Allergen Research Articles

SENSITIZING POTENTIAL OF TEMPORARY FILLING MATERIALS

Introduction: When treatment requires multiple visits, temporary filling materials are needed in order to seal the cavity between the appointments. Some of their substances can be contact allergens. Although the risk is very low, it should not be ignored. The aim of the study is to establish the sensitizing potential of temporary filling materials. Materials and methods: In order to confirm allergy to temporary filling materials, we used a patch test with a panel of 9 allergens – components of temporary filling materials with established strong sensitizing properties. Results: The results showed that sensitization and polysensitization to the examined dental materials are registered more often in women than men and zinc (Zn) is the most common sensitizer among the ingredients of temporary filling materials. Cross-sensitization between acrylates is also found. Conclusion: There is an extremely small risk for the ingredients of the temporary filling materials to cause oral symptoms.

Is the Use of the Extended (Meth)acrylate Series - Nails Justified? Characterization of Nail Acrylate Allergy in a Tertiary Medical Centre.

Methacrylate allergy is a common cause of allergic contact dermatitis, and its incidence has surged over the past decade. Consequently, the primary sensitizing agent, 2-hydroxyethyl methacrylate, was recently added to the European Baseline Series of contact allergens. This study aimed to assess the added value of testing for allergens included in the (Meth)Acrylate Series - Nails, in addition to 2-hydroxyethyl methacrylate, as well as to characterize patients who may benefit from more extensive testing. A retrospective analysis of medical records of patch-tested patients was conducted between June 2013 and July 2022. Among the 3,828 patients who underwent patch testing, 396 were tested with the (Meth)Acrylate Series - Nails; 153 (38.6%) of those patients tested positive for at least 1 acrylate. The most common hapten was 2-hydroxyethyl methacrylate (85.6%), followed by hydroxypropyl methacrylate (85.0%) and ethylene glycol dimethacrylate (80.4%). In our study, 22/153 patients (14.4%) would have been missed if tested only for 2-hydroxyethyl methacrylate. The analysis showed that including hydroxypropyl methacrylate and ethylene glycol dimethacrylate improved detection rate to 98%, rendering the use of the entire tray unnecessary in most cases.

Potential for Allergic Contact Dermatitis in Popular Depilatory Wax Hair Removal Practices and Ingredients.

Allergic contact dermatitis (ACD) is a type IV delayed hypersensitivity reaction that can commonly arise from exposure to allergens in personal care and cosmetic products. Depilatory waxing, a common hair removal practice, involves the use of various products that may contain potential contact allergens. There is limited literature discussing ACD to hair removal products. We aim to discover the most common allergens prevalent in depilatory waxing products used in a popular wax center in the United States and those found in online marketplaces. Through communication with the salon staff, we reviewed the involved products and analyzed all ingredients for common allergens. We also conducted an online search to examine the ingredients and the most common allergens of the top 10 bestselling wax strips across four selected online marketplaces (CVS, Amazon, Walmart, and Walgreens). The final query of online products consisted of 12 distinct wax products and 10 postwax products. Among the products used in the salon, the most common allergens were vitamin E, colophony, botanicals, fragrance, beeswax/propolis, and color additives, in descending order. The most frequent allergens commonly encountered in online wax products included color additives, found in 67% (8/12) products, followed by botanicals and colophony, both present in 58% (7/12) products. In the postwax products, the most frequent allergen was vitamin E present in 100% (10/10) of the products, followed by fragrance (8/10). Although these allergens do not frequently cause ACD, it remains crucial to identify and note them in hair removal products to address any potential cases. Raising awareness of these allergens in all steps of hair removal can help ensure the safety and comfort of patients undergoing waxing treatments.

A lipidomic approach towards identifying the effects of fragrance hydroperoxides on keratinocytes.

Limonene and linalool are used in cosmetic products for their floral scents, but their oxidation products are strong contact allergens whose mechanisms of action are still not fully understood. The effects of limonene hydroperoxide (Lim-2-OOH) and linalool hydroperoxides (Lin-6/7-OOH) on the lipid profile of a human keratinocyte cell line (HaCaT) were evaluated. 2,4-Dinitrofluorobenzene (DNFB) was also included. Lim-2-OOH and Lin-6/7-OOH were synthesised according to previous methods. HaCaT cells were treated with allergens (10 μM) for 24 h and the cellular lipid extracts were analysed by C18 liquid chromatography with tandem mass spectrometry (LC-MS/MS). Data analysis was performed using Lipostar software. Statistical analysis was carried out using Metaboanalyst and R software. All three sensitisers used caused significant changes in the lipidome of HaCaT cells in a similar trend. There was an upregulation in several plasmanyl/plasmenyl phospholipids (O-/P-phosphatidylcholines [PC] and O-/P-phosphatidylethanolamines [PE]), sphingolipids (HexCer) and triacylglycerol lipid species, and a decrease in some polyunsaturated fatty acids-containing phospholipid (PE and PC) species suggesting oxidative stress and inflammation. This study is the first to evaluate the plasticity of the HaCaT cell lipidome in response to allylic hydroperoxide allergens Lim-2-OOH and Lin-6/7-OOH, together with the experimental contact allergen DNFB. These allergens are able to upregulate and downregulate certain lipid classes to a varying degree.

Safety evaluation of the food enzyme endo-1,3(4)-β-glucanase from the non-genetically modified Talaromyces versatilis strain PF8.

The food enzyme endo-1,3(4)-β-glucanase (3-(1-3;1-4)-β-d-glucan 3(4)-glucanohydrolase; EC 3.2.1.6) is produced with the non-genetically modified Talaromyces versatilis strain PF8 by Erbslöh Geisenheim AG. The food enzyme was free from viable cells of the production organism. It is intended to be used in four food manufacturing processes. Dietary exposure to the food enzyme-total organic solids (TOS) was calculated to be up to 0.110 mg TOS/kg body weight (bw) per day in European populations. Genotoxicity tests did not indicate a safety concern. The systemic toxicity was assessed by means of a repeated dose 90-day oral toxicity study in rats. The Panel identified a no observed adverse effect level of 2229 mg TOS/kg bw per day, the highest dose tested, which when compared with the estimated dietary exposure resulted in a margin of exposure of at least 20,264. A search for homology of the amino acid sequence of the food enzyme to known allergens was made and four matches with respiratory or contact allergens were found. The Panel considered that the risk of allergic reactions upon dietary exposure cannot be excluded, but the likelihood is low. Based on the data provided, the Panel concluded that this food enzyme does not give rise to safety concerns, under the intended conditions of use.

Eyelid Dermatitis: Common Patterns and Contact Allergens.

Eyelid dermatitis is a common dermatologic concern representing a broad range of inflammatory dermatoses. The most commonly reported cause of eyelid dermatitis is allergic contact dermatitis (ACD), a type IV delayed hypersensitivity reaction caused by exposure to external allergens that is diagnosed via epicutaneous patch testing. The most common contact allergens associated with eyelid dermatitis are metals, fragrances, preservatives, acrylates, and topical medications, which may be found in a variety of sources, including cosmetics, ophthalmic medications, nail lacquers, and jewelry. Management involves strict allergen avoidance with an emphasis on patient counseling. In this review, we discuss the clinical manifestation, evaluation, patch test considerations, and management of eyelid ACD to provide a valuable reference tool in the management of patients presenting with eyelid dermatitis.

53607 Common Contact Allergens Implicated in Frontal Fibrosing Alopecia Found in Over-the-Counter Hair Growth Serums and Solutions

53607 Common Contact Allergens Implicated in Frontal Fibrosing Alopecia Found in Over-the-Counter Hair Growth Serums and Solutions

50725 Prevalence of Contact Allergens in Self-Tanners

50725 Prevalence of Contact Allergens in Self-Tanners

In vitro characterisation of a novel rubber contact allergen in protective gloves.

Allergic contact dermatitis (ACD) from protective gloves is often caused by rubber additives, such as accelerators. However, while accelerator-free rubber gloves are available, they still cause ACD in some individuals. A new allergen, 2-cyаnоethyl dimethyldithiocarbamate, (CEDMC), has recently been identified in accelerator-free gloves, and we here provide a first in vitro characterisation of CEDMC in a dendritic cell (DC)-like cell model along with three reference sensitizer rubber chemicals, consisting of tetraethylthiuram disulfide (TETD) and two xanthogenates. Cellular responses after the exposure to the rubber chemicals were assessed using a transcriptomic approach, multiplex cytokine secretion profiling, and flow cytometry to determine DC model activation marker expression and apoptosis induction. CEDMC and all other sensitizers were classified as strong skin sensitizers with the transcriptomic approach. They all significantly increased IL-8 secretion and exposure to all except one increased CD86 DC activation marker expression. When tested, CEDMC induced apoptosis, however, delayed compared to TETD. The in vitro data corroborate CEDMC, TETD, and investigated xanthogenates as skin sensitizers. Transcriptomic analyses further reveal unique cellular responses induced by CEDMC, which together with future study can contribute to better understanding of cellular mechanisms underlying the sensitising capacity of rubber chemicals.

Fragrance Contact Allergy - A Review Focusing on Patch Testing.

Fragrance materials are widely used in various types of products in daily life and many of them can be contact sensitizers. Contact allergy to fragrances has been reported to be common worldwide. Unlike other groups of contact allergens such as metals and preservatives, fragrance materials in consumer products can be present as single fragrance chemicals or in the form of mixtures known as natural complex substances. Due to the complexity of the fragrance materials and the high number of fragrance substances known to cause contact sensitization, selecting suitable materials for patch testing is challenging. Emerging fragrance markers have been additionally introduced in different baseline series for screening to enhance the rate of fragrance contact allergy detection. Moreover, there have been continual updates on basic knowledge, clinical perspectives, sources of exposure, and regulations on the use of fragrance materials. Avoiding pitfalls while performing patch testing with fragrance test materials is also crucial and should not be overlooked. Therefore, this review aims to update knowledge to provide a high-quality holistic approach to fragrance contact allergy diagnosis and management.

Allergic contact dermatitis in adults with and without atopic dermatitis: Evaluation of the Spanish Contact Dermatitis Registry (REIDAC).

Atopic dermatitis (AD) and allergic contact dermatitis (ACD) are inflammatory skin conditions whose association is not clearly defined. To identify differences in ACD profile between patients with and without AD among those referred for patch testing. Additionally, to determine the prevalence of sensitisation to standard Spanish contact allergens in both groups. We analysed two groups (AD and non-AD) within the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy (REIDAC). Contact allergy, clinical relevance and epidemiological data were compared between them. A total of 5055 patients were included. Among them, 23% (1168) had a history or final diagnosis of AD. At least one positive reaction was seen in 468 (40%) of AD patients and 1864 (48%) of non-AD patients. In both groups, the most common positive reactions were to nickel sulphate, methylchloroisothiazolinone/methylisothiazolinone and cobalt chloride. Age-adjusted OR for sensitisation to nickel sulphate was 0.72 (95% CI: 0.61-0.86), indicating a decreased likelihood of sensitisation in AD patients compared to non-AD individuals. We did not find an increased presence of ACD in patients with AD referred for patch testing, exhibiting similar profiles to non-AD population, except for a negative relationship between AD and sensitisation to nickel sulphate.

Fecal IgE Analyses Reveal a Role for Stratifying Peanut-Allergic Patients.

Peanut allergy (PA) is an IgE-mediated food allergy with variable clinical outcomes. Mild-to-severe symptoms affect various organs and, often, the gastrointestinal tract. The role of intestine-derived IgE antibodies in astrointestinal PA symptoms is poorly understood. This study aimed to examine fecal IgE responses in PA as a novel approach to patient endotyping. Feces and serum samples were collected from peanut-allergic and healthy children (n=26) to identify IgE and cytokines using multiplex assays. Shotgun metagenomics DNA sequencing and allergen database comparisons made it possible to identify microbial peptides with homology to known allergens. Compared to controls, fecal IgE signatures showed broad diversity and increased levels for 13 allergens, including food, venom, contact, and respiratory allergens (P<.01-.0001). Overall, fecal IgE patterns were negatively correlated compared to sera IgE patterns in PA patients, with the greatest differences recorded for peanut allergens (P<.0001). For 83% of the allergens recognized by fecal IgE, we found bacterial homologs from PA patients' gut microbiome (eg, thaumatin-like protein Acinetobacter baumannii vs Act d 2, 109/124 aa identical). Compared to controls, PA patients had higher levels of fecal IgA, IL-22, and auto-IgE binding to their own fecal proteins (P<.001). Finally, levels of fecal IgE correlated with abdominal pain scores (P<.0001), suggesting a link between local IgE production and clinical outcomes. Fecal IgE release from the intestinal mucosa could be an underlying mechanism of severe abdominal pain through the association between leaky gut epithelia and anticommensal TH2 responses in PA.

Contact Dermatitis From Biomedical Devices, Implants, and Metals—Trouble From Within

Allergic contact dermatitis is characterized by its appearance of red, raised and infiltrated, scaling or scabbed skin and intense pruritus, and distinguished from irritant contact dermatitis by its specific immune process and histopathology. Many contact allergens are low molecular weight chemicals including metals such as nickel, cobalt, and chromium, preservatives, and adhesives. When such materials are used internally in biomedical devices, they are similarly capable of causing sensitization and an inflammatory response. Sometimes the reaction remains internal, and presents as swelling, pain, stiffness, decreased range of motion, and internal itching around the implant. Such reactions may, in some cases, also extend to include a localized or, rarely, systemic contact dermatitis indicative of the same process. This review will present an overview of reported skin and local internal reactions to orthopedic implants, which are the largest category of implanted internal metal devices. Immune reactions to smaller categories of medical appliances include cardiac devices and vascular stents, neuromodulation devices, diabetic appliances, Nuss bar surgery for pectus excavatum, and dental and spinal implants. We will review the available diagnostic tools, the consensus on interpretation, and reported strategies for treatment.

Safety evaluation of the food enzyme subtilisin from the non-genetically modified Bacillus paralicheniformis strain AP-01.

The food enzyme subtilisin (EC 3.4.21.62) is produced with the non-genetically modified Bacillus paralicheniformis strain AP-01 by Nagase (Europa) GmbH. It was considered free from viable cells of the production organism. The food enzyme is intended to be used in five food manufacturing processes. Since residual amounts of food enzyme-total organic solids (TOS) are removed in one process, dietary exposure was calculated only for the remaining four food manufacturing processes. It was estimated to be up to 0.875 mg TOS/kg body weight per day in European populations. The production strain of the food enzyme has the capacity to produce bacitracin and thus failed to meet the requirements of the Qualified Presumption of Safety approach. Bacitracin was detected in the industrial fermentation medium but not in the food enzyme itself. However, the limit of detection of the analytical method used for bacitracin was not sufficient to exclude the possible presence of bacitracin at a level representing a risk for the development of antimicrobial resistant bacteria. A search for the similarity of the amino acid sequence of the food enzyme to known allergens was made and twenty-eight matches with respiratory allergens, one match with a contact allergen and two matches with food allergens (melon and pomegranate) were found. The Panel considered that the risk of allergic reactions upon dietary exposure to this food enzyme, particularly in individuals sensitised to melon or pomegranate, cannot be excluded, but would not exceed the risk of consuming melon or pomegranate. Based on the data provided, the Panel could not exclude the presence of bacitracin, a medically important antimicrobial, and consequently the safety of this food enzyme could not be established.

Allergen content of popular chemical hair relaxers: A product analysis.

Chemical hair relaxers are widely utilized by black women, yet little research exists on the allergens present in these products. This study aims to investigate allergen prevalence in the most popular chemical hair relaxers. We analysed 41 products from five major retailers, identifying allergens through ingredient lists and comparing them to the 2020 American Contact Dermatitis Group Core allergen series. The most common contact allergens in chemical relaxers include propylene glycol, cetyl steryl alcohol, fragrance, D/L-a-tocopherol, tea tree oil and cocamidopropyl betaine. Understanding allergen exposure in products used by individuals with textured hair is needed for managing contact dermatitis in diverse populations. This analysis underscores the presence of potential allergens in hair relaxers, emphasizing the importance of dermatologists' awareness and patient scrutiny of ingredient lists.

Common contact allergens implicated in frontal fibrosing alopecia found in over-the-counter hair growth serums and solutions

Background: Frontal fibrosing alopecia (FFA) is a form of lichen planopilaris with an undetermined etiopathogenesis, predominantly affecting women. There is conflicting evidence as to whether contact allergens may play a role in the underlying etiology or progression of FFA. Objective: The aim of this study is to find the most common products that patients search for online, identify contact allergens present in these advertised over-the-counter hair products, and suggest their role in the development or exacerbation of FFA. Methods: We reviewed current research on this topic and then investigated common allergens found in over-the-counter hair products commonly used for hair regrowth. Results: FFA’s exact etiopathogenesis remains vastly unknown, however, current literature has reported an association between inflammatory skin conditions and FFA. Limitations: The lack of published data on the function of contact allergens in FFA placed restrictions on our study. Conclusion: A survey-based analysis with a larger cohort is needed to further interpret the relationship between product use and FFA presentation based on contact allergens. More research on possible etiopathogenesis and the relationship between contact dermatitis and FFA may prevent further progression of a patient’s disease, leading to an improvement in their quality of life.

Associations between tobacco smoking status and patch test results-A cross-sectional pilot study from the Information Network of Departments of Dermatology (IVDK).

Earlier studies suggested a potential association between tobacco smoking and nickel sensitization, but little is known about other contact allergens. To investigate the association of smoking status and contact sensitizations as well as subtypes of dermatitis, and to analyse the sensitization profiles of tobacco smokers. Within the Information Network of Departments of Dermatology (IVDK), we performed a cross-sectional multicentre pilot study comprising 1091 patch-tested patients from 9 departments, comparing 541 patients with a history of cigarette smoking (281 current and 260 former smokers) with 550 never-smokers. We could not confirm the previously reported association between nickel sensitization and tobacco smoking. Moreover, sensitizations to other allergens, including colophony, fragrance mix I, Myroxylon pereirae and formaldehyde, were not increased in cigarette smokers compared with never smokers. Hand dermatitis (50.6% vs. 33.6%) and occupational cause (36.2% vs. 22.5%) were significantly more frequent among cigarette smokers compared with never-smokers as shown by non-overlapping 95% confidence intervals. Although our study does not allow a firm conclusion on whether smoking status contributes to certain contact sensitizations, it confirms an association of smoking with hand dermatitis and occupational cause.

Contact Allergens in Self Tanner Products.

Contact Allergens in Self Tanner Products.

Étude rétrospective (2007–2022) des causes de dermatites allergiques de contact en Algérie identifiées par la batterie standard européenne : à propos de 202 cas

The European Baseline Series (EBS) of patch tests is the essential tool for allergological exploration of patients suspected of allergic contact dermatitis. The main objective of our study was to define the epidemiological, clinical characteristics, and sensitization profile to contact allergens of the EBS among all patients who underwent contact allergological exploration in an allergology clinic in Algeria over a 15-year period (from 2007 to 2022). Our aim was to generate a map of allergic contact dermatitis in Eastern Algeria to support prevention efforts on a national scale. MethodsOur study was a retrospective descriptive monocentric study conducted in an allergology and contact allergen exploration medical office in Constantine, Algeria. It included all EBS performed between March 2007 and February 2022 on patients who were either first-time visitors or referred for patch testing. ResultsA total of 202 patients suspected of contact dermatitis were tested, with ages ranging from 3 to 75 years. Among them, 125 were female (61.9%) and 77 were male (38.1%). Of these, 138 patients (68.8%) (45 males, 93 females) tested positive for one or more allergens. Fifty-eight patients (42%) had a positive reaction to more than two contact allergens. The most common positive reactions were observed with nickel (30.2%), cobalt (28.2%), potassium dichromate (27.2%), myroxylon pereirae (9.9%), and fragrance mix I (8.4%). Sensitivity to nickel was more frequent among females (P < 0.0001), while sensitivity to potassium dichromate was more frequent among males (P = 0.01). ConclusionsThe distribution of different causes of contact allergy identified through EBS was similar to what is observed in Europe. It allowed us to define, based on the sensitization profile of the patients included in our study, the most frequent causes of allergic contact dermatitis within our population. However, the emergence of new contact allergens can only be identified if Algeria establishes an allergo-vigilance network, similar to that in Europe, enabling both the evolution of patch test compositions and the detection of new allergic risks within the population.

Clinico-epidemiological and Patch Test Profile of Patients with Suspected Allergic Contact Dermatitis to Cosmetics in a Tertiary Care Hospital in the Southern Philippines: A 3-year Retrospective Study

Background: Allergic contact dermatitis (ACD) is a common skin inflammatory reaction occurring at the site of challenge with a contact allergen in sensitized individuals and one of the most common causes for consultation in dermatology clinics. Patch testing is a method for detecting the causative component in suspected cases of ACD. Awareness about the causative allergen aids in reducing morbidity and can significantly minimize the impact of ACD in the affected people. Objectives: The study aimed to measure the number of relevant positive reactions in patch tests being performed in our institution in patients with ACD to cosmetic products. Methods: A total of 60 patients who were diagnosed with ACD to cosmetics and underwent patch testing were reviewed to identify the clinico-epidemiological and patch test profiles of these patients. Results: The study showed that the mean age of patients was 42 comprising mostly of females. Most of the patients were unemployed, office workers, and medical workers. The most common cosmetic products that caused ACD include soaps, shampoos, lotions, and moisturizers. Nickel is still the most tested positive among these patients, followed by fragrance mixes and 4-phenylenediamine base. They are widely distributed in cosmetic products, especially in soaps and lotions. The pattern of dermatitis revealed facial dermatitis to be the most common reason for consult of these patients. Conclusion: Patch test is valuable in the setting of establishing the etiology of ACD to cosmetic products.