NASAL CHALLENGE, SKIN-TESTS, AND SERUM ANTIBODIES IN THE DIAGNOSIS OFLATEX-INDUCED OCCUPATIONAL RHINITIS

The purpose of the study was to develop a suitable natural rubber late x (NRL) antigen powder and a control material for the nasal applicatio n of the test reagent and to evaluate the nasal provocation test (NPT) response pattern in latex allel gic and nonlatex allergic subjects wi th a suspicion of latex-induced rhinitis. A questionnaire was complete d among health care workers (n = 268) in one hospital. Seven health ca re workers who had upper respiratory symptoms associated with daily us age of latex gloves were examined by using skin prick test (SPT), NPT, and sinus plain X-ray. NRL allergen for the nasal challenge was colle cted from surgical gloves. The powder was obtained by washing the glov es, freeze-drying the solution, and the powder was then used in NPT. A s a negative control, clean corn starch powder was applicated on nasal mucons. SDS-PAGE analysis of the NRL test powder was performed. After the nasal challenge, one of seven workers showed rhinorrhea, a signif icant increase in nasal obstruction, and in the amount of nasal secret ion in NPT. This patient also showed a positive SPT to NRL allergens a nd an elevated NRL specific IgE level in her serum. In six patients NP T, SPT, and specific IgE for Inter were negative. SDS-PAGE analysis of the glove powder showed a major NRL antigen, with molecular weight of 14 kDa. The NPT may be used in persons with a suspicion of latex-indu ced rhinitis and borderline skin and humoral test results for NRL and in subjects with heavy glove powder-associated nasal symptoms but nega tive skin and humoral tests for latex. Only well known test reagents s hould be used in NPT.