The accompanying explanations are intended to provide users with a general, informative understanding of proteins in latex, and additionally allergies associated with the use of gloves.
What is meant by an antigen and an allergen?
Antigens are every one of the substances that provoke an immune response when they enter the body. This should be possible as complex proteins or carbohydrates. As a result, the lymphocytes are stimulated to produce substances (eg antibodies) which react specifically with antigens.
Allergens are antigens that cause an allergic immune response that is typically transmitted by IgE antibodies. Allergic reactions happen when exposed to very concentrated foreign material over an extended period of time. Potential allergens have no influence on non-sensitized persons.
What are antibodies?
Antibodies are immunoglobulins (Ig). These are proteins produced by plasma cells and lymphocytes. There are 5 classes of antibodies, namely IgA, IgG, IgM, IgD, IgE. IgE affects every single allergic reaction.
How does an allergy begin?
Antigens enter the body, animating B and T cells, which then produce antibodies. The antibodies tie to the pole cells and cause a stepwise part of the pole cells. It releases histamines and other mediators. Manifestations include dilated vessels, decreased circulatory strain, faster heart rate, breathlessness, hives and possible unconsciousness. This is a type I reaction. However, there are additionally type II, III and IV reactions. You would need to know about different types of latex allergy as well.
What does this have to do with latex gloves?
There are many different types of common proteins in latex. Some of these proteins are known to sensitize certain users. The remaining proteins in gloves are suspected to induce Type VI reactions in sensitized users. The issue of sensitization has not been completely clarified, but rather there is a general consensus that an abnormal state of residual protein in the gloves causes sensitization. This incidence varies between people and furthermore from race to race, with the frequency or the wear, as a decisive factor, happening in all cases.
Which protein content is considered “safe”?
Studies by the Rubber Research Institute in Malaysia have demonstrated that 80% of the sensitized users did not demonstrate an allergic reaction to the content of water-soluble proteins below 100 µg/g of the glove material. This examination was conducted by a gathering of health care professionals. Further studies on this point are already in progress.
No, the powders on the gloves has nothing to do with the protein reactions that are described above. The powder is a modified maize starch that is bioabsorbable (converted to glucose when absorbed by the body) and isn’t previously known to cause the type of allergies ordinarily associated with the use of the gloves , However, there is evidence that the powder retains proteins of the host glove and subsequently carries a certain percentage of the remaining proteins of the host glove.
For what reason are reactions more unlikely in powder-free gloves?
The process of removing the powder is a post-processing process, that is, the removal happens only when the glove has been completely made. This is done by a process called chlorination. While the process of chlorination ostensibly serves to remove the powder, it likewise removes a considerable measure of the remaining protein at the same time.
Reducing the residual proteins is the reason why powder-free gloves rarely cause allergic reactions to proteins. Therefore, the powder can not be held responsible as a source of allergic reactions to proteins.
Some methods of removing the powder are just by replacing the powder with another covering, for example, polyurethane or acrylic amid the manufacture of the glove. While removing the powder from the gloves, no more proteins are removed here than with a pre-powdered glove. This can lead to misunderstandings among the end users.
What should be possible to reduce proteins in gloves?
The manufacturing process needs to be extended by one step to reduce proteins. This means the remaining proteins happen to be reduced by intensive washing before the glove is coated with the powder. We were able to reduce the protein content to less than 100 µg/g for pre-powdered gloves compared to the general 200-500 µg/g level in comparable items on the market.
Could the use of nitrile gloves eliminate allergic reactions?
Nitrile material does not contain proteins that are different from latex. Therefore, nobody who is allergic to latex proteins won’t have latex protein allergies when utilizing nitrile gloves. This is an alternative item.
However, wearers of nitrile gloves report allergic reactions that are not due to the proteins but rather are triggered by other antigens in the synthetic material.
What are the possible tests that can be used to determine the protein content?
There are several test methods for proteins and allergies:
Modified Lowry method
This is the only test approved by the US Food and Drug Administration (ASTM 5712-2000). It has a sensitivity to at least 50 µg/g. After that, it can never again be determined.
This is a colorimetric shading restricting test based on shading change as a result of different protein concentrations. This includes extraction of residual aqueous soluble proteins latex items, followed by the centrifugation and the addition of phosphotungstic acids (PTA) to remove the interfering water-soluble things. This protein content is quantified utilizing a standard protein. A spectrophotometric measurement is carried out at a wavelength in the range of 600 to 750 Hz (nm).
ELISA (Enzyme Linked Immunosorbent Assay)
A latex allergy is based on human IgE, which reacts to certain proteins in the latex. However, the ELISA test is based on the IgE of rabbit antibodies that react with all proteins. This test isn’t approved by the American Society for Testing and Materials and furthermore by the US Food and Drug Administration.
The test measures the antigenic protein level. An example is the currently available options is the LEAP test. Here, antibodies are used to tie the special antigenic proteins (rabbit antibodies). The antibodies bound to the proteins then react with an added chemical and a shading development happens, the intensity of which depends on the measure of the antigenic protein.
RAST (Radio Allergo Sorbent Test)
This is a test of the allergenic protein levels of gloves. The test is based on the reaction between the allergenic protein and the antibody (IgE). Unlike LEAP, the antibody here is composed of allergic substances of the human body. The weakness of this test is that the concentrated allergic plasma of the patient affects the outcome and along these lines the relevance of the test.
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