-33. [PMID: 15180759 DOI: 10.1111/j.1398-9995.2004.00475.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Multiple immunoglobulin E (IgE)-binding proteins in natural rubber latex extracts have been identified. In the case of Hev b 6 a differentiation was made between the precursor protein prohevein (Hev b 6.01) and its two post-transcriptionally formed proteins, the N-terminal hevein (Hev b 6.02) and the C-terminal domain (Hev b 6.03). All three components act as independent allergens. The aim of this study was a detailed analysis of the T-cell responses and the IgE-binding capacity of Hev b 6.01, Hev b 6.02 and Hev b 6.03 by using these allergens as recombinant maltose-binding fusion (MBP) proteins and the usage of synthetic modified hevein peptides. METHODS Latex-allergic health care workers (HCWs) suffering from rhinitis, conjunctivitis, contact urticaria and/or asthma with increased specific IgE-antibodies to latex were tested for their IgE-binding capacity and T-cell reactivity (by proliferation response) to the recombinant MBP-rHev b 6.01, MBP-rHev b 6.02, MBP-rHev b 6.03, to native Hev b 6.02, to modified hevein peptides and wheat germ agglutinin (WGA). For testing of the human leucocyte antigen (HLA) class II restriction of MBP-rHev b 6.01 induced peripheral blood mononuclear cell (PBMC) responses, monoclonal antibodies against HLA-DR, HLA-DP or HLA-DQ were added. RESULTS Seventeen of 18 (94%) serum samples from latex-allergic HCWs had increased levels of specific IgE to MBP-rHev b 6.01, 16 (89%) to MBP-rHev b 6.02 and 13 (72%) to MBP-rHev b 6.03. A significant difference existed between the specific IgE-values of MBP-rHev b 6.02 and MBP-rHev b 6.03 (P < 0.01). Proliferation responses of PBMC of the same 18 latex-allergic patients were positive for MBP-rHev b 6.01 and MBP-rHev b 6.03 in 83 and 67% of the tested PBMC suspension, whereas the proliferation responses induced with MBP-rHev b 6.02 or native Hev b 6.02 were very low (5.6 and 22.2%). Sera from nine additional latex-allergic patients showed specific IgE binding to the native Hev b 6.02, but none of these sera showed specific IgE binding to the modified Hev b 6.02-peptides [whereby all eight cysteine residues were substituted by serine (C --> S) or by alanine (C --> A)]. Proliferation responses induced by the modified Hev b 6.02 peptides were not significantly different from that induced by Hev b 6.02. Potential HLA-DR4Dw4(DRB1*0401)-restricted T-cell epitopes of Hev b 6.01 predicted by two computer algorithms were only found in the Hev b 6.03-part of Hev b 6.01. CONCLUSION In the Hev b 6.01 precursor the regions responsible for IgE binding and those for inducing the T-cell proliferation responses are settled in different parts of the protein. The Hev b 6.02 domain is responsible for IgE binding and carries discontinuous B-cell epitopes whereas Hev b 6.03 is a better inducer of a proliferation response and contains HLA-DR4-binding motifs.
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Affiliation(s)
- M Raulf-Heimsoth
- Research Institute for Occupational Medicine of the Berufsgenossenschaften (BGFA), Institute of the Ruhr-University Bochum, Bochum, Germany
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Hanson M, Lobner D. In vitro neuronal cytotoxicity of latex and nonlatex orthodontic elastics. Am J Orthod Dentofacial Orthop 2004; 126:65-70. [PMID: 15224061 DOI: 10.1016/j.ajodo.2003.07.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Although the toxicity of many dental materials has been thoroughly investigated, the toxicity of orthodontic elastic materials has not been extensively tested. We evaluated the neurotoxicity of 3 latex and 3 nonlatex orthodontic elastics in murine cerebral cortical cell cultures. Standard-sized pieces of each material from 3 manufacturers (American, Masel, and GAC) were placed on culture well inserts, allowing the material to be exposed to the culture bathing media without causing physical disruption of the cells. Cell death was quantified by assaying the release of the cytosolic enzyme lactate dehydrogenase. Exposure of cortical cultures to the nonlatex elastics did not cause significant neuronal death, but exposure to each of the latex elastics resulted in significant neuronal death. The neuronal death induced by each of the latex elastics was blocked by adding the metal chelator, EDTA (calcium disodium ethylenediaminetetraacetate). Because many latexes use zinc-containing compounds in the prevulcanization process, and the death induced had characteristics similar to zinc-induced neuronal death, it seems likely that the toxicity of latex elastics was mediated by zinc release. Because ingestion of zinc is not a health risk, the results suggest that, in spite of the finding that latex elastics have higher in vitro cytotoxicity than nonlatex elastics, the use of latex elastics in orthodontics is acceptable.
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Affiliation(s)
- Mark Hanson
- Department of Biomedical Sciences, School of Dentistry, Marquette University, 561 N. 15th Street, Room 426, Milwaukee, WI 53201, USA
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