Latex sensitization by dermal exposure can lead to airway hyperreactivity

Using non-powdered, low-protein natural rubber latex (NRL) gloves has been shown to reduce the elicitation of respiratory symptoms in latex-allergic individuals; however, the role of dermal exposure in the induction of sensitization is not completely understood.

These studies were conducted to (1) determine levels of NRL protein in gloves currently in use and (2) evaluate, using a murine model, the potential for dermal exposure to induce NRL sensitization and subsequent airway hyperreactivity upon respiratory challenge.

Total extractable protein and NRL allergen levels were evaluated from 38 glove samples using the Lowry and CAP inhibition assays, respectively. BALB/c mice were dermally exposed to non-ammoniated latex (NAL, 6.25-25 microg) 5 days/week for 13 weeks and monitored weekly/biweekly for IgE levels. Airway hyperreactivity was determined following respiratory challenge with methacholine (MCH) or NAL proteins on days 60 and 93, respectively.

Glove total protein and NRL allergen levels ranged from below the limit of detection to 946 microg/g and from 0.002 to 112 microg/g, respectively. Mice demonstrated dose-dependent increases in total serum IgE levels by day 58 with increased airway hyperreactivity observed upon respiratory challenge with MCH (day 60) or NAL proteins (day 93).

These studies investigated the continued use of gloves with high levels of total extractable protein and NRL allergen. The potential for dermal exposure to induce NRL-specific IgE and airway hyperreactivity upon respiratory challenge suggests there should be continued concern regarding the induction of sensitization in individuals using non-powdered latex gloves.