[Latex allergy and cross-reactions: a new threat?]

Allergy to latex proteins has become an important problem, especially in the medical profession, but also in people who have regularly contact with latex products. The responsible antigens are proteins, which are present in the natural rubber latex (NRL), extracted from Hevea brasiliensis. These proteins are important in the synthesis of rubber and in the defence of the plant against external noxes (pathogenesis related proteins). Life threathening reactions occur more frequently in the operating theatre. Sensitisation can occur via different routes (aerogen, skin, parenteral, ...) but aerogenic sensitisation seems to be very important. Starch particles are important vectors of the antigens. Diagnosis is made via history, confirmed by demonstration of specific IgE via skin test (in vivo) or via an in vitro method (e.g. CAP, ELISA). Immunological cross reactions are very frequent with other plant or fruit allergens but cross allergy is less frequent (sensitivity and specificity of the in vitro test varies considerably depending on the nature of the fruit or vegetable investigated). There is also a cross reactivity with Ficus. Prevention with latex allergens becomes primordial in hospital settings. The industry is aware of the problem and produces more and more synthetic latex products.