In vivo sensitization to purified Hevea brasiliensis proteins in health care workers sensitized to natural rubber latex

David I. Bernstein, Raymond E. Biagini, Ravi Karnani, Robert Hamilton, Karen Murphy, Cheryl Bernstein, Siti Arija M. Arif, Brian Berendts, H. Y. Yeang

Research output: Contribution to journalArticlepeer-review

84 Scopus citations


Background: Thirteen proteins of natural rubber latex (Hevea brasiliensis) known to bind human IgE have been isolated and characterized as Hev b allergens. However, the in vivo importance of native Hev b allergens has not been defined in health care workers (HCWs) with natural rubber latex (NRL) allergy. Objectives: The principal aim of this study was to identify the major in vivo Hev b allergens in HCWs with NRL allergy confirmed by percutaneous sensitivity to nonammoniated latex (NAL). Methods: Skin prick testing was performed with 7 (native) proteins purified from NAL (Hev b 1, 2, 3, 4, 6.01, 7.01, and a newly described Hev b 13) and recombinant Hev b 5 in 62 HCWs with histories of NRL allergy (group 1) confirmed by percutaneous reactivity to NAL and in 49 atopic HCWs without NRL allergy (group 2). Serial 10-fold concentrations of Hev b proteins (5 × 10-5 μg/mL to 50 μg/mL) were tested; serum samples of subjects were assayed for serum specific IgE by immunoassays. Results: Hev b 2, Hev b 5, Hev b 6.01, and Hev b 13 produced skin reactions in more than 60% of group 1 subjects, with Hev b 1, 3, 4, and 7.01 eliciting reactions in less than 50%. Only 1 of 49 group 2 workers reacted to a single Hev b antigen (Hev b 13). Specificity of 7 Hev b allergens was 100% and 98% for Hev b 13 in identifying workers with confirmed NRL allergy. Specific IgE by AlaSTAT and CAP immunoassays was elevated in 40 of 60 (67%) and 33 of 62 (53%) of NAL-reactive workers and produced false-positive test results in 4 of 49 (8%) and 3 of 48 (6%) group 2 subjects, respectively. Conclusion: Hev b 2, 5, and 6.01 are major in vivo allergens and Hev b 13 is a new major in vivo allergen among HCWs with allergy to NRL.

Original languageEnglish (US)
Pages (from-to)610-616
Number of pages7
JournalJournal of Allergy and Clinical Immunology
Issue number3
StatePublished - Mar 1 2003


  • Health care workers
  • Hev b
  • Hev b 13
  • Latex
  • Latex allergy
  • Natural rubber latex
  • Skin prick test

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


Dive into the research topics of 'In vivo sensitization to purified Hevea brasiliensis proteins in health care workers sensitized to natural rubber latex'. Together they form a unique fingerprint.

Cite this