The use of graded concentrations in studying skin sensitizers: experimental contact sensitization in man

Development of a hierarchical support vector regression-based in silico model for the prediction of the cysteine depletion in DPRA

Topical and transdermal treatments have been dramatically growing recently and it is crucial to consider skin sensitization during the drug discovery and development process for these administration routes. Various tests, including animal and non-animal approaches, have been devised to assess the potential for skin sensitization. Furthermore, numerous in silico models have been created, providing swift and cost-effective alternatives to traditional methods such as in vivo, in vitro, and in chemico methods for categorizing compounds. In this study, a quantitative structure-activity relationship (QSAR) model was developed using the innovative hierarchical support vector regression (HSVR) scheme. The aim was to quantitatively predict the potential for skin sensitization by analyzing the percent of cysteine depletion in Direct Peptide Reactivity Assay (DPRA). The results demonstrated accurate, consistent, and robust predictions in the training set, test set, and outlier set. Consequently, this model can be employed to estimate skin sensitization potential of novel or virtual compounds.

Quantitative Risk Assessment of Dermal Sensitization Potential Following Use of Shampoo Products Containing the Formaldehyde Releasing Preservative DMDM Hydantoin

Historically, formaldehyde was used as a preservative in personal care products to extend product shelf-life; however, given its skin sensitization potential it has been phased out of use and replaced with formaldehyde-releasing preservatives, such as Dimethyloldimethyl hydantoin (DMDMH). A relationship has been established between positive patch test results following exposure to DMDMH and previous sensitization to formaldehyde. Upon direct contact with the skin, formaldehyde can react with skin proteins and cause an acute inflammatory reaction, which may progress to skin sensitization following repeated exposure. This quantitative risk assessment (QRA) aimed to assess the risk of skin sensitization induction following use of shampoo products containing the maximum allowable concentrations of DMDMH in formulation (1% w/v), translating to a free formaldehyde concentration of 0.02%. To determine a margin of safety (MOS) for exposure to DMDMH from use of shampoo products, consumer exposure levels (CEL) were estimated based on typical use scenarios and then benchmarked against an acceptable exposure level (AEL). The AEL was derived using a weight of evidence approach where a range of no expected sensitization induction levels (NESILs) was utilized. The MOS values for a shampoo product containing 1% DMDMH (.02% formaldehyde) was above 1 for the typical use scenario indicating a low likelihood of skin sensitization induction among healthy individuals. Thus, it can be concluded that shampoo products containing DMDMH at or below current allowable concentrations are not expected to increase the risk of skin sensitization induction.

Skin Sensitization Testing: The Ascendancy of Non-Animal Methods

A century ago, toxicology was an empirical science identifying substance hazards in surrogate mammalian models. Over several decades, these models improved, evolved to reduce animal usage, and recently have begun the process of dispensing with animals entirely. However, despite good hazard identification, the translation of hazards into adequately assessed risks to human health often has presented challenges. Unfortunately, many skin sensitizers known to produce contact allergy in humans, despite being readily identified as such in the predictive assays, continue to cause this adverse health effect. Increasing the rigour of hazard identification is inappropriate. Regulatory action has only proven effective via complete bans of individual substances. Since the problem applies to a broad range of substances and industry categories, and since generic banning of skin sensitizers would be an economic catastrophe, the solution is surprisingly simple—they should be subject to rigorous safety assessment, with the risks thereby managed accordingly. The ascendancy of non-animal methods in skin sensitization is giving unparalleled opportunities in which toxicologists, risk assessors, and regulators can work in concert to achieve a better outcome for the protection of human health than has been delivered by the in vivo methods and associated regulations that they are replacing.

Allergens in Hand, Foot, and Hand-Foot Eczema: An Intercomparison by Patch Testing

Background:

Hand eczema (HE), foot eczema (FE), and hand–foot eczema (HFE) manifest on exposure to various agents in day-to-day life or in occupations or both.

Objectives:

The objectives of this study were to identify pattern of allergens causing HE, FE, and HFE and to identify multiple and concurrent contact allergies.

Materials and Methods:

A study was conducted from October 2013 to August 2015 which included 190 patients. Patch test was performed for 78.94% of patients (n = 150). The statistical tests used were descriptive, Cramer's V, and Chi-square tests.

Results:

The most commonly affected group was HFE (55.8%) followed by HE (22.1%) and FE (22.1%). Allergens showed positivity either singly 56.3% (n = 67) or in combination 43.69% (n = 52). Nickel (41.79%) was the most common allergen in all the three groups followed by potassium dichromate. Late reactions (after day 7) were observed in 17.64% of patients (n = 21). Nickel was observed in 42.85% (n = 9) and paraphenylenediamine was observed in 28.57% of patients (n = 6) with P values of <0.001 and 0.050, respectively. Multiple contact allergies were seen in 44% of patients (n = 52). Concurrent reactions (55.8% [n = 29]), polysensitization (34.6% [n = 18]), and mixed reactions (9.6% [n = 5]) (P value of <0.001) were observed.

Conclusion:

Significant multiple contact allergies including concurrent reactions with nickel sulfate, potassium dichromate, cobalt chloride, and polysensitization were observed. No significant differences in allergen pattern were observed in HE, FE, and HFE.

Recommendation:

Day 7 reading is recommended in HFE.

In silico Prediction of Skin Sensitization: Quo vadis?

Skin direct contact with chemical or physical substances is predisposed to allergic contact dermatitis (ACD), producing various allergic reactions, namely rash, blister, or itchy, in the contacted skin area. ACD can be triggered by various extremely complicated adverse outcome pathways (AOPs) remains to be causal for biosafety warrant. As such, commercial products such as ointments or cosmetics can fulfill the topically safe requirements in animal and non-animal models including allergy. Europe, nevertheless, has banned animal tests for the safety evaluations of cosmetic ingredients since 2013, followed by other countries. A variety of non-animal in vitro tests addressing different key events of the AOP, the direct peptide reactivity assay (DPRA), KeratinoSens™, LuSens and human cell line activation test h-CLAT and U-SENS™ have been developed and were adopted in OECD test guideline to identify the skin sensitizers. Other methods, such as the SENS-IS are not yet fully validated and regulatorily accepted. A broad spectrum of in silico models, alternatively, to predict skin sensitization have emerged based on various animal and non-animal data using assorted modeling schemes. In this article, we extensively summarize a number of skin sensitization predictive models that can be used in the biopharmaceutics and cosmeceuticals industries as well as their future perspectives, and the underlined challenges are also discussed.

Draize human repeat insult patch test (HRIPT): Seven decades of pitfalls and progress

Allergic contact dermatitis, a Type IV delayed hypersensitivity reaction, can result in dermatologic signs/symptoms for patients/workers. The likelihood of this phenomenon has been estimated/predicted for numerous chemicals/drugs by animal model and human patch testing protocols developed over the last century. Karl Landsteiner initiated testing with guinea pig studies; further studies based on his initial concept were in continual development. John Draize extended Landsteiner's guinea pig studies (which led to development of blood transfusions) to a human assay documenting irritant and allergic contact dermatitis potential - for drugs, chemicals, mixtures and products. We performed a literature search of major Draize derived protocols of the human repeat insult patch test (HRIPT). Our results reveal minor and major differences between protocols and lack of international standardization. Key clarification and principles post-Draize modified and improved usefulness of the HRIPT. Without a standard method of performing the HRIPT, it is problematic to generalize results of studies summarized here. Furthermore, we suggest a potential standardization procedure/protocol combining the work of the most satisfactory HRIPT methods. As the HRIPT constitutes a key parameter in current quantitative risk assessment for chemicals/drugs, such standardization should aid potential prediction of allergic contact dermatitis potential.

Fragrance Skin Sensitization Evaluation and Human Testing: 30-Year Experience

Background

The human repeated insult patch test (HRIPT) has a history of use in the fragrance industry as a component of safety evaluation, exclusively to confirm the absence of skin sensitization at a defined dose.

Objective

The aim of the study was to document the accumulated experience from more than 30 years of conducting HRIPTs.

Methods

A retrospective collation of HRIPT studies carried out to a consistent protocol was undertaken, with each study comprising a minimum of 100 volunteers.

Conclusions

The HRIPT outcomes from 154 studies on 134 substances using 16,512 volunteers were obtained. Most studies confirmed that at the selected induction/challenge dose, sensitization was not induced. In 0.12% of subjects (n = 20), there was induction of allergy. However, in the last 11 years, only 3 (0.03%) of 9854 subjects became sensitized, perhaps because of improved definition of a safe HRIPT dose from the local lymph node assay and other skin sensitization methodologies, as well as more rigorous application of the standard protocol after publication in 2008. This experience with HRIPTs demonstrates that de novo sensitization induction is rare and becoming rarer, but it plays an important role as an indicator that toxicological predictions from nonhuman test methods (in vivo and in vitro methods) can be imperfect.

The 21st Century movement within the area of skin sensitization assessment: From the animal context towards current human-relevant in vitro solutions

In a regulatory context, skin sensitization hazard and risk evaluations of manufactured products and their ingredients (e.g. cosmetics) are mandatory in several regions. Great efforts have been made within the field of 21st Century Toxicology to provide non-animal testing approaches to assess the skin allergy potential of materials (e.g. chemicals, mixtures, nanomaterials, particles). Mechanistic understanding of skin sensitization process through the adverse outcome pathway (AOP) has promoted the development of in vitro methods, demonstrating accuracies superior to the traditional animal testing. These in vitro testing approaches are based on one of the four AOP key events (KE) of skin sensitization: formation of immunogenic hapten-protein complexes (KE-1 or the molecular initiating event, MIE), inflammatory keratinocyte responses (KE-2), dendritic cell activation (KE-3), and T-lymphocyte activation and proliferation (KE-4). This update provides an overview of the historically used in vivo methods as well as the current in chemico and in cell methods with and without OECD guideline designations to analyze the progress towards human-relevant in vitro test methods for safety assessment of the skin allergenicity potential of materials. Here our focus is to review 96 in vitro testing approaches directed to the KEs of the skin sensitization AOP.

Percutaneous permeability of 1-phenoxy-2-propanol, a preservative in cosmetics

1-Phenoxy-2-propanol (PP) is used as a preservative in cosmetics. PP is currently permitted to be used to up to 1% in cosmetic formulations in Korea and Europe. For risk assessment, percutaneous absorption is a crucial factor, but dermal absorption of PP has not yet been reported. In this study, Franz diffusion method was used to determine the percutaneous penetration of PP using the dorsal skin of rats. Each formulation of shampoo or cream, 113.6 mg/cm², was applied to a donor compartment of Franz diffusion cell for 24 h. Receptor fluid was collected at 0, 1, 2, 4, 8, 12, and 24 h following dermal application. Remaining formulation was removed with a cotton swab after last sampling. Using tape stripping method, stratum corneum was removed. PP in epidermis and dermis was extracted in PBS for 24 h. The concentration of PP from the swab, stratum corneum, and epidermis and dermis samples was determined using high performance liquid chromatography. Total percutaneous absorption rates of PP for shampoo and cream were 50.0 ± 6.0% and 33.0 ± 3.2%, respectively. In vitro skin permeability was calculated as 1,377.2 ± 240.1 mg/cm² for shampoo and 1,038.0 ± 72.2 mg/cm² for cream for 24 h.

Toxicity and Metal Corrosion of Glutaraldehyde-Didecyldimethylammonium Bromide as a Disinfectant Agent

The wide use of disinfectants has prompted resistance from the microbiome which will in turn reduce the bactericidal effect of disinfectants. Hence, glutaraldehyde (GA) and didecyldimethylammonium bromide (DDAB) were used to develop a combination disinfectant with high stability and antimicrobial effects, which was named GA-DDAB combination disinfectant (GD). The bactericidal mechanism against Escherichia coli was studied in our earlier work. In this study, we focused on GD's bactericidal efficacy in both the laboratory and environment, the genetic toxicity to mouse lymphoma L5178Y TK^+/− cells, acute peroral toxicity in mice, and its metal corrosion properties with a view to providing theoretical support for developing a high-efficiency, low toxicity, and weakly corrosive disinfectant for general use.

Preliminary Data on the Safety of Phytoene- and Phytofluene-Rich Products for Human Use including Topical Application

The colorless carotenoids phytoene and phytofluene are comparatively understudied compounds found in common foods (e.g., tomatoes) and in human plasma, internal tissues, and skin. Being naturally present in common foods, their intake at dietary levels is not expected to present a safety concern. However, since the interest in these compounds in the context of many applications is expanding, it is important to conduct studies aimed at assessing their safety. We present here results of in vitro cytotoxicity and genotoxicity studies, revealing no significant cytotoxic or genotoxic potential and of short- and long-term human in vivo skin compatibility studies with phytoene- and phytofluene-rich tomato and Dunaliella salina alga extracts, showing a lack of irritancy or sensitization reactions. These results support the safe use of phytoene- and phytofluene-rich products in human topical applications.

Final Report on the Safety Assessment of Sodium p -Chloro- m -Cresol, p -Chloro- m -Cresol, Chlorothymol, Mixed Cresols, m -Cresol, o -Cresol, p -Cresol, Isopropyl Cresols, Thymol, o -Cymen-5-ol, and Carvacrol1

Sodium p -Chloro- m -Cresol, p -Chloro- m -Cresol (PCMC), Mixed Cresols, m -Cresol, o -Cresol, p -Cresol, Isopropyl Cresols, Thymol, Chlorothymol, o -Cymen-5-ol, and Carvacrol are substituted phenols used as cosmetic biocides/preservatives and/or fragrance ingredients. Only PCMC, Thymol, and o -Cymen-5-ol are reported to be in current use, with the highest concentration of use at 0.5% for o -Cymen-5-ol in perfumes. The use of PCMC in cosmetics is restricted in Europe and Japan. Cresols can be absorbed through skin, the respiratory tract, and the digestive tract; metabolized by the liver; and excreted by the kidney as glucuronide and sulfate metabolites. Several of these cresols increase the dermal penetration of other agents, including azidothymidine. In acute oral toxicity studies, LD50 values were in the 200 to 5000 mg/kg day-1 range across several species. In short-term studies in rats and mice, an o -Cresol, m -Cresol, p -Cresol or m -Cresol/ p -Cresol mixture at 30,000 ppm in the diet produced increases in liver and kidney weights, deficits in liver function, bone marrow hypocellularity, irritation to the gastrointestinal tract and nasal epithelia, and atrophy of female reproductive organs. The no observed effect levels (NOEL) of o -Cresol was 240 mg/kg in mink and 778 mg/kg in ferrets in short-term feeding studies, with no significant dose-related toxicity (excluding body weight parameters). In mice, 0.5% p -Cresol, but neither m -Cresol nor o -Cresol, caused loss of pigmentation. Short-term and subchronic oral toxicity tests performed with various cresols using mice, rats, hamsters, and rabbits resulted in no observed adverse effect levels (NOAELs) for mice of 625 ppm and rats of 50 mg/kg day -1, although the NOEL was 2000 ppm ina chronic study using rats. In rabbits, 160 mg/kg PCMC was found to produce irritation and erythema, but no systemic effects. Hamsters dosed with 1.5% p -Cresol in diet for 20 weeks had a greater incidence of mild and moderate forestomach hyperplasia as compared to the control. Acute inhalation toxicity studies using rats yielded LC50 values ranging from > 20 mg/m3 for o -Cresol to > 583 mg/m3 for PCMC. No deaths were recorded in mice given o -Cresol at 50 mg/m3. Cats exposed (short-term) to 9 to 50 mg/m3 of o -Cresol developed inflammation and irritation of the upper respiratory tract, pulmonary edema, and hemorrhage and perivascular sclerosis in the lungs. Rats exposed (subchronic) to o -Cresol at 9 mg/m3 had changes in leukocytes, spinal cord smears, nervous activity, liver function, blood effects, clinical signs, and neurological effects. In guinea pigs, exposure to 9 mg/m3 produced changes in hemoglobin concentrations and electrocardiograms (EKGs). Rats exposed (subchronic) to 0.05 mg/m3 Mixed Cresols by inhalation exhibited central nervous system (CNS) excitation, denaturation of lung protein, and decreased weight gain. All cresols appear to be ocular irritants. Numerous sensitization studies have been reported and most positive reactions were seen with higher concentrations of Cresol ingredients. Developmental toxicity is seen in studies of m -Cresol, o -Cresol, and p -Cresol, but only at maternally toxic levels. In a reproductive toxicity study of a mixture of m -Cresol and p -Cresol using mice under a continuous breeding protocol, 1.0% caused minimal adult reproductive and significant postnatal toxicity in the presence of systemic maternal toxicity. The o -Cresol NOAEL was 0.2% for both reproductive and general toxicity in both generations. Cresol ingredients were generally nongenotoxic in bacterial, fruit fly, and mammalian cell assays. Thymol did not induce primary lung tumors in mice. No skin tumors were found in mice exposed dermally to m -Cresol, o -Cresol, or p -Cresol for 12 weeks. In the tryphan blue exclusion assay, antitumor effects were observed for Thymol and Carvacrol. Clinical patch testing with 2% PCMC may produce irritant reactions, particularly in people with multiple patch test reactions, that are misinterpreted as allergic responses. o -Cresol, p -Cresol, Thymol, Carvacrol, and o -Cymen-5-ol caused no dermal irritation at or above use concentrations. In two predictive patch tests, PCMC did not produce a sensitization reaction. Overall, these ingredients are not significant sensitizing or photosensitizing agents. The Cosmetic Ingredient Review (CIR) Expert Panel noted some of these ingredients may increase the penetration of other cosmetic ingredients and advised cosmetic formulators to take this into consideration. The CIR Expert Panel concluded that the toxic effects of these ingredients are observed at doses higher than would be available from cosmetics. A concentration limitation of 0.5% was chosen to ensure the absence of a chemical leukoderma effect. For p -Cresol and Mixed Cresols (which contain p -Cresol), the Panel considered that the available data are insufficient to support the safety of these two ingredients in cosmetics. Studies that would demonstrate no chemical leukoderma at concentrations of use of p -Cresol and Mixed Cresols, or would demonstrate a dose response from which a safe concentration could be derived, are needed.

6 Final Report on the Safety Assessment of p-Phenylenediamine

p-Phenylenediamine is a cosmetic hair dye intermediate used in permanent hair coloring products at concentrations of up to 5 percent (diluted 1:1 with an oxidizing agent prior to application). The extensive animal toxicity test data on p-Phenylenediamine and permanent cosmetic hair dyes containing this compound show that the degree of toxicity varies with concentration, test system and animal species. Animal data support a conclusion that this compound is neither a teratogen nor a carcinogen. Epidemiological data also support that hair dyes containing this ingredient are not carcinogenic. p-Phenylenediamine is a sensitizer and some persons may be sensitized under intended conditions of use.

For those persons not sensitized, it is concluded that p-Phenylenediamine is safe as a hair dye ingredient at the current concentrations of use.

Final Report on the Safety Assessment of Sodium Cocoyl Isethionate

Sodium Cocoyl Isethionate is used as a surfactant-cleansing agent in cosmetic formulations. Sodium Cocoyl Isethionate is slightly to practically nontoxic, with an oral LD50 of ≥ 4.33 g/kg for rats. Dermal application of 1.0–36.0% w/w aqueous Sodium Cocoyl Isethionate to rats for 28 days did not produce any significant toxic effects.

The ocular irritation produced by Sodium Cocoyl Isethionate was concentration dependent, ranging from a mild reaction at a test concentration of 2.5% to a primary ocular irritant at test concentrations of 49%. Sodium Cocoyl Isethionate is neither a sensitizer nor phototoxic compound.

Sodium Cocoyl Isethionate was nonmutagenic in an in vitro chromosomal aberration assay and did not produce a positive response in an S. typhimurium reverse mutation assay.

Based on the concentration of test cited in this report, it is concluded that Sodium Cocoyl Isethionate is safe for use in cosmetic formulations at 50% in rinse-off products and at 17% in leave-on products.

6 Final Report on the Safety Assessment of Formaldehyde

The report selectively reviews the extensive literature available on the toxicity of Formaldehyde. It is concluded that Formaldehyde in cosmetic products is safe to the great majority of consumers. Because of the skin sensitivity of some individuals to this agent, the formulation and manufacture of a cosmetic product should be such as to ensure use at the minimal effective concentration of Formaldehyde, not to exceed 0.2% measured as free Formaldehyde. It cannot be concluded that Formaldehyde is safe in cosmetic products intended to be aerosolized.

Final Report on the Safety Assessment of Polyoxymethylene Urea

Polyoxymethylene Urea is a variable molecular weight polymer formed in stages from the condensation reaction of urea with formaldehyde. It is used in a wide range of cosmetic formulations as a bulking agent and to form the outer shell of microcapsules. Because of the nature of the polymerization process, residual formaldehyde is present at levels typically between 17 and 30 ppm. Polyoxymethylene Urea shows low toxicity. The oral LD50 in rats was 10 g/kg for the bulk material and 20 g/kg when the microcapsule form was used. Polyoxymethylene Urea was a mild skin irritant and caused mild, transient ocular irritation in rabbits. Ames tests were negative for mutagenesis. Clinical data showed no irritation or sensitization. On the basis of the data, it is concluded that Polyoxymethylene Urea is safe for use as a cosmetic ingredient. A previous determination, however, that the concentration of free formaldehyde in cosmetic formulations should not exceed 0.2% was considered appropriate for this ingredient as well. Likewise, the previous finding that the safety of formaldehyde was not ensured in cosmetic products intended to be aerosolized is extended to this ingredient.

Final Report on the Safety Assessment of Glutaral

The dialdehyde Glutaral (also commonly called glutaraldehyde) is used in a wide variety of cosmetics as a preservative. In vitro dermal penetration studies of Glutaral indicate low penetration through animal skin and even less through human skin. The oral LD50 of Glutaral for rats ranged from 66 mg/kg up to 733 mg/kg. A 28-day dermal toxicity study of Glutaral produced skin irritation and slight effects on weight and blood chemistry with concentrations as low as 50 mg/kg/day. Animal skin irritation was dose-dependant, with a no-effect concentration of 1%. Ocular exposure to Glutaral caused severe irritation in rabbits at concentrations 1%, with a no-effect level of 0.1%. Glutaral was not embryotoxic, fetotoxic, or teratogenic at concentrations that did not cause severe maternal toxicity. The no observable adverse effects level for reproduction toxicity was > 1,000 ppm. Bacterial mutagenesis tests produced mixed results, as would be expected for a preservative. In most mammalian system mutagenesis tests, Glutaral was not genotoxic. In a 2-year drinking water study in rats, there was an increase in large granular lymphocytic leukemia (LGLL), but only in females administered 50–1,000 ppm Glutaral. The response was not dose dependent. Clinical studies report some evidence of dermal irritation and sensitization, but no photosensitization. Occupational data and animal studies indicate that inhalation of Glutaral can cause respiratory irritation, in addition to skin effects. Evaluation of the increased incidence of LGLL in the 2-year drinking water study indicated that the incidence was within the historical control levels for this spontaneously occurring neoplasm. These data, however, were not considered sufficient to base a finding of safety of Glutaral in products intended for prolonged use. It was concluded that a 2-year dermal carcinogenicity study following National Toxicology Program (NTP) procedures was needed to complete the safety assessment of Glutaral for use in leave-on products. For rinse-off products, it was concluded that the ocular and dermal irritancy of Glutaral could be substantially avoided if the concentration did not exceed 0.5% and exposure was only brief and discontinuous. Because it can cause respiratory irritation, it was concluded that Glutaral should not be used in aerosolized cosmetic products.

Final Report on the Safety Assessment of Melamine/Formaldehyde Resin

Melamine/Formaldehyde Resin is intended for use as a film former in cosmetic formulations, but there are no current uses reported. Respiratory distress, bleeding in the lungs, significant weight loss, and macrophage influx into the alveoli were observed during inhalation studies in rats. A 2-year chronic feeding study in rats at concentrations ≥ 10% produced little toxicity. Similar results were found in dogs at concentrations of 2.5, 3, and 5%. Reproductive toxicity was evaluated in rats through two generations with no evidence of reproductive effects. Case reports in the clinical literature have reported sensitization to Melamine/Formaldehyde Resin, not all of which were attributed to the presence of formaldehyde. Available data on melamine were reviewed. No irritation or sensitization was produced by 1% (aqueous) melamine in guinea pigs. In an oral carcinogenesis assay in male rats, melamine caused transitional-cell carcinomas of the urinary bladder, but produced no tumors in female rats. Adverse effects of formaldehyde were summarized from an earlier review of that ingredient by the Cosmetic Ingredient Review. The adverse effects included respiratory damage, skin irritation and sensitization, and carcinogenesis. The available data were insufficient to support the safety of Melamine/Formaldehyde Resin. Additional data were considered necessary in order to evaluate the safety of this ingredient, including chemical and physical data (such as p H), amount of free formaldehyde as a function of p H, and the aqueous or alcohol vehicle used; impurities (or purity); physical form of the ingredient as it would be used; UV absorption data (if the ingredient absorbs in the UVB or UVA regions of the electromagnetic spectrum, photosensitization studies would be needed); 28-day dermal toxicity tests; and human irritation and sensitization. It cannot be concluded that this ingredient is safe for use in cosmetic products until the listed safety data have been obtained and evaluated.

Final Report on the Safety Assessment of p-Chloro-m-Cresol

p-Chloro-m-Cresol is a substituted phenol that functions as a cosmetic biocide preservative in skin care and suntan cosmetic formulations. While p-Chloro-m-Cresol is approved for preservative use by the European Union at concentrations of up to 0.2%, it can be used at other concentrations when not intended as a preservative, and it is prohibited from use in products intended to contact mucous membranes. p-Chloro-m-Cresol is approved for use as an indirect food additive in the United States. Acute, short-term, and subchronic tests in animals indicate no dose-related toxicity other than reduced body weight gain. A chronic feeding study in rats identified kidney damage in high-dose males and an increase in pituitary adenomas in mid- and high-dose females. No evidence of mutagenicity was seen in Ames tests, but there was an increase in SOS-DNA repair synthesis in Escherichia coli. A solution of p-Chloro-m-Cresol at concentrations as low as 0.05% produced ocular irritation in rabbits. Some evidence of dermal irritation and sensitization was found in animal studies. In clinical studies, 2%o p-Chloro-m-Cresol seems to be a skin irritant. Predictive patch tests using 5% p-Chloro-m-Cresol as the challenge were negative, but provocative patch tests yielded positive responses in a few individuals. Other data pertinent to the safety assessment of thisingredient are not available, including the concentration of use in cosmetics, UV absorption data (photosensitization data also are needed if theingredient absorbs in the UVA or UVB region), dermal developmental toxicity data and a mutagenicity study using a mammalian system (a 2-year dermal carcinogenicity study is also needed if the mutagenesis study is positive). Based on the presently available data, the safety of thisingredient in cosmetic formulations cannot be supported.

Characterization of allergic response induced by repeated dermal exposure of IL-4/Luc/CNS-1 transgenic mice to low dose formaldehyde

Although formaldehyde (FA) is known to be a major allergen responsible for allergic contact dermatitis, there are conflicting reports regarding correlation between FA exposure and interleukin (IL-4) expression. To investigate whether allergic responses including IL-4 expression were induced by repeated dermal exposure to low dose FA, alterations in the luciferase signal and allergic phenotypes were measured in IL-4/Luc/CNS-1 transgenic (Tg) mice containing luciferase cDNA under control of the IL-4 promoter after exposure to 4% FA for 2 weeks. High levels of luciferase were detected in the abdominal region of the whole body and submandibular lymph node (SLN) of FA treated mice. Additionally, the ear thickness and IgE concentration were significantly upregulated in the FA treated group when compared with the acetone olive oil (AOO) treated group. FA treated mice showed enhanced auricular lymph node (ALN) weight, epidermis and dermis thickness, and infiltration of inflammatory cells. Furthermore, the expression of IL-6 among T helper 2 cytokines was higher in the FA treated group than the AOO treated group, while vascular endothelial growth factor (VEGF) levels remained constant. Overall, the results presented herein provide additional evidence that various allergic responses may be successfully induced in IL-4/Luc/CNS-1 Tg mice after exposure to low dose FA for 2 weeks. The luciferase signal under the IL-4 promoter may reflect general indicators of the allergic response induced by exposure to low dose FA.

Confirmation of in vitro and clinical safety assessment of behentrimonium chloride-containing leave-on body lotions using post-marketing adverse event data

Behentrimonium chloride (BTC) is a straight-chain alkyltrimonium chloride compound commonly used as an antistatic, hair conditioning, emulsifier, or preservative agent in personal care products. Although the European Union recently restricted the use of alkyltrimonium chlorides and bromides as preservatives to ≤0.1%, these compounds have been safely used for many years at ≤5% in hundreds of cosmetic products for other uses than as a preservative. In vitro, clinical, and controlled consumer usage tests in barrier-impaired individuals were conducted to determine if whole body, leave-on skin care products containing 1-5% BTC cause dermal irritation or any other skin reaction with use. BTC-containing formulations were predicted to be non-irritants by the EpiDerm® skin irritation test and the bovine corneal opacity and permeability (BCOP)/chorioallantoic membrane vascular assay (CAMVA) ocular irritation test battery. No evidence of allergic contact dermatitis or cumulative dermal irritation was noted under the exaggerated conditions of human occlusive patch tests. No clinically assessed or self-reported adverse reactions were noted in adults or children with atopic, eczematous, and/or xerotic skin during two-week and four-week monitored home usage studies. These results were confirmed by post-marketing data for five body lotions, which showed only 0.69 undesirable effects (mostly skin irritation) reported per million shipped consumer units during 2006-2011; a value consistent with a non-irritating body lotion. No serious undesirable effects were reported during in-market use of the products. Therefore, if formulated in appropriate conditions at 1-5%, BTC will not cause dermal irritation or delayed contact sensitization when used in a whole-body, leave-on product.

Penetration and haptenation of p-phenylenediamine

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.

Elicitation of the immune response to p-phenylenediamine in allergic patients: the role of dose and exposure time

BACKGROUND

Usage of hair dye products containing p-phenylenediamine (PPD) is a concern for PPD-allergic individuals.

OBJECTIVES

The present study investigates the role of dose and exposure time on elicitation of allergic contact dermatitis under conditions of permanent hair dyeing.

METHODS

Elicitation responses after application of a typical hair dye product containing 2% PPD for 30 min followed by rinsing were analysed in 38 PPD-allergic individuals with a documented history of hair dye-related allergy. Skin binding experiments in vitro were performed to distinguish the dose available for elicitation from the dose applied.

RESULTS

A positive reaction was elicited in 20 of 20 patients with grades ++ to +++ and 12 of 18 with grade + according to the classification of the International Contact Dermatitis Research Group. Under conditions of diagnostic patch testing (48 h exposure), the dose available for elicitation is more than 10-fold higher compared with the dose available for hair dyeing (30-min exposure, rinsing of product).

CONCLUSIONS

This investigation demonstrates that under simulated hair dye use conditions the actual exposure to PPD is more than an order of magnitude lower than under diagnostic patch testing, although sufficient to elicit a clearly noticeable reaction in 84% of PPD patch test-positive individuals.

Consumer exposure to biocides--identification of relevant sources and evaluation of possible health effects

BACKGROUND

Products containing biocides are used for a variety of purposes in the home environment. To assess potential health risks, data on products containing biocides were gathered by means of a market survey, exposures were estimated using a worst case scenario approach (screening), the hazard of the active components were evaluated, and a preliminary risk assessment was conducted.

METHODS

Information on biocide-containing products was collected by on-site research, by an internet inquiry as well as research into databases and lists of active substances. Twenty active substances were selected for detailed investigation. The products containing these substances were subsequently classified by range of application; typical concentrations were derived. Potential exposures were then estimated using a worst case scenario approach according to the European Commission's Technical Guidance Document on Risk Assessment. Relevant combinations of scenarios and active substances were identified. The toxicological data for these substances were compiled in substance dossiers. For estimating risks, the margins of exposure (MOEs) were determined.

RESULTS

Numerous consumer products were found to contain biocides. However, it appeared that only a limited number of biocidal active substances or groups of biocidal active substances were being used. The lowest MOEs for dermal exposure or exposure by inhalation were obtained for the following scenarios and biocides: indoor pest control using sprays, stickers or evaporators (chlorpyrifos, dichlorvos) and spraying of disinfectants as well as cleaning of surfaces with concentrates (hydrogen peroxide, formaldehyde, glutardialdehyde). The risk from aggregate exposure to individual biocides via different exposure scenarios was higher than the highest single exposure on average by a factor of three. From the 20 biocides assessed 10 had skin-sensitizing properties. The biocides isothiazolinone (mixture of 5-chloro-2-methyl-2H-isothiazolin-3-one and 2-methyl-2H-isothiazolin-3-one, CMI/MI), glutardialdehyde, formaldehyde and chloroacetamide may be present in household products in concentrations which have induced sensitization in experimental studies.

CONCLUSIONS

Exposure to biocides from household products may contribute to induction of sensitization in the population. The use of biocides in consumer products should be carefully evaluated. Detailed risk assessments will become available within the framework of the EU Biocides Directive.

[Recent development in animal testing to predict the skin and respiratory sensitizing potential of chemicals]

The identification of chemicals with skin and/or respiratory sensitizing potential is important for the prevention of allergic diseases in both living and work environments. Although a number of animal models for respiratory allergic diseases have been reported, none of these models meets the goals of broad assessments of chemical sensitizing potential. We are attempting to develop a test for predicting the respiratory sensitization of chemicals. In the evaluation of skin sensitization of chemicals, the mostly used predictive tests are the guinea pig maximization test, Buehler test, and mouse local lymph node assay (LLNA). However, only LLNA has been validated formally and independently. Recent studies have revealed that EC3 estimated by LLNA correlates well with human skin sensitizing potency and the threshold for the induction of skin sensitization in the human repeat patch test. Thus, LLNA can predict the potency of skin sensitizing potential of a chemical and its risk in humans.

The human repeated insult patch test in the 21st century: a commentary

The human repeated insult patch test (HRIPT) is over half a century old, but is still used in several countries as a confirmatory test in the safety evaluation of skin sensitizers. This is despite the criticism it receives from an ethical perspective and regarding the scientific validity of such testing. In this commentary, the HRIPT is reviewed, with emphasis on ethical aspects and where the test can, and cannot, contribute in a scientifically meaningful manner to safety evaluation. It is concluded that where there is a specific rationale for testing, for example, to substantiate a no-effect level for a sensitizing chemical or to ensure that matrix effects are not making an unexpected contribution to sensitizing potency, then rigorous independent review may confirm that an HRIPT is ethical and scientifically justifiable. The possibility that sensitization may be induced in volunteers dictates that HRIPTs should be conducted rarely and in cases where the benefits overwhelmingly outweigh the risk. However, for the very large majority of HRIPTs conducted concerning the risk of skin sensitization, there is neither scientific justification nor any other merit.

Dose-Response Relationships and Threshold Levels in Skin and Respiratory Allergy

A literature study was performed to evaluate dose-response relationships and no-effect levels for sensitization and elicitation in skin- and respiratory allergy. With respect to the skin, dose-response relationships and no-effect levels were found for both intradermal and topical induction, as well as for intradermal and topical elicitation of allergenic responses in epidemiological, clinical, and animal studies. Skin damage or irritation may result in a significant reduction of the no-effect level for a specific compound. With respect to the respiratory tract, dose-response relationships and no-effect levels for induction were found in several human as well as animal studies. Although dose-response relationships for elicitation were found in some epidemiological studies, concentration-response relationships were present only in a limited number of animal studies. Reported results suggest that especially relatively high peak concentrations can induce sensitization, and that prevention of such concentrations will prevent workers from developing respiratory allergy. Moreover, induction of skin sensitization may result in subsequent heightened respiratory responsiveness following inhalation exposure. The threshold concentration for the elicitation of allergic airway reactions in sensitized subjects is generally lower than the threshold to induce sensitization. Therefore, it is important to consider the low threshold levels for elicitation for recommendation of health-based occupational exposure limits, and to avoid high peak concentrations. Notwithstanding the observation of dose-response relationships and no-effect levels, due to a number of uncertainties, no definite conclusions can be drawn about absolute threshold values for allergens with respect to sensitization of and elicitation reactions in the skin and respiratory tract. Most predictive tests are generally meant to detect the potential of a chemical to induce skin and/or respiratory allergy at relatively high doses. Consequently, these tests do not provide information of dose-response relationships at lower doses such as found in, for example, occupational situations. In addition, the observed dose-response relationships and threshold values have been obtained by a wide variety of test methods using different techniques, such as intradermal exposure versus topical or inhalation exposure at the workplace, or using different endpoints, which all appear important for the outcome of the test. Therefore, especially with regard to respiratory allergy, standardized and validated dose-response test methods are urgently required in order to be able to recommend safe exposure levels for allergens at the workplace.

Skin sensitization to p-phenylenediamine: the diverging roles of oxidation and N-acetylation for dendritic cell activation and the immune response

Skin is a target of allergic reactions to aromatic amine hair dye precursors, such as p-phenylenediamine (PPD). As conversion of PPD on or in the skin is expected to be required for the induction of allergic contact dermatitis, we analyzed the role of oxidation and N-acetylation as major transformation steps. PPD and its oxidative and N-acetylated derivatives were tested for their sensitizing potential in vitro using a dendritic cell (DC) activation assay and in vivo using the local lymph node assay (LLNA). PPD did not induce relevant DC activation but induced a positive LLNA response. In contrast, DC activation was obtained when PPD was chemically pre-oxidized or after air oxygen exposure. Under both conditions, the potent sensitizing PPD oxidation product Bandrowski's base was identified along with other di- and trimeric species, indicating that PPD oxidation products provide an effective immune stimulation (danger signal). In contrast mono- and diacetylated PPD did not induce DC activation or a positive LLNA response. We conclude that dermal N-acetylation of PPD competes with the formation of oxidized PPD whereas skin exposure conditions allowing auto-oxidation, as in the LLNA, provide an effective danger signal necessary to induce skin sensitization to PPD.