Identification of hevein (Hev b 6.02) in Hevea latex as a major cross-reacting allergen with avocado fruit in patients with latex allergy

doi:10.1016/S0091-6749(98)70138-1

Journal of Allergy and Clinical Immunology

Volume 102, Issue 3, September 1998, Pages 476-481

https://doi.org/10.1016/S0091-6749(98)70138-1 Get rights and content

Abstract

Background: Recent studies demonstrated that allergy to natural rubber latex is frequently associated with hypersensitivity to avocado fruit. The responsible cross-sensitizing allergen has not been identified.

Objective: The purpose of this study was to investigate the cross-reactivity of a latex major allergen, hevein, with avocado proteins.

Methods: Serum samples from 118 health care workers (HCWs) allergic to latex (HCW group) and 78 patients with spina bifida (SB) allergic to latex (SB group) were included in this study. Anti-hevein and anti-avocado IgE antibodies were measured by enzyme-linked allergosorbent assay. Cross-reactivity of hevein to avocado proteins was assessed by inhibition of the IgE binding in individual patients’ sera containing IgE antibodies to both hevein and avocado.

Results: The prevalence of seropositive IgE antibodies to avocado was found to be strongly associated with the presence of hevein-specific IgE antibodies in subjects of both groups (P < .001). Sixty-seven of 91 (73%) subjects from the HCW group and all 19 subjects in the SB group with positive IgE antibodies to hevein also had elevated IgE values to avocado. Competitive RAST inhibition with 42 sera showed that IgE binding to avocado could be completely inhibited in 27 (64%) sera by preincubation with hevein. By contrast, the degrees of inhibition of IgE to hevein by avocado extract ranged from 0% to 36% (n = 16). These results indicate that sensitization to avocado in most patients allergic to latex is caused exclusively by IgE-binding epitopes present in hevein. Results of immunoblots and immunoblot inhibition with 11 serum samples confirmed that a 30-kd protein in avocado was the major IgE-binding component; the IgE-binding reactivity to this protein could be inhibited by hevein in all sera tested.

Conclusion: Hevein is the major cross-reacting allergen with avocado in subjects with latex allergy. (J Allergy Clin Immunol 1998;102:476-81.)

Section snippets

Study subjects

Serum samples from 118 HCWs allergic to latex (HCW group: 26 men/92 women) and 78 patients with SB (SB group: 43 men/35 women) were included in this study. The serum samples were consecutively collected between July 1993 and December 1996. All of the subjects were previously given a diagnosis of latex allergy on the basis of clinical history and showed the presence of specific IgE antibodies to latex in their sera by latex-RAST (CAP system, Pharmacia). In the HCW group, the mean age of the

Prevalence of sensitization to hevein and avocado

To analyze the prevalence of sensitization to hevein and avocado in patients with latex allergy, 196 serum samples from HCWs allergic to latex (n = 118) and patients with SB (n = 78) were tested by EAST for specific IgE antibodies against hevein and avocado proteins. Twelve sera from individuals without a history of latex allergy were also used as controls. As shown in Fig 1, in the HCW group 91 (77%) samples exhibited elevated IgE antibodies to hevein, and 72 (61%) were found to have positive

DISCUSSION

The aim of this study was to investigate the cross-reactivity potential of hevein from Hevea latex in patients with allergies to both latex and avocado. Recently,²⁰ we demonstrated that hevein (4.7 kd, Hev b 6.02) is one of the most common allergens in latex. However, among the 2 risk groups (HCWs and patients with SB) exhibiting the highest risk of having latex allergies, the prevalence of sensitization to hevein is rather different. Although about 75% of HCWs with latex allergy are sensitized

Acknowledgements

We thank Maria Düser, Angelika Flagge, and Silke Maryska for their technical assistance.

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^☆: From ^athe Research Institute for Occupational Medicine (BGFA), Ruhr-University of Bochum, Bochum; and ^bChildren’s Hospital Cologne, Cologne.

^☆☆: Supported by the German Central Association of Statutory Accident Insurance Institutions, St. Augustin (Project All 6).

^★: Reprint requests: Zhiping Chen, PhD, BGFA, Buerkle de la Camp Platz 1, 44789 Bochum, Germany.

^★★: 0091-6749/98 $5.00 + 0 1/1/92241

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Identification of hevein (Hev b 6.02) in Hevea latex as a major cross-reacting allergen with avocado fruit in patients with latex allergy☆,☆☆,★,★★

Abstract

Section snippets

Study subjects

Prevalence of sensitization to hevein and avocado

DISCUSSION

Acknowledgements

The prevalence of anti-latex IgE antibodies among registered nurses

J Allergy Clin Immunol

Lancet

J Allergy Clin Immunol

J Allergy Clin Immunol

J Allergy Clin Immunol

J Allergy Clin Immunol

FEBS Lett

J Allergy Clin Immunol

J Biol Chem

Lancet

Natural rubber latex allergy

Allergy

Latex allergy in hospital employees

Ann Allergy

Incidence of immediate allergy to latex gloves in hospital personnel

Contact dermatitis