Background: In addition to their disease-associated handicaps, patients with spina bifida (SB) are at high risk of developing latex allergy. Individuals with SB represent a special group of latex-allergic patients, inasmuch as their IgE-binding patterns differ from those of other populations of latex-allergic individuals. Two allergens strongly associated with latex allergy in patients with SB--Hev b 1 and Hev b 3--have already been identified.
Objective: We intended to identify a predominant IgE-binding band--in addition to Hev b 1 and 3--at 43 kDa in a study population of 38 latex-allergic (IgE antibodies to latex and symptoms on provocation with latex gloves) and 15 latex-sensitized (IgE antibodies to latex but no symptoms on provocation) children with SB (mean age, 12.3 years) and to determine its frequency of recognition.
Methods: Sera of latex-sensitized or latex-allergic patients with SB were tested on latex C extract containing natural Hev b 1, Hev b 3, and Hev b 7 and with the recombinant 43-kDa Hev b 7 in immunoblot and inhibition studies.
Results: Natural Hev b 1 was recognized by 82% and natural Hev b 3 by 79% of the latex-allergic children with SB. In addition to some other proteins, 15 (39.5%) of 38 latex-allergic and 2 (13%) of 5 latex-sensitized children with SB revealed IgE binding to a 43-kDa band in the latex protein extract. We identified this 43-kDa IgE-binding band as natural Hev b 7 by immunoblotting and inhibition experiments using recombinant Hev b 7.
Conclusion: From these data, we conclude that Hev b 7, the patatin-like Hevea latex protein, is the third SB-associated latex allergen. Future immunotherapy for latex-allergic individuals with SB will have to include Hev b 7 in addition to Hev b 1 and Hev b 3.