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Biomedical subjects

J E Slater

Publications and source records attributed to J E Slater.

At least 37 records · Page 2Linked to original sources
PubMed1996

Identification, cloning, and sequence of a major allergen (Hev b 5) from natural rubber latex (Hevea brasiliensis).

Proteins in commercial latex products, derived from the rubber tree Hevea brasiliensis, cause anaphylaxis in susceptible individuals, especially health care workers and children with spina bifida. To identify latex allergens, we utilized IgE from the serum of a latex-allergic health care worker to screen a cDNA library from Hevea latex. The identified cDNA clone, cDNA Hev b 5, encodes an open reading frame of 163 peptide residues. Hybridization analysis of cDNA Hev b 5 with RNA extracted from Hevea tissue indicates that the full-length transcript is about 1000 bases. The nucleotide and deduced protein sequences have significant homology to sequences from kiwi and potato, which are known to cause allergic reactions in some latex-allergic patients. Fifty-six percent of spina bifida patients and 92% of health care workers with latex allergy have IgE specific to the protein encoded by cDNA Hev b 5. A monoclonal antibody raised from a mouse immunized with Hev b 5 binds to a protein in Hevea latex with an Mr identical to that of the expressed and cleaved recombinant protein. Taken together, these results establish that the antigen Hev b 5 contains a major epitope for IgE-mediated reactions to H. brasiliensis latex products.

Adult↗
PubMed1995

Latex hypersensitivity in children.

Latex is a natural substance used in the manufacture of thousands of products. Although latex allergy is uncommon in the general population, health care workers and children with spina bifida appear to be at high risk for latex allergy. These patients may experience urticaria, rhinoconjunctivitis, bronchospasm, and anaphylaxis following contact with or inhalation of latex antigens. Several protein allergens in latex have been identified, some of which appear to cross-react clinically and immunochemically with fruit antigens. Good diagnostic tests are available for latex allergy, but strict avoidance is still the only available treatment.

Asthma↗
PubMed1994

Latex allergy.

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Humans↗
PubMed1994

A cluster of anaphylactic reactions in children with spina bifida during general anesthesia: epidemiologic features, risk factors, and latex hypersensitivity.

BACKGROUND: Anaphylactic reactions (ARs) in high-risk pediatric patients undergoing general anesthesia, especially those with spina bifida, have been attributed to anesthetics, muscle relaxants, antimicrobials, ethylene oxide, and latex. METHODS: To identify risk factors for AR during general anesthesia and to investigate the role of latex allergy, we studied epidemiologic and immunologic characteristics of patients with ARs during general anesthesia during a 13-month cluster of such reactions at Children's Hospital of Wisconsin (case patients). Patients with AR were compared with patients with spina bifida undergoing uneventful general anesthesia during the same period (control patients). For each case patient and control patient, we conducted a chart review; a parental interview; skin prick testing with latex, anesthetics, aeroallergens, and banana extract; ELISA and RAST for latex-specific IgE; a total serum IgE; and an ELISA for IgE antibody to ethylene oxide. RESULTS: Anaphylactic reactions occurred exclusively in patients with spina bifida (n = 10) or patients with a congenital urinary tract anomaly (n = 1). Case-patients were more likely than control patients to have a history of asthma (p = 0.002), rubber contact allergy (p = 0.001), food allergy (p = 0.001), rash caused by adhesive tape (p = 0.05), daily rectal disimpaction (p < 0.001), nine or more prior surgical procedures (p < 0.002), latex-specific IgE (p = 0.027), or elevated total serum IgE levels (p = 0.002). Multivariate analysis identified non-white race, rubber contact allergy, history of food allergy, and nine or more surgical procedures as significant independent risk factors. Logistic model equation identified the predicted probability of AR with a sensitivity, specificity, and positive predictive value of 82%, 97%, and 82%, respectively. CONCLUSIONS: These findings demonstrate that atopy, especially symptomatic latex allergy, is associated with AR during anesthesia in patients with spina bifida. Until a standardized latex test is available, a medical history of immediate rubber contact allergy, non-white race, food allergy, or nine or more prior surgical procedures can identify patients with spina bifida at highest risk for ARs. A complete history, including rubber contact and food allergy, should be compiled on all patients with spina bifida before surgery.

Anaphylaxis↗
PubMed1994

Immunodetection of latex antigens.

BACKGROUND: Protein antigens in latex products can cause type I reactions. In the past antigens have been measured by protein assays, high-performance liquid chromatography, RAST inhibition, and skin tests. We examined the use of a mouse monoclonal antibody (CRI-C) to latex in the detection of latex antigens. METHODS: CRI-C was raised by standard techniques after immunization of a BALB/c mouse with ammoniated latex. Medical gloves were extracted and assayed with: (1) standard protein assays, (2) RAST inhibition assays with sera from health care workers allergic to latex and patients with spina bifida, (3) an ELISA with a biotinylated form of CRI-C (BiC). Reference proteins included bovine serum albumin for the protein assays and nonammoniated latex and affinity-purified C antigen for the immunoassays. RESULTS: Among the protein assays, the best correlation was between the Bradford and bicinchoninic acid assays. In absolute numbers the Bradford assay produced the lowest results, and OD280 the highest. The OD280, BCA, and Bradford methods "detected" protein in vinyl gloves. The results of RAST inhibition and BiC ELISA correlated with the protein assays. These immunoassays appeared to be more specific than the protein assays. CONCLUSIONS: The BiC ELISA is an easy and reproducible in vitro assay of relevant latex antigen. Clinical correlation will be required for validation.

Animals↗
PubMed1994

Affinity purification of latex antigens.

Latex extracts are complex mixtures of antigenic peptides. We attempted to raise monoclonal antibodies to latex and to use these antibodies to purify latex antigens. A monoclonal antibody, CRI-C, was raised by standard techniques. Peptides of nonammoniated latex (NAL) and ammoniated latex were electrophoretically separated and transferred for immunoblots. CRI-C was covalently attached to an agarose column. NAL was passed over the column, and purified antigen was then eluted. The eluate was analyzed by sodium dodecylsulfate-polyacrylamide gel electrophoresis and RAST inhibition with sera from health care workers and children with spina bifida. CRI-C recognized a single band in ammoniated latex immunoblots and several distinct bands in NAL. The affinity-purified antigen of CRI-C (C-Ag) had multiple bands of less than 20 kd and was 3.9 times more potent in RAST inhibition than NAL when sera from patients with spina bifida were used. However, when health care workers' sera were used, there was no significant difference in the inhibitory potency of NAL and C-Ag. CRI-C appears to recognize a distinct and important epitope in the IgE immune response to latex of patients with spina bifida.

Animals↗
PubMed1993

Latex allergy in children.

Natural latex, a product of the tropical rubber tree, Hevea brasiliensis, has been shown to cause allergic reactions in an increasing number of individuals. Severity of reaction has ranged from mild contact dermatitis to anaphylaxis. Individuals with spina bifida, congenital urogenital anomalies, health care workers, and those employed in the rubber industry are at highest risk for immediate hypersensitivity to latex. Health care workers should be aware of this high risk to minimize exposure of patients.

Child↗
PubMed1993

Latex allergy.

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Anaphylaxis↗
PubMed1992

Latex antigens.

Previous studies have demonstrated that some children with spina bifida have IgE to proteins in natural rubber. In this study we compare different sources of latex antigen and identify possible antigenic peptides by radioimmunoblotting technique. Sera were collected from 26 children with spina bifida, tested by RAST with ammoniated latex extract (AL), and frozen until use. Extracts were prepared from ammoniated and nonammoniated latex, and the proteins were separated by electrophoresis on a 15% sodium dodecyl suflate-polyacrylamide gel and transferred to polyvinylene difluoride (PVDF). Strips of PVDF were then incubated with individual sera and 125I-labeled rabbit antihuman IgE before development by autoradiography; 18/26 sera were AL RAST positive; 0/8 AL RAST-negative patients had any binding to the latex proteins on PVDF. Sera from all patients were tested in a RAST with a nonammoniated latex extract (NAL), and the results were comparable to the AL RAST. Liquid-phase AL and NAL were comparable in their ability to inhibit the binding of patient's IgE to solid-phase AL and NAL. Sera from 14 RAST-positive patients were tested by immunoblotting with separated, reduced, and nonreduced AL and NAL. All 14 sera demonstrated IgE binding to a 14 kd peptide, which was more pronounced in reduced NAL. These results suggest that the 14 kd peptide in NAL is a major antigen in rubber allergy but that AL is an acceptable antigen source for in vitro diagnostic studies.

Antibody Specificity↗
PubMed1992

Allergic reactions to natural rubber.

Immediate hypersensitivity reactions to natural rubber pose a significant risk to patients with spina bifida and urogenital abnormalities, health care workers, and rubber industry workers. Other patients, outside of these high risk groups, have experienced severe allergic reactions to natural rubber as well. Awareness of this life-threatening condition by health care providers is essential if reactions are to be prevented. History alone is inadequate to identify all patients at risk, and reliable testing materials are not yet approved or widely available. Nonrubber medical devices are readily available for most uses; however, the only rubber-free condoms currently on the market do not prevent the transmission of sexually transmitted disease. The identification and detection of rubber antigens, along with mandated labeling for rubber antigen content, will contribute to the care of this growing population of patients. Efforts by the rubber industry to decrease the antigen content of natural rubber products will decrease the risk of reaction among sensitized patients and will, very likely, decrease the rate of sensitization in the future.

Humans↗
PubMed1991

Rubber-specific IgE in children with spina bifida.

We attempted to determine the prevalence and clinical significance of rubber-specific IgE in a prospective case control study of 32 preoperative children with spina bifida, compared with 45 outpatient controls and 35 age-matched preoperative controls without spina bifida. A latex-specific radioallergosorbent test was positive in 11 of the 32 spina bifida patients (34%), compared with 1 (2%) and 4 (11%) of the respective controls (p less than 0.05). Within the spina bifida group 5 of 11 antibody-positive patients had a history of rubber-associated, intraoperative or otherwise idiopathic allergic episodes and 1 of 21 antibody-negative patients gave such a history (p = 0.012). Children with spina bifida have a significantly greater likelihood than controls of having IgE specific for rubber antigens. In addition, the presence of rubber-specific IgE is associated with a higher frequency of rubber-associated, intraoperative or idiopathic allergic reactions.

Adolescent↗