What is a Type 1 Reaction to Latex?
Currently , 14 allergens have been identify named by the abbreviation Hev b “ n ” . Allergens sensitize someone through different path establishing different peril groups . Major allergens in patients with spina bifida and multiple operation are Hev b1 and 3 , and in health care professionals , Hev b 5 and 6 .
Reactions Associated with Latex : Sensitization is the process by which anti - latex specific IgE is father , without clinical manifestations . In fact , sensitization does not of necessity mean clinical allergic reaction . Clinical symptom are produce by mechanisms of immediate hypersensitivity ( IgE , type 1 ) and delay hypersensitivity ( character 4 ) .
Clinical Manifestations
Clinical manifestations due to hypersensitivity eccentric I to latex proteins deviate widely and depend on the road of picture , the amount of allergen and individual factors :
-Contact Urticaria : It is the most frequent manifestation and the most common causa of urticaria of occupational contact , which may be unique or forgo systemic reactions . Pruritus , xerodermaandeczemaare nonspecific manifestations .
-Rhinitis and Allergic Asthma : They affect mainly wellness pro and worker exposed to latex in their oeuvre environment . The main source is pulverised glove . It is a cause of occupationalasthma .
-Systemic Reactions : Latex is the second cause , aftermuscle relaxant , of intraoperative anaphylaxis , and occurs more unremarkably during the maintenance phase angle of anesthesia as a cardiogenic shock . Abdominal , gynecological and traumatological interventions are the ones with the greatest risk .
-Latex - fruit Syndrome : The rubber-base paint - fruit association is varying , with a high asymptomatic sensitivity index . It is due to cross - responsiveness mediated mainly by Hev b 6 . The most oftentimes connect solid food are banana tree , kiwi , chestnut tree and aguacate . The clinical presentation varies wide , and can be present as anaphylaxis ( keen allergic reaction ) in up to 50 % of cases .
-Clinical Presentation in Spina Bifida : These children are sensitized by several route , including the mucous membrane , and its most frequent manifestation is urticaria - Quincke’s edema .
Type 1 Hypersensitivity Reaction
It is the most serious and can be link up with considerable unwholesomeness and death rate . It depend on the production of specific IgE against Hev b , sensitizing of mast cell and degranulation before a 2nd vulnerability . Clinically it can be manifested by urticaria and even by anaphylaxis .
Latex proteins are absorbed slowly when they are in the air and symptoms ordinarily seem about 30 minutes after exposure . Mild response let in urticaria , rhinitis andconjunctivitisand are normally triggered by exposure through inhalation or by verbatim contact with the pelt . grave reaction unremarkably occur soon after parenteral or mucosal pic . A late study of anaphylaxis during anesthesia demonstrate that cardiovascular symptoms ( 73.6 % ) , cutaneous manifestations ( 69.6 % ) and bronchospasm ( 44.2 % ) are the most frequent findings . However , in anaphylaxis during anaesthesia other possible causes should be considered , including propofol , muscle relaxant and opioids .
Risk Factors
worker in the wellness area , other prole exposed to latex , patient with atopic feature article and children with spina bifida or genitourinary anomalies submit to multiple surgery stand for the primary grouping at risk of present latex allergic reaction . Hev b 1 is the most important allergen in the sensitization of babe with spina bifida . The prevalence of latex sensitization in the non - atopic general population is less than 1 % while it is 3 % to 12 % in health proletarian . Although sensitization does not always build up to the appearance of symptoms , continued exposure may predispose to symptom . In contrast , eld , airstream and sexual activity do not influence latex allergic reaction .
In recent years the exercise of latex gloves in developed res publica has been greatly reduce . At the same time , sensitivity and symptom related to rubber-base paint photo – allergy , pruritus , bronchial asthma and rhinoconjunctivitis – also appear to have declined in association with the increased role of mitt with low protein message and no dust .
Conclusion
Type I hypersensitivity response , mediated by IgE is the most serious reaction . It command sensitization and the production of specific IgE. During the initial pic , the person is sensitise with the coevals of specific IgE against Hev b. The released intermediator such as histamine , proteases , metabolites of arachidonic loony toons ( leukotrienes and prostaglandins ) head to reactions that fluctuate in intensity between urticaria and anaphylaxis .
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