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Wennervaldt M, Vaher H, Ahlström MG, Bischofberger N, Menné T, Thyssen JP, Johansen JD, Bonefeld CM. Subclinical immune responses to nickel in sensitized individuals-a dose-response study. Contact Dermatitis 2024; 91:1-10. [PMID: 38577784 DOI: 10.1111/cod.14549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/10/2024] [Accepted: 03/08/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Nickel is the leading cause of contact allergy in Europe, with 14.5% of the adult population being sensitized. Despite regulations limiting nickel release from consumer items, the incidence and prevalence of nickel allergy remain high. OBJECTIVE To investigate the clinical and subclinical immune response to low-dose nickel exposure on nickel pre-exposed skin to assess the adequacy of current regulatory limits. METHOD Nickel-allergic and healthy controls were patch tested with nickel twice with a 3-4 weeks interval. The first exposure used the diagnostic concentration of 2000 μg/cm2 nickel sulphate, and the same skin areas were then re-exposed to 0.2, 0.5, 12.8 and 370 μg/cm2 nickel sulphate. After 48 h, the patch reactions were examined for clinical signs of eczema, and skin biopsies were collected. The transcriptomic immune profile was analysed with Nanostring nCounter and quantitative polymerase chain reaction. RESULTS Two nickel-allergic participants (15%) had clinical reactions to the regulatory limiting doses for nickel (0.2/0.5 μg/cm2) following re-exposure. There was immune activation in all skin areas following re-exposure to nickel, predominantly mediated by up-regulation of cytokines and chemokines. In all nickel re-exposed skin areas, 81 genes were up-regulated independent from the clinical response. In skin areas exposed to 0.2 μg/cm2, 101 immune-related genes were differentially expressed, even when no clinical response was observed. Healthy controls showed up-regulation of three genes in response to nickel re-exposures without any clinical reactions. CONCLUSION Immune activation can be induced in skin with local memory to nickel upon challenge with nickel doses within the regulatory limits. Our findings suggest that the regulatory limits in the European nickel regulation may not provide sufficient protection for consumers against low-dose exposures.
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Affiliation(s)
- Michael Wennervaldt
- Department of Dermatology and Allergy, National Allergy Research Centre, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark
| | - Helen Vaher
- Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, The LEO Foundation Skin Immunology Research Center, University of Copenhagen, Copenhagen, Denmark
| | - Malin G Ahlström
- Department of Dermatology and Allergy, National Allergy Research Centre, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark
| | - Nuno Bischofberger
- Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, The LEO Foundation Skin Immunology Research Center, University of Copenhagen, Copenhagen, Denmark
| | - Torkil Menné
- Department of Dermatology and Allergy, National Allergy Research Centre, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark
| | - Jacob P Thyssen
- Department of Dermatology and Allergy, National Allergy Research Centre, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark
| | - Jeanne D Johansen
- Department of Dermatology and Allergy, National Allergy Research Centre, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark
| | - Charlotte M Bonefeld
- Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, The LEO Foundation Skin Immunology Research Center, University of Copenhagen, Copenhagen, Denmark
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2
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Brancaccio R, Murdaca G, Casella R, Loverre T, Bonzano L, Nettis E, Gangemi S. miRNAs' Cross-Involvement in Skin Allergies: A New Horizon for the Pathogenesis, Diagnosis and Therapy of Atopic Dermatitis, Allergic Contact Dermatitis and Chronic Spontaneous Urticaria. Biomedicines 2023; 11:biomedicines11051266. [PMID: 37238937 DOI: 10.3390/biomedicines11051266] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/29/2023] [Accepted: 04/21/2023] [Indexed: 05/28/2023] Open
Abstract
Skin inflammation is a common underlying feature of atopic dermatitis, allergic contact dermatitis and chronic spontaneous urticaria. The pathogenetic mechanisms have not been fully elucidated. The purpose of this study was to examine whether miRNA, by regulating inflammatory mechanisms through the modulation of innate and adaptive immune responses, could play a major role in the pathogenesis of these skin conditions. We conducted a narrative review using the Pubmed and Embase scientific databases and search engines to find the most relevant miRNAs related to the pathophysiology, severity and prognosis of skin conditions. The studies show that miRNAs are involved in the pathogenesis and regulation of atopic dermatitis and can reveal an atopic predisposition or indicate disease severity. In chronic spontaneous urticaria, different miRNAs which are over-expressed during urticaria exacerbations not only play a role in the possible response to therapy or remission, but also serve as a marker of chronic autoimmune urticaria and indicate associations with other autoimmune diseases. In allergic contact dermatitis, miRNAs are upregulated in inflammatory lesions and expressed during the sensitization phase of allergic response. Several miRNAs have been identified as potential biomarkers of these chronic skin conditions, but they are also possible therapeutic targets.
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Affiliation(s)
- Raffaele Brancaccio
- Dermatology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio nell'Emilia, Italy
| | - Giuseppe Murdaca
- Department of Internal Medicine, University of Genova, 16132 Genova, Italy
- Department of Internal Medicine, Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Rossella Casella
- Department of Emergency and Organ Transplantation, School of Allergology and Clinical Immunology, University of Bari Aldo Moro, Policlinico di Bari, 70124 Bari, Italy
| | - Teresa Loverre
- Department of Emergency and Organ Transplantation, School of Allergology and Clinical Immunology, University of Bari Aldo Moro, Policlinico di Bari, 70124 Bari, Italy
| | - Laura Bonzano
- Dermatology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio nell'Emilia, Italy
| | - Eustachio Nettis
- Department of Emergency and Organ Transplantation, School of Allergology and Clinical Immunology, University of Bari Aldo Moro, Policlinico di Bari, 70124 Bari, Italy
| | - Sebastiano Gangemi
- Department of Clinical and Experimental Medicine, School and Division of Allergy and Clinical Immunology, University of Messina, 98125 Messina, Italy
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3
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Jacobsen G, Rasmussen K, Bregnhøj A, Isaksson M, Diepgen TL, Carstensen O. Causes of irritant contact dermatitis after occupational skin exposure: a systematic review. Int Arch Occup Environ Health 2022; 95:35-65. [PMID: 34665298 PMCID: PMC8755674 DOI: 10.1007/s00420-021-01781-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 07/11/2021] [Indexed: 01/15/2023]
Abstract
PURPOSE Irritant contact dermatitis (ICD) is a major cause of occupational disease. The aim was to review the relation between exposure to occupational irritants and ICD and the prognosis of ICD. METHODS Through a systematic search, 1516 titles were identified, and 48 studies were included in the systematic review. RESULTS We found that the evidence for an association between ICD and occupational irritants was strong for wet work, moderate for detergents and non-alcoholic disinfectants, and strong for a combination. The highest quality studies provided limited evidence for an association with use of occlusive gloves without other exposures and moderate evidence with simultaneous exposure to other wet work irritants. The evidence for an association between minor ICD and exposure to metalworking fluids was moderate. Regarding mechanical exposures, the literature was scarce and the evidence limited. We found that the prognosis for complete healing of ICD is poor, but improves after decrease of exposure through change of occupation or work tasks. There was no substantial evidence for an influence of gender, age, or household exposures. Inclusion of atopic dermatitis in the analysis did not alter the risk of ICD. Studies were at risk of bias, mainly due to selection and misclassification of exposure and outcome. This may have attenuated the results. CONCLUSION This review reports strong evidence for an association between ICD and a combination of exposure to wet work and non-alcoholic disinfectants, moderate for metalworking fluids, limited for mechanical and glove exposure, and a strong evidence for a poor prognosis of ICD.
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Affiliation(s)
- Gitte Jacobsen
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, University Research Clinic, Herning, Denmark.
- Department of Occupational Medicine, Hospital South West Jutland, University Hospital of Southern Denmark, Esbjerg, Denmark.
| | - Kurt Rasmussen
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, University Research Clinic, Herning, Denmark
| | - Anne Bregnhøj
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Marléne Isaksson
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Thomas L Diepgen
- Department of Clinical Social Medicine, Occupational and Environmental Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Ole Carstensen
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, University Research Clinic, Herning, Denmark
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4
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Geier J, Schubert S, Schnuch A, Szliska C, Weisshaar E, Kränke B, Werfel T, Ruëff F, Schröder-Kraft C, Buhl T. A negative breakdown test in a fragrance mix I-positive patient does not rule out contact allergy to its fragrance constituents. Contact Dermatitis 2021; 84:407-418. [PMID: 33533485 DOI: 10.1111/cod.13803] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/19/2021] [Accepted: 01/26/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND In about half of the patients reacting positive to fragrance mix I (FM I), breakdown testing remains negative. This raises the question of whether the reaction to FM I is false-positive, or the breakdown test is false-negative. OBJECTIVES To identify characteristics and sensitization patterns of patients positive to FM I, but not to its fragrance constituents. PATIENTS AND METHODS Retrospective analysis of data from the Information Network of Departments of Dermatology (IVDK) between 2005 and 2019. Three patient groups were defined according to their reaction pattern: Group I, FM I positive and ≥1 single fragrance positive in the breakdown test (n = 1912); Group II, FM I positive and breakdown test negative (n = 1318); Group III, FM I negative (n = 19 790). RESULTS Regarding the pattern of concomitant reactions to other fragrances, Group II had an intermediate position between Group I and Group III. In other respects (age and sex distribution, frequency of sensitization to non-fragrance baseline series allergens), Group II rather resembled Group I. CONCLUSIONS Not every positive reaction to FM I in patients with negative breakdown tests is false-positive. There may be false-negative reactions to the single fragrance components when patch tested at 1% pet. Raising patch concentrations of some single fragrances is recommended.
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Affiliation(s)
- Johannes Geier
- Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Center Göttingen, Göttingen, Germany
| | - Steffen Schubert
- Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Center Göttingen, Göttingen, Germany
| | - Axel Schnuch
- Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Center Göttingen, Göttingen, Germany
| | | | - Elke Weisshaar
- Occupational Dermatology, Department of Dermatology, Ruprecht-Karl University Heidelberg, Heidelberg, Germany
| | - Birger Kränke
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - Thomas Werfel
- Department of Dermatology and Allergy, Division of Immunodermatology and Allergy Research, Hannover Medical School, Hannover, Germany
| | - Franziska Ruëff
- Department of Dermatology and Allergology, Ludwig-Maximilian University of Munich, Munich, Germany
| | - Claudia Schröder-Kraft
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) of the University of Osnabrück and Dermatologic Center, BG Trauma Hospital Hamburg, Hamburg, Germany
| | - Timo Buhl
- Department of Dermatology, Venereology and Allergy, University Medical Center Göttingen, Göttingen, Germany
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5
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De Rentiis AMA, Pink M, Verma N, Schmitz-Spanke S. Assessment of the different skin sensitization potentials of irritants and allergens as single substances and in combination using the KeratinoSens assay. Contact Dermatitis 2021; 84:317-325. [PMID: 33320367 DOI: 10.1111/cod.13762] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 12/07/2020] [Accepted: 12/10/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND People are exposed to mixtures containing allergens and irritants often causing contact dermatitis. Therefore, regulatory authorities require systematic information on the effects of mixtures on the sensitization threshold. In this study a moderate (cinnamal) and a weak (ethylene glycol dimethacrylate) allergen were combined with irritants covering different mechanisms of action (sodium dodecyl sulfate, salicylic acid, and α-pinene). For a systematic approach, the single substances were initially tested using the KeratinoSens assay. Thereafter, each allergen was combined with noncytotoxic concentrations of the irritants. METHOD The KeratinoSens assay was applied for the single substances according to OECD (Organisation for Economic Co-operation and Development) Test Guideline 442D. Based on these results, three noncytotoxic concentrations of the irritants were selected and applied simultaneously with 12 concentrations of the allergens to the KeratinoSens cells. Sensitization threshold and cytotoxicity were measured and compared with the individual testing. RESULTS The combinations of allergens and irritants differed from the effects of the single substances and lowered the sensitization threshold. The quantitative approach allowed a clear description of the changes which varied by factors between 1.1 and 10.3. CONCLUSIONS Overall, the allergen was the prominent compound in the mixture and its nature appeared to determine the degree of the response.
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Affiliation(s)
- Anna M A De Rentiis
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Mario Pink
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany.,Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Nisha Verma
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Simone Schmitz-Spanke
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
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6
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Simonsen AB, Ruge IF, Quaade AS, Johansen JD, Thyssen JP, Zachariae C. Increased occurrence of hand eczema in young children following the Danish hand hygiene recommendations during the COVID-19 pandemic. Contact Dermatitis 2020; 84:144-152. [PMID: 33085086 DOI: 10.1111/cod.13727] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/11/2020] [Accepted: 10/15/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND During the first wave of the COVID-19 pandemic of Spring 2020, Denmark was one of the first countries to introduce lockdown measures, including closing of all daycare centers. Following the reopening of daycare centers, Danish Health Authorities implemented a mandatory intensive hand hygiene regimen. OBJECTIVES To examine the occurrence and point prevalence of hand eczema as a consequence of more intensive hand hygiene among Danish children attending daycare. METHODS The heads of 1667 daycare centers in Denmark were contacted and asked to forward a link to a questionnaire to parents of the children attending the daycare center. RESULTS Among 6858 children, 12.1% had hand eczema before reopening of daycare centers, whereas 38.3% reported hand eczema after the children returned to daycare. Of the children who never had hand eczema, 28.6% developed hand eczema after returning to daycare. The risk of hand eczema was significantly associated with atopic dermatitis, female gender, higher age, and frequency of handwashing. CONCLUSION Following the implemented hygiene regimen, a high proportion of young children rapidly developed hand eczema. Well-established prophylactic skin care might have spared a proportion of the children from developing hand eczema.
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Affiliation(s)
- Anne B Simonsen
- Department of Dermatology and Allergy, Copenhagen University Hospital, Herlev and Gentofte, Hellerup, Denmark
| | - Iben F Ruge
- Department of Dermatology and Allergy, Copenhagen University Hospital, Herlev and Gentofte, Hellerup, Denmark
| | - Anna S Quaade
- Department of Dermatology and Allergy, Copenhagen University Hospital, Herlev and Gentofte, Hellerup, Denmark
| | - Jeanne D Johansen
- Department of Dermatology and Allergy, Copenhagen University Hospital, Herlev and Gentofte, Hellerup, Denmark
| | - Jacob P Thyssen
- Department of Dermatology and Allergy, Copenhagen University Hospital, Herlev and Gentofte, Hellerup, Denmark
| | - Claus Zachariae
- Department of Dermatology and Allergy, Copenhagen University Hospital, Herlev and Gentofte, Hellerup, Denmark
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7
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Mahler V, Nast A, Bauer A, Becker D, Brasch J, Breuer K, Dickel H, Drexler H, Elsner P, Geier J, John SM, Kreft B, Köllner A, Merk H, Ott H, Pleschka S, Portisch M, Spornraft-Ragaller P, Weisshaar E, Werfel T, Worm M, Schnuch A, Uter W. S3 Guidelines: Epicutaneous patch testing with contact allergens and drugs - Short version, Part 2. J Dtsch Dermatol Ges 2020; 17:1187-1207. [PMID: 31765083 DOI: 10.1111/ddg.13971] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Epicutaneous patch testing is the diagnostic standard for the detection of allergic contact dermatitis. The present guidelines are aimed at residents and board-certified physicians in the fields of dermatology and allergology as well as other medical specialties involved in establishing the indication for patch testing and its execution in patients with contact dermatitis and other forms of delayed-type hypersensitivity. The target audience also includes other health care providers and insurance funds. Based on a systematic literature search and a formal consensus process (S3), the guidelines were developed by dermatologists in collaboration with pediatricians, occupational medicine physicians, nursing staff as well as patient representatives. The systematic methodological approach and appraisal of evidence upon which the recommendations are based are outlined in a separate method report that also contains evidence tables. The guidelines address general aspects of patch testing as well as medicolegal issues. The recommendations given relate to topics such as the indication for patch testing, informed patient consent, as well as the choice of test substances, test chambers and test site, duration of exposure, reading times and interpretation of test reactions. Furthermore, recommendations are provided with respect to endogenous and exogenous factors, specific patient groups (children, pregnant women, immunosuppressed individuals) as well as possible risks and adverse events associated with patch testing using contact allergens.
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Affiliation(s)
- Vera Mahler
- Department of Dermatology, University Medical Center, Friedrich Alexander University, Erlangen, Germany.,Paul Ehrlich Institute, Langen, Germany
| | - Alexander Nast
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt University of Berlin, and Berlin Institute of Health, Department of Dermatology, Venereology und Allergology, Division of Evidence-based Medicine (dEBM), Berlin, Germany
| | - Andrea Bauer
- Department of Dermatology, University Medical Center, Dresden Technical University, Dresden, Germany
| | - Detlef Becker
- Department of Dermatology, University Medical Center, Mainz, Germany
| | - Jochen Brasch
- Department of Dermatology, Venereology und Allergology, University Medical Center, Kiel, Germany
| | - Kristine Breuer
- Dermatology Practice (Dermatologie Reinbek), Reinbek, Germany
| | - Heinrich Dickel
- Department of Dermatology, Venereology und Allergology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Hans Drexler
- Institute for Occupational, Social and Environmental Medicine, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Peter Elsner
- Department of Dermatology, University Hospital Jena, Jena, Germany
| | - Johannes Geier
- Information Network of Dermatology Departments in Germany (IVDK), Göttingen University Medical Center, Göttingen, Germany
| | - Swen Malte John
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrück, Osnabrück, Germany
| | - Burkhard Kreft
- Department of Dermatology and Venereology, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | | | - Hans Merk
- Professor of Dermatology and Allergology, Former Chairman of the Department of Dermatology, RWTH University, Aachen, Germany
| | - Hagen Ott
- Division of Pediatric Dermatology and Allergology, Children's Hospital Auf der Bult, Hannover, Germany
| | - Silvia Pleschka
- German Allergy and Asthma Foundation (Deutscher Allergie- und Asthmabund e.V.), Mönchengladbach, Germany
| | - Maria Portisch
- Department of Dermatology, University Medical Center, Friedrich Alexander University, Erlangen, Germany
| | | | - Elke Weisshaar
- Division of Occupational Dermatology, Department of Dermatology, University Medical Center, Heidelberg, Germany
| | - Thomas Werfel
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - Margitta Worm
- Department of Dermatology, Venereology und Allergology, Charité - University Medicine, Berlin, Germany
| | - Axel Schnuch
- Information Network of Dermatology Departments in Germany (IVDK), Göttingen University Medical Center, Göttingen, Germany
| | - Wolfgang Uter
- Institute for Medical Informatics, Biometrics and Epidemiology (IMBE), Medical Faculty, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
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8
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Jee MH, Mraz V, Geisler C, Bonefeld CM. γδ T cells and inflammatory skin diseases. Immunol Rev 2020; 298:61-73. [DOI: 10.1111/imr.12913] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/07/2020] [Accepted: 07/15/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Mia Hamilton Jee
- The LEO Foundation Skin Immunology Research Center Department of Immunology and Microbiology Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| | - Veronika Mraz
- The LEO Foundation Skin Immunology Research Center Department of Immunology and Microbiology Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| | - Carsten Geisler
- The LEO Foundation Skin Immunology Research Center Department of Immunology and Microbiology Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| | - Charlotte Menné Bonefeld
- The LEO Foundation Skin Immunology Research Center Department of Immunology and Microbiology Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
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9
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Murata A, Hayashi SI. CD4 + Resident Memory T Cells Mediate Long-Term Local Skin Immune Memory of Contact Hypersensitivity in BALB/c Mice. Front Immunol 2020; 11:775. [PMID: 32508808 PMCID: PMC7248184 DOI: 10.3389/fimmu.2020.00775] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 04/06/2020] [Indexed: 12/23/2022] Open
Abstract
In allergic contact dermatitis (ACD) and contact hypersensitivity (CHS), the healed skin shows greater swelling than the naïve skin in the same individual upon re-exposure to the same hapten. This “local skin memory” (LSM) in healed skin was maintained for a prolonged period of time and mediated by skin CD8+-resident memory T (TRM) cells in C57BL/6 mice. However, the number of CD4+ T cells is elevated in ACD-healed human skin, and the contribution of CD4+ TRM cells to the formation of LSM currently remains unclear. We herein demonstrated that immediately after CHS subsided, the healed skin in BALB/c mice showed an accumulation of hapten-specific CD4+ and CD8+ TRM cells, with a predominance of CD4+ TRM cells. The presence of CD4+ or CD8+ TRM cells in the healed skin was sufficient for the induction of a flare-up reaction upon a re-challenge. The CD4+ and CD8+ TRM cells both produced interferon-γ and tumor necrosis factor early after the re-challenge. Moreover, while CD8+ TRM cells gradually decreased over time and were eventually lost from the healed skin at 40–51 weeks after the resolution of CHS, the CD4+ TRM cell numbers remained elevated during this period. The present results indicate that the long-term maintenance of LSM is mediated by CD4+ TRM cells, and thus CD4+ TRM cells are an important target for the treatment of recurrent human ACD.
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Affiliation(s)
- Akihiko Murata
- Division of Immunology, Department of Molecular and Cellular Biology, School of Life Science, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Shin-Ichi Hayashi
- Division of Immunology, Department of Molecular and Cellular Biology, School of Life Science, Faculty of Medicine, Tottori University, Yonago, Japan
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10
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Mahler V, Nast A, Bauer A, Becker D, Brasch J, Breuer K, Dickel H, Drexler H, Elsner P, Geier J, John SM, Kreft B, Köllner A, Merk H, Ott H, Pleschka S, Portisch M, Spornraft‐Ragaller P, Weisshaar E, Werfel T, Worm M, Schnuch A, Uter W. S3‐Leitlinie: Durchführung des Epikutantests mit Kontaktallergenen und Arzneimitteln – Kurzfassung Teil 2. J Dtsch Dermatol Ges 2019; 17:1187-1207. [DOI: 10.1111/ddg.13971_g] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Vera Mahler
- Hautklinik Universitätsklinikum ErlangenFriedrich‐Alexander‐Universität Erlangen‐Nürnberg Erlangen
- Paul‐Ehrlich‐Institut Langen
| | - Alexander Nast
- Division of Evidence‐based Medicine (dEBM)Klinik für DermatologieVenerologie und AllergologieCharité – Universitätsmedizin Berlin Berlin
| | - Andrea Bauer
- Klinik und Poliklinik für Dermatologie Universitätsklinikum Carl Gustav CarusTechnische Universität Dresden Dresden
| | | | - Jochen Brasch
- Klinik für DermatologieVenerologie und AllergologieUniversitätsklinikum Schleswig‐Holstein Kiel
| | | | - Heinrich Dickel
- Klinik für DermatologieVenerologie und AllergologieSt. Josef‐Hospital, Ruhr‐Universität Bochum Bochum
| | - Hans Drexler
- Institut für Arbeits‐Sozial‐ und Umweltmedizin der Friedrich‐Alexander‐Universität Erlangen‐Nürnberg Erlangen
| | - Peter Elsner
- Klinik für HautkrankheitenUniversitätsklinikum Jena Jena
| | - Johannes Geier
- Informationsverbund Dermatologischer Kliniken (IVDK) e.V. an der Universitätsmedizin Göttingen Göttingen
| | - Swen Malte John
- Institut für interdisziplinäre Dermatologische Prävention und Rehabilitation (iDerm) an der Universität Osnabrück Osnabrück
| | - Burkhard Kreft
- Klinik und Poliklinik für Dermatologie und VenerologieUniversitätsklinikum (Saale) Halle
| | | | - Hans Merk
- Univ.‐Professor für Dermatologie & AllergologieDirektor (em.) der Hautklinik – RWTH Aachen University Aachen
| | - Hagen Ott
- Hannoversche Kinderheilanstalt (HKA): Kinder‐ und Jugendkrankenhaus auf der Bult Hannover
| | | | - Maria Portisch
- Hautklinik Universitätsklinikum ErlangenFriedrich‐Alexander‐Universität Erlangen‐Nürnberg Erlangen
| | | | - Elke Weisshaar
- BerufsdermatologieHautklinikUniversitätsklinikum Heidelberg Heidelberg
| | - Thomas Werfel
- Klinik für DermatologieAllergologie und VenerologieMedizinische Hochschule Hannover Hannover
| | - Margitta Worm
- Klinik für DermatologieVenerologie und Allergologie Charité – Universitätsmedizin Berlin Berlin
| | - Axel Schnuch
- Informationsverbund Dermatologischer Kliniken (IVDK) e.V. an der Universitätsmedizin Göttingen Göttingen
| | - Wolfgang Uter
- Institut für MedizininformatikBiometrie und Epidemiologie (IMBE)Medizinische Fakultät der Friedrich‐Alexander‐Universität Erlangen‐Nürnberg Erlangen
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11
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Gilmour N, Kimber I, Williams J, Maxwell G. Skin sensitization: Uncertainties, challenges, and opportunities for improved risk assessment. Contact Dermatitis 2019; 80:195-200. [PMID: 30525211 PMCID: PMC6587935 DOI: 10.1111/cod.13167] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 10/23/2018] [Indexed: 02/01/2023]
Abstract
At the ESCD congress held in Manchester in 2016, a session was organized to encourage more dialogue between clinicians with expertise in skin sensitization and toxicologists seeking to provide effective risk assessment to prevent human health issues. That session focused on the remaining uncertainties regarding the induction and regulation of skin sensitization in humans, and the opportunities and challenges associated with the refinement and improvement of risk assessment methodologies. This short article, prompted by those discussions, debates what the authors regard as being among the most important and most intriguing uncertainties about skin sensitization and allergic contact dermatitis in humans, and the most significant opportunities for improving risk assessment. The aim has been to provide a basis for mapping out the areas that might benefit from a closer alignment between the relevant clinical community and toxicologists charged with the responsibility of ensuring that skin sensitization risks are understood and managed.
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Affiliation(s)
- Nicola Gilmour
- Unilever Safety and Environmental Assurance CentreBedfordUK
| | - Ian Kimber
- Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
| | - Jason Williams
- Contact Dermatitis Investigation Unit, Salford NHS Foundation TrustSalfordUK
| | - Gavin Maxwell
- Unilever Safety and Environmental Assurance CentreBedfordUK
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12
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Kimber I, Poole A, Basketter DA. Skin and respiratory chemical allergy: confluence and divergence in a hybrid adverse outcome pathway. Toxicol Res (Camb) 2018; 7:586-605. [PMID: 30090609 PMCID: PMC6060610 DOI: 10.1039/c7tx00272f] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 01/18/2018] [Indexed: 12/14/2022] Open
Abstract
Sensitisation of the respiratory tract to chemicals resulting in respiratory allergy and allergic asthma is an important occupational health problem, and presents toxicologists with no shortage of challenges. A major issue is that there are no validated or, even widely recognised, methods available for the identification and characterisation of chemical respiratory allergens, or for distinguishing respiratory allergens from contact allergens. The first objective here has been review what is known (and what is not known) of the mechanisms through which chemicals induce sensitisation of the respiratory tract, and to use this information to construct a hybrid Adverse Outcome Pathway (AOP) that combines consideration of both skin and respiratory sensitisation. The intention then has been to use the construction of this hybrid AOP to identify areas of commonality/confluence, and areas of departure/divergence, between skin sensitisation and sensitisation of the respiratory tract. The hybrid AOP not only provides a mechanistic understanding of how the processes of skin and respiratory sensitisation differ, buy also a means of identifying areas of uncertainty about chemical respiratory allergy that benefit from a further investment in research.
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Affiliation(s)
- Ian Kimber
- Faculty of Biology , Medicine and Health , University of Manchester , Oxford Road , Manchester M13 9PT , UK . ; Tel: +44 (0) 161 275 1587
| | - Alan Poole
- European Centre for Ecotoxicology and Toxicology of Chemicals (ECETOC) , 2 Av E Van Nieuwenhuyse , 1160 Brussels , Belgium
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13
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Koppes SA, Engebretsen KA, Agner T, Angelova-Fischer I, Berents T, Brandner J, Brans R, Clausen ML, Hummler E, Jakasa I, Jurakić-Tončic R, John SM, Khnykin D, Molin S, Holm JO, Suomela S, Thierse HJ, Kezic S, Martin SF, Thyssen JP. Current knowledge on biomarkers for contact sensitization and allergic contact dermatitis. Contact Dermatitis 2017; 77:1-16. [DOI: 10.1111/cod.12789] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 02/07/2017] [Accepted: 02/09/2017] [Indexed: 12/13/2022]
Affiliation(s)
- Sjors A. Koppes
- Department of Coronel Institute of Occupational Health, Academic Medical Center; University of Amsterdam; 1105 AZ Amsterdam The Netherlands
- Department of Dermatology-Allergology; VU University Medical Centre; 081 HV Amsterdam The Netherlands
| | - Kristiane A. Engebretsen
- Department of Dermatology and Allergy, National Allergy Research Centre; Herlev and Gentofte Hospital, University of Copenhagen; 2900 Hellerup Denmark
| | - Tove Agner
- Department of Dermatology; Bispebjerg Hospital, University of Copenhagen; 2400 Copenhagen Denmark
| | | | - Teresa Berents
- Institute of Clinical Medicine; University of Oslo; 0318 Oslo Norway
- Department of Dermatology; Oslo University Hospital; 0424 Oslo Norway
| | - Johanna Brandner
- Department of Dermatology and Venerology; University Hospital Hamburg-Eppendorf; 20246 Hamburg Germany
| | - Richard Brans
- Department of Dermatology, Environmental Medicine and Health Theory; University of Osnabrück; 49076 Osnabrück Germany
| | - Maja-Lisa Clausen
- Department of Dermatology; Bispebjerg Hospital, University of Copenhagen; 2400 Copenhagen Denmark
| | - Edith Hummler
- Department of Pharmacology and Toxicology; University of Lausanne; 1011 Lausanne Switzerland
| | - Ivone Jakasa
- Faculty of Food Technology and Biotechnology, Department of Chemistry and Biochemistry, Laboratory for Analytical Chemistry; University of Zagreb; 10000 Zagreb Croatia
| | - Ružica Jurakić-Tončic
- University Department of Dermatovenereology; Clinical Hospital Zagreb and School of Medicine; 10000 Zagreb Croatia
| | - Swen M. John
- Department of Dermatology, Environmental Medicine and Health Theory; University of Osnabrück; 49076 Osnabrück Germany
| | - Denis Khnykin
- Department of Pathology; Oslo University Hospital - Rikshospitalet; 0424 Oslo Norway
- Centre for Immune Regulation; University of Oslo; 0424 Oslo Norway
| | - Sonja Molin
- Department of Dermatology and Allergology; Ludwig-Maximilians-University; 81377 München Germany
| | - Jan O. Holm
- Institute of Clinical Medicine; University of Oslo; 0318 Oslo Norway
- Department of Dermatology; Oslo University Hospital; 0424 Oslo Norway
| | - Sari Suomela
- Department of Dermatology; Finnish Institute of Occupational Health; 00251 Helsinki Finland
| | - Hermann-Josef Thierse
- Department of Chemicals and Product Safety; German Federal Institute for Risk Assessment; 10589 Berlin Germany
- Laboratory for Immunology & Proteomics, Department of Dermatology and University Medical Centre Mannheim; University of Heidelberg; 68167 Mannheim Germany
| | - Sanja Kezic
- Department of Coronel Institute of Occupational Health, Academic Medical Center; University of Amsterdam; 1105 AZ Amsterdam The Netherlands
| | - Stefan F. Martin
- Department of Dermatology, Allergy Research Group; Medical Centre - University of Freiburg; 79104 Freiburg Germany
| | - Jacob P. Thyssen
- Department of Dermatology and Allergy, National Allergy Research Centre; Herlev and Gentofte Hospital, University of Copenhagen; 2900 Hellerup Denmark
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14
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Westphal GA, Rihs HP, Schaffranek A, Zeiler T, Werfel T, Heratizadeh A, Dickel H, Weisshaar E, Bauer A, Schliemann S, Reich K, Breuer K, Schröder-Kraft C, Worm M, Molin S, Brans R, Schäkel K, Schwantes H, Pföhler C, Szliska C, Kreft B, Löffler H, Bünger J, Brüning T, Geier J, Schnuch A. A variant of the CXCL11 gene may influence susceptibility to contact allergy, particularly in polysensitized patients. Contact Dermatitis 2017; 75:303-307. [PMID: 27356947 DOI: 10.1111/cod.12623] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 04/27/2016] [Accepted: 04/28/2016] [Indexed: 01/18/2023]
Abstract
BACKGROUND Hereditary factors may influence individual susceptibility to contact allergy. OBJECTIVES To investigate genetic variants with impacts on early inflammatory reactions and T cell functions that possibly increase the risk of contact allergy. PATIENTS AND METHODS Three hundred and seventy two patients undergoing patch testing were recruited from the Information Network of Departments of Dermatology (IVDK). Of these, 133 were monosensitized and 239 were polysensitized, defined as reacting to three or more unrelated sensitizers. Within the polysensitized individuals, a subgroup with at least one particularly strong patch test reaction (strong reactors; n = 194) was considered. Three hundred and forty-seven blood bank donors served as controls. Fifteen genetic variants in 13 genes were analysed. RESULTS The homozygous variant CXCL11 AA genotype (rs6817952) was significantly more frequent among polysensitized patients (10 of 239 = 4.2%; p = 0.0048; odds ratio 7.49; 95%CI: 1.7-36.1) than among monosensitized patients (2.2%) and in the control group (0.6%). None of the remaining genetic variants investigated were characterized by similarly strong associations. However, the significance was lost after correction for multiple comparisons. CONCLUSIONS The homozygous variant CXCL11 genotype is associated with an increased risk of contact allergy. To confirm this exploratory finding, further independent studies are needed.
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Affiliation(s)
- Götz A Westphal
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Ruhr-University Bochum, 44789, Bochum, Germany.
| | - Hans-Peter Rihs
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Ruhr-University Bochum, 44789, Bochum, Germany
| | - Antje Schaffranek
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Ruhr-University Bochum, 44789, Bochum, Germany
| | - Thomas Zeiler
- DRK-Blood Transfusion Service West, Centre for Transfusion Medicine Breitscheid, 40885, Ratingen, Germany
| | - Thomas Werfel
- Klinik für Dermatologie, Allergologie und Venerologie Medizinische Hochschule, 30625, Hannover, Germany
| | - Annice Heratizadeh
- Klinik für Dermatologie, Allergologie und Venerologie Medizinische Hochschule, 30625, Hannover, Germany
| | - Heinrich Dickel
- Department of Dermatology, Venereology and Allergology, St. Josef-Hospital, Ruhr-University Bochum, 44791, Bochum, Germany
| | - Elke Weisshaar
- Department of Clinical Social Medicine, Centre of Occupational and Environmental Dermatology, Heidelberg University Hospital, 69115, Heidelberg, Germany
| | - Andrea Bauer
- Department of Dermatology, Universitätsklinikum Carl Gustav Carus, 01307, Dresden, Germany
| | - Sibylle Schliemann
- Department of Dermatology, Jena University Hospital, 07743, Jena, Germany
| | | | | | - Claudia Schröder-Kraft
- Berufsgenossenschaftliches, Unfallkrankenhaus Hamburg Dermatologie, 21033, Hamburg, Germany
| | - Margitta Worm
- Department of Dermatology and Allergy, Allergy-Center Charite, Universitätsmedizin Berlin, 10117, Berlin, Germany
| | - Sonja Molin
- Department of Dermatology and Allergy, Ludwig Maximilian University, 80337, Munich, Germany
| | - Richard Brans
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, 49090, Osnabrück, Germany
| | - Knut Schäkel
- Department of Dermatology, University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Hilmar Schwantes
- Department of Occupational Dermatology, Berufsgenossenschaftliche-Klinik Falkenstein, 08223, Falkenstein, Germany
| | - Claudia Pföhler
- Department of Dermatology, Saarland University Medical School, 66424, Homburg, Saar, Germany
| | - Christiane Szliska
- Department of Dermatology, Bethesda Hospital, 57258, Freudenberg, Germany
| | - Burkhard Kreft
- Department of Dermatology and Venereology, Martin Luther University Halle-Wittenberg, 06120, Halle, Saale, Germany
| | - Harald Löffler
- Department of Dermatology, SLK Hospital Heilbronn, 74078, Heilbronn, Germany
| | - Jürgen Bünger
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Ruhr-University Bochum, 44789, Bochum, Germany
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Ruhr-University Bochum, 44789, Bochum, Germany
| | - Johannes Geier
- Information Network of Departments of Dermatology (IVDK), Georg-August-University Göttingen, 37075, Göttingen, Germany
| | - Axel Schnuch
- Information Network of Departments of Dermatology (IVDK), Georg-August-University Göttingen, 37075, Göttingen, Germany
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15
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Bäsler K, Brandner JM. Tight junctions in skin inflammation. Pflugers Arch 2016; 469:3-14. [DOI: 10.1007/s00424-016-1903-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 11/01/2016] [Accepted: 11/07/2016] [Indexed: 12/27/2022]
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Abstract
For toxicologists who are in any way associated with skin sensitisation, the last two decades have seen a series of fundamental changes. We have migrated from old-style guinea-pig assays, via the refined and reduced Local Lymph Node Assay (LLNA), to witness the imminent dominance of in vitro and in silico methods. Yet, over the same period, the use of the output data for human safety assurance has evolved from ‘black box’ risk assessment, via the quantitative risk assessment enabled by the LLNA measurement of potency, to a new period of relative uncertainty. This short review will endeavour to address these topics, all the while keeping a focus on three essential principles: a) that skin sensitisation potential is intrinsic in the molecular structure of the chemical; b) that test methods should have a mechanistic foundation; and finally c) that the only reason for undertaking any skin sensitisation work has to be the protection of human health.
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17
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Ho KK, Campbell KL, Lavergne SN. Contact dermatitis: a comparative and translational review of the literature. Vet Dermatol 2015; 26:314-27, e66-7. [DOI: 10.1111/vde.12229] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2015] [Indexed: 12/31/2022]
Affiliation(s)
- Karen K. Ho
- Veterinary Clinical Medicine; College of Veterinary Medicine; University of Illinois; 1008 W Hazelwood Dr Urbana IL 61802 USA
| | - Karen L. Campbell
- Veterinary Clinical Medicine; College of Veterinary Medicine; University of Illinois; 1008 W Hazelwood Dr Urbana IL 61802 USA
| | - Sidonie N. Lavergne
- Comparative Biosciences; College of Veterinary Medicine; University of Illinois; 2001 South Lincoln Av Urbana IL 61802 USA
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18
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Schwensen JF, Menné T, Johansen JD. The combined diagnosis of allergic and irritant contact dermatitis in a retrospective cohort of 1000 consecutive patients with occupational contact dermatitis. Contact Dermatitis 2014; 71:356-63. [PMID: 25099171 DOI: 10.1111/cod.12288] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 06/18/2014] [Accepted: 06/18/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND The diagnosis of combined allergic and irritant contact dermatitis is an accepted subdiagnosis for hand dermatitis, and it is often considered in a patient with contact dermatitis, a positive and relevant patch test result, and wet work exposure. We therefore hypothesize that it is arbitrary for wet work exposure to be taken into consideration in a patient with newly diagnosed relevant contact allergy. Furthermore, an overestimation of the diagnosis will probably occur if the criteria for wet work exposure are applied correctly, as many occupations have an element of wet work. OBJECTIVES To find the statistically expected number of combined allergic and irritant contact dermatitis cases in 1000 patients, and to evaluate the diagnostic criteria for the diagnosis. METHODS One thousand consecutive patients with occupational contact dermatitis from a hospital unit in Denmark were assessed. RESULTS The expected number of cases with the diagnosis of combined allergic and irritant contact dermatitis was 0.33%, as compared with the observed number of 6.4%. Females occupied in wet occupations were often diagnosed with combined allergic and irritant contact dermatitis (p < 0.005). CONCLUSION The diagnosis of combined allergic and irritant contact dermatitis should be used critically to avoid misclassification, and possible criteria for the diagnosis are proposed.
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Affiliation(s)
- Jakob F Schwensen
- Department of Dermato-Allergology, National Allergy Research Centre, Copenhagen University Hospital Gentofte, 2900, Hellerup, Denmark
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19
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20
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Jung PK, Lee JH, Baek JH, Hwang J, Won JU, Kim I, Roh J. The effect of work characteristics on dermatologic symptoms in hairdressers. Ann Occup Environ Med 2014; 26:13. [PMID: 25028609 PMCID: PMC4097089 DOI: 10.1186/2052-4374-26-13] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 05/28/2014] [Indexed: 11/18/2022] Open
Abstract
Objectives Hairdressers in Korea perform various tasks and are exposed to health risk factors such as chemical substances or prolonged duration of wet work. The objective of this study is to provide descriptive statistics on the demographics and work characteristics of hairdressers in Korea and to identify work-related risk factors for dermatologic symptoms in hairdressers. Methods 1,054 hairdressers were selected and analyzed for this study. Independent variables were exposure to chemical substances, the training status of the hairdressers, and the main tasks required of them, and the dependent variable was the incidence of dermatologic symptoms. The relationships between work characteristics and dermatologic symptoms were evaluated by estimating odds ratios using multiple logistic regression analysis. Results Among the 1,054 study subjects, 212 hairdressers (20.1%) complained of dermatologic symptoms, and the symptoms were more prevalent in younger, unmarried or highly educated hairdressers. The main tasks that comprise the majority of the wet work were strictly determined by training status, since 96.5% of staff hairdressers identified washing as their main task, while only 1.5% and 2.0% of master and designer hairdressers, respectively, identified this as their main task. Multiple logistic regressions was performed to estimate odds ratios. While exposure to hairdressing chemicals showed no significant effect on the odds ratio for the incidence of dermatologic symptoms, higher odds ratios of dermatologic symptoms were shown in staff hairdressers (2.70, 95% CI: 1.32 - 5.51) and in hairdressers who perform washing as their main task (2.03, 95% CI: 1.22 - 3.37), after adjusting for general and work characteristics. Conclusions This study showed that the training status and main tasks of hairdressers are closely related to each other and that the training status and main tasks of hairdressers are related to the incidence of dermatologic symptoms. This suggests that in the future, regulations on working conditions and health management guidelines for hairdressers should be established.
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Affiliation(s)
- Pil Kyun Jung
- Graduate School of Public Health, Yonsei University, Seoul, Korea ; The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea
| | - June-Hee Lee
- Graduate School of Public Health, Yonsei University, Seoul, Korea ; The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Hye Baek
- Korea Occupational Safety and Health Agency (KOSHA), Service Industry Safety Team, Chungbuk Area Office, Ulsan, Korea
| | - Jungho Hwang
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea ; Department of Preventive Medicine and Public Health, Yonsei University College of Medicine, Seoul, Korea
| | - Jong-Uk Won
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea ; Department of Preventive Medicine and Public Health, Yonsei University College of Medicine, Seoul, Korea
| | - Inah Kim
- Graduate School of Public Health, Yonsei University, Seoul, Korea ; Department of Preventive Medicine and Public Health, Yonsei University College of Medicine, Seoul, Korea
| | - Jaehoon Roh
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea ; Department of Preventive Medicine and Public Health, Yonsei University College of Medicine, Seoul, Korea
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21
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Vocanson M, Nicolas JF, Basketter D. In vitroapproaches to the identification and characterization of skin sensitizers. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/17469872.2013.814882] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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22
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23
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Pot LM, Scheitza SM, Coenraads PJ, Blömeke B. Penetration and haptenation of p-phenylenediamine. Contact Dermatitis 2013; 68:193-207. [PMID: 23510340 DOI: 10.1111/cod.12032] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Although p-phenylenediamine (PPD) has been recognized as an extreme sensitizer for many years, the exact mechanism of sensitization has not been elucidated yet. Penetration and the ability to bind to proteins are the first two hurdles that an allergen has to overcome to be able to sensitize. This review is an overview of studies regarding PPD penetration through skin (analogues) and studies on the amino acids that are targeted by PPD. To complete this review, the auto-oxidation and N-acetylation steps involved in PPD metabolism are described. In summary, under normal hair dyeing exposure conditions, <1% of the applied PPD dose penetrates the skin. The majority (>80%) of PPD that penetrates will be converted into the detoxification products monoacetyl-PPD and diacetyl-PPD by the N-acetyltransferase enzymes. The small amount of PPD that does not become N-acetylated is susceptible to auto-oxidation reactions, yielding protein-reactive PPD derivatives. These derivatives may bind to specific amino acids, and some of the formed adducts might be the complexes responsible for sensitization. However, true in vivo evidence is lacking, and further research to unravel the definite mechanism of sensitization is needed.
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Affiliation(s)
- Laura M Pot
- Department of Dermatology, University Medical Centre Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
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24
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Dearman RJ, Basketter DA, Kimber I. Inter-relationships between different classes of chemical allergens. J Appl Toxicol 2012; 33:558-65. [PMID: 22271251 DOI: 10.1002/jat.1758] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2011] [Revised: 09/15/2011] [Accepted: 09/15/2011] [Indexed: 11/06/2022]
Abstract
Although allergic sensitization of the respiratory tract induced by chemicals is not as common as skin sensitization, it is nevertheless an important occupational health issue. Respiratory allergy to chemicals, characterized typically by rhinitis and asthma, is associated with considerable morbidity and with related socioeconomic costs. Several experimental approaches have been proposed for the prospective identification of chemical respiratory allergens, but none of these has yet been validated formally. In the absence of a widely accepted method for respiratory allergen identification, it is appropriate and relevant to explore their relationship with skin-sensitizing chemicals. A series of chemicals known to cause immune-mediated respiratory allergy in humans has been examined. The majority of the respiratory allergens tested were found to elicit positive responses in one or more standard tests used for the identification of skin-sensitizing potential (guinea pig maximization test, the Buehler test and/or the local lymph node assay). We suggest that this observation might form the basis of a potentially useful paradigm for initial characterization of the respiratory-sensitizing potential of chemicals. Specifically, chemicals that fail to elicit positive responses in accepted skin-sensitization test methods might also be regarded as lacking the inherent potential to cause allergic sensitization of the respiratory tract.
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Affiliation(s)
- R J Dearman
- Faculty of Life Sciences, University of Manchester, Michael Smith Building, Oxford Road, Manchester, M13 9PT, UK.
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25
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White JML. Patch testing: what allergists should know. Clin Exp Allergy 2011; 42:180-5. [DOI: 10.1111/j.1365-2222.2011.03862.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Revised: 07/21/2011] [Accepted: 07/22/2011] [Indexed: 11/28/2022]
Affiliation(s)
- J. M. L. White
- St John's Institute of Dermatology; St Thomas’ Hospital; London; UK
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