Alergia al látex: opciones terapéuticas

Autores/as

  • Claudia Elizabeth Jiménez-Carrillo Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Hospital Regional Dr. Valentín Gómez Farías, Servicio de Alergia e Inmunología Clínica, Zapopan, Jalisco https://orcid.org/0000-0002-2311-4751
  • Karen Miroslava Piña-Ramos Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Hospital Regional Dr. Valentín Gómez Farías, Servicio de Alergia e Inmunología Clínica, Zapopan, Jalisco https://orcid.org/0000-0002-9554-6836
  • Carolina Meza-Arrayales Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Hospital Regional Dr. Valentín Gómez Farías, Servicio de Alergia e Inmunología Clínica, Zapopan, Jalisco https://orcid.org/0000-0002-3138-521X
  • Kathya Pamela Villaruel-Flores Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Hospital Regional Dr. Valentín Gómez Farías, Servicio de Alergia e Inmunología Clínica, Zapopan, Jalisco https://orcid.org/0000-0002-8727-1297
  • Alejandro García-Aguirre Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Hospital Regional Dr. Valentín Gómez Farías, Servicio de Alergia e Inmunología Clínica, Zapopan, Jalisco https://orcid.org/0000-0002-5021-2146

DOI:

https://doi.org/10.29262/ram.v69iSupl1.1035

Palabras clave:

Látex, inmunoterapia, desensibilización

Resumen

La alergia al látex es un problema importante en el mundo debido a la gravedad de la sintomatología que produce y a los grupos de riesgo expuestos. La evitación completa es difícil, casi imposible, dada su ubicuidad. El látex de caucho natural (LCN) es un polímero secretado por el árbol Hevea brasiliensis (Hev b), que funciona como sellador protector. Actualmente se usa para fabricar productos para el cuidado de la salud como tapones para tubos, pistones, mascarillas y cánulas. El objetivo de esta revisión es resaltar los aspectos epidemiológicos, clínicos y diagnósticos de la alergia al LCN, y realizar una revisión de la literatura sobre su manejo, mediante una búsqueda bibliográfica de artículos en bases de datos como PubMed, Cochrane, UpToDate y Google Académico, hasta septiembre del 2021. Se revisaron aproximadamente 121 artículos, de los cuales se utilizaron 76 como referencia. Concluimos que la alergia al látex es una entidad cuyo tratamiento aún hoy en día es la evitación, a pesar de tener una prevalencia mundial de 4.3 % y representar una complicación quirúrgica de cerca de 20 % de las cirugías con una reacción anafiláctica y una mortalidad que puede llegar a 9 %. El único tratamiento que podría modificar la evolución de esta enfermedad es la inmunoterapia, pero aún no se cuenta con extractos estandarizados y no se ha podido determinar la vía más segura y efectiva.

Citas

abar AI, Gómez B, Arroabarren E, Rodríguez M, Lázaro I, Anda M. Perspectivas de tratamiento de la alergia al látex: inmunoterapia [Perspectives in the treatment of allergy to latex: immunotherapy]. An Sist Sanit Navar. 2003;26(Suppl 2):97-102. Disponible en: https://recyt.fecyt.es/index.php/ASSN/article/view/5002/

Nucera E, Aruanno A, Rizzi A, Centrone M. Latex allergy: current status and future perspectives. J Asthma Allergy. 2020;13:385-98. DOI: 10.2147/JAA.S242058

Cabañes N, Igea JM, de la Hoz B, Agustín P, Blanco C, Domínguez J, et al. Latex allergy: position paper. J Investig Allergol Clin Immunol. 2012;22(5):313-30. Disponible en: http://www.jiaci.org/issues/vol22issue5/vol22issue05-1.htm

Ownby DR. A history of latex allergy. J Allergy Clin Immunol. 2002;110(2 Suppl):S27-32. DOI: 10.1067/mai.2002.125336

Czuppon AB, Chen Z, Rennert S, Engelke T, Meyer HE, Heber M, et al. The rubber elongation factor of rubber trees (Hevea brasiliensis) is the major allergen in latex. J Allergy Clin Immunol. 1993;92(5):690-7. DOI: 10.1016/0091-6749(93)90012-5.

Czuppon AB, Jaeger D, Baur X. Purification and characterization of a 67 kD latex (Heveu brasiliensis) major allergen from surgical gloves. Allergy Clin Immunol News Suppl. 1991:201.

Yamashita S, Mizuno M, Hayashi H, Yamaguchi H, Miyagi-Inoue Y, Fushihara K, et al. Purification and characterization of small and large rubber particles from Hevea brasiliensis. Biosci Biotechnol Biochem. 2018;82(6):1011-1020. DOI: 10.1080/09168451.2017.1401913

Ohya N, Tanaka Y, Wititsuwannakul, R, Koyama T. Activity of rubber transferase and rubber particle size in Hevea latex. J Rubber Res. 2000;3(4):214-21.

Churinthorn N, Nimpaiboon A, Sakdapipanich J, Ho CC. Effect of particle sizes on film formation behavior of Hevea brasiliensis natural rubber latex. Key Eng Mat. 2015;659:383-7. DOI: 10.4028/www.scientific.net/KEM.659.383

Wood D.F, Cornish K. Microstructure of purified rubber particles. Int J Plant Sci. 2000;161(3):435-45. DOI: 10.1086/314269

Wang S, Liu J, Wu Y, You Y, He J, Zhang J, et al. Micromorphological characterization and label-free quantitation of small rubber particle protein in natural rubber latex. Anal Biochem. 2016;499:34-42. DOI: 10.1016/j.ab.2016.01.015

Berthelot K, Lecomte S, Estevez Y, Zhendre V, Henry S, Thévenot J, et al. Rubber particle proteins, HbREF and HbSRPP, show different interactions with model membranes. Biochim Biophys Acta. 2014;1838(1 Pt B):287-99. DOI: 10.1016/j.bbamem.2013.08.025

Rolere S, Liengprayoon S, Vaysse L, Sainte-Beuve J, Bonfils F. Investigating natural rubber composition with Fourier Transform Infrared (FT-IR) spectroscopy: a rapid and non-destructive method to determine both protein and lipid contents simultaneously. Polym Test. 2015;43:83-93. DOI: 10.1016/j.polymertesting.2015.02.011

Brown D, Feeney M, Ahmadi M, Lonoce C, Sajari R, Di Cola A, et al. Subcellular localization and interactions among rubber particle proteins from Hevea brasiliensis. J Exp Bot. 2017;68(18):5045-55. DOI: 10.1093/jxb/erx331

Berthelot K, Lecomte S, Estevez Y, Peruch F. Hevea brasiliensis REF (Hev b 1) and SRPP (Hev b 3): An overview on rubber particle proteins. Biochimie. 2014;106:1-9. DOI: 10.1016/j.biochi.2014.07.002

Lau NS, Makita Y, Kawashima M, Taylor TD, Kondo S, Othman AS, et al. The rubber tree genome shows expansion of gene family associated with rubber biosynthesis. Sci Rep. 2016;6:28594. DOI: 10.1038/srep28594

Ebo DG, Bridts CH, Rihs HP. Hevea latex-associated allergies: piecing together the puzzle of the latex IgE reactivity profile. Expert Rev Mol Diagn. 2020;20(4):367-73. DOI: 10.1080/14737159.2020.1730817

Kurup VP, Alenius H, Kelly KJ, Castillo L, Fink JN. A two-dimensional electrophoretic analysis of latex peptides reacting with IgE and IgG antibodies from patients with latex allergy. Int Arch Allergy Immunol. 1996;109(1):58-67. DOI: 10.1159/000237232

Woods JA, Lambert S, Platts-Mills TA, Drake DB, Edlich RF. Natural rubber latex allergy: spectrum, diagnostic approach, and therapy. J Emerg Med. 1997;15(1):71-85. DOI: 10.1016/s0736-4679(96)00256-9

Kumar RP. Latex allergy in clinical practice. Indian J Dermatol. 2012;57(1):66-70. DOI: 10.4103/0019-5154.92686

Kelly KJ, Kelly BT. Latex allergy. En: Leung DYM, Sampson HA, Bonilla FA, Akdis CA, Szefler SJ, editores. Pediatric allergy: principles and practice. 3ra ed. Elsevier; 2016. p. 505-12. DOI: 10.1016/B978-0-323-29875-9.00056-2

Cox AL, Eigenmann PA, Sicherer SH. Clinical Relevance of cross-reactivity in food allergy. J Allergy Clin Immunol Pract. 2021;9(1):82-99. DOI: 10.1016/j.jaip.2020.09.030

Kaczmarek RG, Silverman BG, Gross TP, Hamilton RG, Kessler E, Arrowsmith-Lowe JT. Prevalence of latex-specific IgE antibodies in hospital personnel. Ann Allergy Asthma Immunol. 1996;76(1):51-6. DOI: 10.1016/S1081-1206(10)63406-0

Catalano K. Risk management and latex allergies. Surg Serv Manage. 1997;3(42):44–6.

Parisi CAS, Kelly KJ, Ansotegui IJ, Gonzalez-Díaz SN, Bilò MB, Cardona V, et al. Update on latex allergy: New insights into an old problem. World Allergy Organ J. 2021;14(8):100569. DOI: 10.1016/j.waojou.2021.100569

Gastaminza G, Algorta J, Uriel O, Audicana MT, Fernandez E, Sanz ML, et al. Randomized, double-blind, placebo-controlled clinical trial of sublingual immunotherapy in natural rubber latex allergic patients. Trials. 2011;12:191. DOI: 10.1186/1745-6215-12-191

Vargas A, Foncea C, Astorga P. Latex allergy: overview and recommendations for the perioperative management of high-risk patients. J Head Neck Spine Surg. 207;1(1): 555552. DOI :10.19080/jhnss.2017.01.555552

Bedolla-Barajas M, Macriz-Romero N, Jara-Ettinger AC, Macriz-Romero M, Fregoso-Fregoso M, Morales-Romero J. Autorreporte de alergia al látex en estudiantes de medicina: prevalencia y factores asociados [Latex allergy self-report in medical students: prevalence and associated factors]. Rev Alerg Mex. 2018;65(1):10-8. DOI: 10.29262/ram.v65i1.290.

Wu M, McIntosh J, Liu J. Current prevalence rate of latex allergy: why it remains a problem? J Occup Health. 2016;58(2):138-44. DOI: 10.1539/joh.15-0275-RA

Binkley HM, Schroyer T, Catalfano J. Latex Allergies: a review of recognition, evaluation, management, prevention, education, and alternative product use. J Athl Train. 2003;38(2):133-40. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC164902/

Peixinho C, Tavares-Ratado P, Tomás MR, Taborda-Barata L, Tomaz CT. Latex allergy: new insights to explain different sensitization profiles in different risk groups. Br J Dermatol. 2008;159(1):132-6. DOI: 10.1111/j.1365-2133.2008.08614.x

Patriarca G, Nucera E, Buonomo A, Del Ninno M, Roncallo C, Pollastrini E, et al. Latex allergy desensitization by exposure protocol: five case reports. Anesth Analg. 2002;94(3):754-8. DOI: 10.1097/00000539-200203000-00051

Blanco Guerra C. Síndrome látex-frutas [Latex-fruit syndrome]. Allergol Immunopathol (Madr). 2002;30(3):156-63. DOI: 10.1016/s0301-0546(02)79109-x

Calamelli E, Piccinno V, Giannetti A, Giampaolo R, Pession, A. Latex-fruit syndrome and degree of severity of natural rubber latex allergy: is there a link?. Clin Transl Allergy. 2011;1(Suppl 1):O18. DOI: 10.1186/2045-7022-1-S1-O18

Chong Quero LE, Orozco Martínez S, Huerta López JG. Alergia al látex. Alergia Asma Inmunol Ped. 2004;13(2):44-52. Disponible en: https://www.medigraphic.com/pdfs/alergia/al-2004/al042b.pdf

Anda M, Gómez B, Lasa E, Arroabarren E, Garrido S, Echechipía S. Alergia al látex. Manifestaciones clínicas en la población general y reactividad cruzada con alimentos [Latex allergy. Clinical manifestations in the general population and reactivity crossed with foodstuffs]. An Sist Sanit Navar. 2003;26(Suppl 2):75-80. Disponible en: https://recyt.fecyt.es/index.php/ASSN/article/view/4998

Alenius H, Turjanmaa K, Palosuo T. Natural rubber latex allergy. Occup Environ Med. 2002;59(6):419-24. DOI: 10.1136/oem.59.6.419

Kelly KJ, Sussman G. Latex allergy: where are we now and how did we get there?. J Allergy Clin Immunol Pract. 2017;5(5):1212-6. DOI: 10.1016/j.jaip.2017.05.029

Kelly KJ, Kelly BT. Latex allergy. En: Leung DYM, Sampson HA, Geha R, Szefler SJ, editores. Pediatric allergy: principles and practice. 2da ed. Saunders; 2010. p. 631-9.

Task force on allergic reactions to latex. American Academy of Allergy and Immunology. Committee report. J Allergy Clin Immunol. 1993;92(1 Pt 1):16-8. Disponible en: https://www.jacionline.org/article/0091-6749(93)90031-A/pdf

Patriarca G, Nucera E, Pollastrini E, Roncallo C, Buonomo A, Bartolozzi F, et al. Sublingual desensitization: a new approach to latex allergy problem. Anesth Analg. 2002;95(4):956-60. DOI: 10.1097/00000539-200210000-00031

Nucera E, Mezzacappa S, Buonomo A, Centrone M, Rizzi A, Manicone PF, et al. Latex immunotherapy: evidence of effectiveness. Postepy Dermatol Alergol. 2018;35(2):145-50. DOI: 10.5114/ada.2018.75235

Liberatore K. Protecting Patients with Latex Allergies. Am J Nurs. 2019;119(1):60-3. DOI: 10.1097/01.NAJ.0000552616.96652.72

U.S. Food and Drug Administration. Recommendations for labeling medical products to inform users that the product or product container is not made with natural rubber latex. Guidance for industry and Food and Drug Administration staff. Rockville, MD; 2014. FDA-2013-D0168. Disponible en: https://www.fda.gov/media/85473/download

Cusick C. A latex-safe environment is in everyone’s best interest. Mater Manag Health Care. 2007;16(11):24-6.

Mercurio J. Creating a latex perioperative environment. OR Nurse. 2011;5(6):18-25. Disponible en: https://nursing.ceconnection.com/ovidfiles/01271211-201111000-00006.pdf

Minami CA, Barnard C, Bilimoria KY. Management of a patient with a latex allergy. JAMA. 2017;317(3):309-10. DOI: 10.1001/jama.2016.20034

Kahn SL, Podjasek JO, Dimitropoulos VA, Brown CW Jr. Natural rubber latex allergy. Dis Mon. 2016;62(1):5-17. DOI: 10.1016/j.disamonth.2015.11.002

De Queiroz M, Combet S, Bérard J, Pouyau A, Genest H, Mouriquand P, et al. Latex allergy in children: modalities and prevention. Paediatr Anaesth. 2009;19(4):313-9. DOI: 10.1111/j.1460-9592.2009.02955.x

Stinkens R, Verbeke N, Van de Velde M, Ory JP, Baldussu E, Ruiters C, et al. Safety of a powder-free latex allergy protocol in the operating theatre: A prospective, observational cohort study. Eur J Anaesthesiol. 2019;36(4):312-3. DOI: 10.1097/EJA.0000000000000953

Agarwal N, McDonnell S, Khan W. Management of latex hypersensitivity in the perioperative setting. J Perioper Pract. 2020;30(7-8):199-203. DOI: 10.1177/1750458919882222

Caballero ML, Quirce S. Identification and practical management of latex allergy in occupational settings. Expert Rev Clin Immunol. 2015;11(9):977-92. DOI: 10.1586/1744666X.2015.1059754

Chromoy, GC. Alergia al látex: el farmacéutico como agente de cambio. Sociedad Argentina de Alergia e Inmunopatología. 2016. Disponible en: http://www.saaei-med.org/docs/artPublicos/DRA.%20CHROMOY%20GABRIELA%20%20LATEX%20EN%20FARAMCEUTICOS.pdf

Kerner MM, Newman A. Diagnosis and management of latex allergy in surgical patients. Am J Otolaryngol. 1993;14(6):440-3. DOI: 10.1016/0196-0709(93)90120-v

Hollnberger H, Gruber E, Frank B. Severe anaphylactic shock without exanthema in a case of unknown latex allergy and review of the literature. Paediatr Anaesth. 2002;12(6):544-51. DOI: 10.1046/j.1460-9592.2002.00890.x

Makatsori M, Durham S, Calderon MA. Specific immunotherapy for latex allergy. Cochrane Database Syst Rev. 2017; (4):CD009240. DOI: 10.1002/14651858.CD009240.pub2

Nucera E, Schiavino D, Pollastrini E, Roncallo C, De Pacuale T, Buonomo A, et al. Desensitization to latex by percutaneous route. J Invest Allergol Clin Immunol 2002;12(2):134-5.

Ring J, Gutermuth J. 100 years of hyposensitization: history of allergen-specific immunotherapy (ASIT). Allergy. 2011;66(6):713-24. DOI: 10.1111/j.1398-9995.2010.02541.x

Bueno-De Sá A, Gaspar A, Solé D, Morais-Almeida M. Desensibilización exitosa al látex con inmunoterapia sublingual en una trabajadora de salud [Successful desensitization to latex by sublingual immunotherapy in a health worker]. Rev Alerg Mex. 2014;61(4):372-5

Leynadier F, Herman D, Vervloet D, Andre C. Specific immunotherapy with a standardized latex extract versus placebo in allergic healthcare workers. J Allergy Clin Immunol. 2000;106(3):585-90. DOI: 10.1067/mai.2000.109173

Sastre J, Fernández-Nieto M, Rico P, Martín S, Barber D, Cuesta J, et al. Specific immunotherapy with a standardized latex extract in allergic workers: a double-blind, placebo-controlled study. J Allergy Clin Immunol. 2003;111(5):985-94. DOI: 10.1067/mai.2003.1390

Tabar AI, Anda M, Bonifazi F, Bilò MB, Leynadier F, Fuchs T, et al. Specific immunotherapy with standardized latex extract versus placebo in latex-allergic patients. Int Arch Allergy Immunol. 2006;141(4):369-76. DOI: 10.1159/000095463

Nucera E, Schiavino D, Buonomo A, Roncallo C, Del Ninno M, Milani A, et al. Latex rush desensitization. Allergy. 2001;56(1):86-7. DOI: 10.1034/j.1398-9995.2001.00904.x

Nettis E, Colanardi MC, Soccio AL, Marcandrea M, Pinto L, Ferrannini A, et al. Double-blind, placebo-controlled study of sublingual immunotherapy in patients with latex-induced urticaria: a 12-month study. Br J Dermatol. 2007;156(4):674-81. DOI: 10.1111/j.1365-2133.2006.07738.x

Bernardini R, Campodonico P, Burastero S, Azzari C, Novembre E, Pucci N, et al. Sublingual immunotherapy with a latex extract in paediatric patients: a double-blind, placebo-controlled study. Curr Med Res Opin. 2006;22(8):1515-22. DOI: 10.1185/030079906X115711

Cisteró Bahima A, Sastre J, Enrique E, Fernández M, Alonso R, Quirce S, Gandarias B, Parmiani S, Rico P. Tolerance and effects on skin reactivity to latex of sublingual rush immunotherapy with a latex extract. J Investig Allergol Clin Immunol. 2004;14(1):17-25. Disponible en: http://www.jiaci.org/issues/vol14issue01/17-25.pdf

Lasa Luaces EM, Tabar Purroy AI, García Figueroa BE, Anda Apiñaniz M, Sanz Laruga ML, Raulf-Heimsoth M, et al. Component-resolved immunologic modifications, efficacy, and tolerance of latex sublingual immunotherapy in children. Ann Allergy Asthma Immunol. 2012;108(5):367-72. DOI: 10.1016/j.anai.2012.03.005

Smith DM, Freeman TM. Sublingual immunotherapy for other Indications: venom large local, latex, atopic dermatitis, and food. Immunol Allergy Clin North Am. 2020;40(1):41-57. DOI: 10.1016/j.iac.2019.09.011

Sridharan K, Sivaramakrishnan G. Sublingual immunotherapy in patients with latex allergy: systematic review and meta-analysis of randomized controlled trials. J Dermatolog Treat. 2017;28(7):600-5. DOI: 10.1080/09546634.2017.1303567

Adkinson NF, Jr., Bochner BS, Burks AW, Busse WW, Holgate ST, Lemanske RF, Jr., et al. Middleton’s allergy: principles and practice. 8va ed. ElSevier, 2013. pág. 1418:

Leynadier F, Doudou O, Gaouar H, Le Gros V, Bourdeix I, Guyomarch-Cocco L, et al. Effect of omalizumab in health care workers with occupational latex allergy. J Allergy Clin Immunol. 2004;113(2):360-1. DOI: 10.1016/j.jaci.2003.11.020

Holguín L, Muñóz A, Cardona R. Omalizumab más allá del asma y la urticaria crónica espontánea. Rev Alerg Mex. 2018;65(Suppl 1):73.

Publicado

2022-01-08

Número

Sección

Artículos de revisión