Ahmed has worked as a phlebotomist in the local hospital for the last 7 years. Last year, he began to complain of watery, nasal congestion and wheezing whenever he went to work

Question

He suspected he was allergic to something at the hospital because his symptoms abated when he was at home over the weekends. One day he arrived at work for the morning shift and put on his gloves. Within minutes, he went into severe respiratory distress requiring treatment in the emergency ward. It was determined at that time his allergic response was due to latex exposure.

Ahmed experienced a type I, IgE-mediated hypersensitivity response. How can this be determined by his signs and symptoms? How might another type of latex hypersensitivity reaction present?

How do T2H cells, mast cells, and eosinophils function to produce the signs and symptoms typical of a type I hypersensitivity disorder?

How is it that someone who does not come into direct contact with latex can still have a hypersensitivity response to the material? What do food allergies have to do with latex allergies?

Answer 1

Ahmed demonstrated a type I, IgE-mediated hypersensitivity reaction as indicated by his rhinoconjunctivitis and asthmatic symptoms. The rapid onset of his respiratory symptoms shortly after putting on the gloves is also typical of the type I response. Latex allergy can also be attributed to a type IV, T-cell-mediated response that presents with dermatological signs and symptoms that are more delayed in their onset.

In a type I hypersensitivity disorder, T2H cells differentiate in response to an allergen and in turn release IL-3, IL-4, and IL-5. Interleukins-3 and 5 recruit and activate eosinophils, while interleukin-4 stimulates the differentiation of B cells into IgE-producing plasma cells. The IgE antibodies in turn sensitize mast cells, which subsequently undergo degranulation when exposed to the allergen. Mast cells produce vasodilation and smooth muscle spasm. Both mast cells and eosinophils contribute to the mucosal edema, secretion, and bronchospasm seen in type I hypersensitivity responses.

The latex proteins responsible for allergic reactions bind readily with the cornstarch used to coat gloves. In any environment where gloves are frequently changed, the cornstarch becomes airborne and liberates aerosolized latex. A susceptible individual can react to the airborne proteins without having had contact with the latex material itself.
The proteins responsible for latex allergy reactions have a similar structure to the proteins found in bananas, avocado, kiwis, tomatoes, and chestnuts. Those with latex allergy often show cross-sensitivity to these foods.