Abstract
The purpose of the study was to develop a suitable natural rubber latex (NRL) antigen powder and a control material for the nasal application of the test reagent and to evaluate the nasal provocation test (NPT) response pattern in latex allergic and nonlatex allergic subjects with a suspicion of latex-induced rhinitis. A questionnaire was completed among health care workers (n = 268) in one hospital. Seven health care workers who had upper respiratory symptoms associated with daily usage of latex gloves were examined by using skin prick test (SPT), NPT, and sinus plain X-ray. NRL allergen for the nasal challenge was collected from surgical gloves. The powder was obtained by washing the gloves, freeze-drying the solution, and the powder was then used in NPT. As a negative control, clean corn starch powder was applicated on nasal mucous. SDS-PAGE analysis of the NRL test powder was performed. After the nasal challenge, one of seven workers showed rhinorrhea, a significant increase in nasal obstruction, and in the amount of nasal secretion in NPT. This patient also showed a positive SPT to NRL allergens and an elevated NRL specific IgE level in her serum. In six patients NPT, SPT, and specific IgE for latex were negative. SDS-PAGE analysis of the glove powder showed a major NRL antigen, with molecular weight of 14 kDa. The NPT may be used in persons with a suspicion of latex-induced rhinitis and borderline skin and humoral test results for NRL and in subjects with heavy glove powder-associated nasal symptoms but negative skin and humoral tests for latex. Only well known test reagents should be used in NPT.
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