A variant of the CXCL11 gene may influence susceptibility to contact allergy, particularly in polysensitized patients

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.

Contact allergy induced by bisphenol A diglycidyl ether leachables from aluminium tubes for pharmaceutical use

BACKGROUND

Aluminium tubes for pharmaceutical use are internally lacquered with epoxy resins (ER) based on bisphenol A diglycidyl ether (BADGE). Recently, it was shown that remnants of ER polymerization like BADGE are extractable from epoxy-based coatings of commercially available tubes and may leach into semi-solid drug preparations. We aimed to evaluate the safety of BADGE-contaminated macrogol ointments in individuals sensitized to ER based on BADGE by use tests.

METHODS

Repeated open application testing (ROAT) in 11 patients sensitized to ER based on BADGE with BADGE in macrogol ointments (3 mg/kg; 30 mg/kg, equivalent to BADGE concentration determined in macrogol ointment after storage in a commercially available tube; 300 mg/kg).

RESULTS

The 30 mg/kg BADGE ointment elicited reactions in three patients, and another three patients reacted to 300 mg/kg BADGE ointment. No reactions to the vehicle control and 3 mg/kg BADGE were observed.

CONCLUSIONS

Elevated BADGE concentrations in ER-coated aluminium tubes pose a risk of developing contact dermatitis to patients sensitized to ER based on BADGE. Quality standards are deemed necessary for the production of ER-coated aluminium tubes intended for pharmaceutical use and should consider the results of the present ROAT study.

[Rehabilitation for occupational dermatoses. Outpatient and inpatient measures]

In recent years, the number of reports of suspicions of occupational diseases, received by the public statutory employer's liability insurance bodies, has remained constant. The recognition of occupational diseases under number 5101 BKV, however, has decreased considerably. This is more than likely due to improved prevention management concepts by the public statutory employer's liability insurance bodies. Nevertheless there are still severe occupational skin diseases that are resistant to or relapse under therapy, thus threatening discontinuation of the occupation. For these cases, an interdisciplinary inpatient treatment as a tertiary individual prevention measure was introduced. This consists of a three-week inpatient period followed by a three-week outpatient sick leave for further stabilization of the skin condition. During the inpatient stay intensive dermatological diagnosis and treatment are accompanied by in-depth health education seminars and psychological interventions. The selection of individually suitable skin protection measures and their practical trial in a workplace simulation model with an ergotherapist are of particular importance. Evaluations of this program showed that two-thirds of the participants with the defined risk of having to give up their occupation were able to continue with their occupation on a long-term basis.

[Evaluation of the effectiveness of high voltage irradiation of malignant gynecologic tumors in a nude mouse model]

Not only the effect of cytostatic drugs and hormones, but also that of ionizing radiation can be tested after transplantation of human tumoral tissue into nu/nu mice with thymic aplasia. In this study, the effects of high voltage irradiations dosed up to 60 Gy (fractionation 2 X 5 Gy per week) to three carcinomas of the endometrium, three carcinomas of the cervix, three ovarian carcinomas, and one mammary metastasis of an immunoblastic sarcoma were observed during a period of 120 days. This irradiation plan could be performed without problems in eight cases, in two cases it had to be stopped after 50 Gy. Nine tumors decreased significantly in size, reaching sizes which were below those measured before irradiation. In six among the nine cases, the tumors grew again after different periods of observation. In case of rather long periods of observation, those points within the curves of development can be taken as efficacy indices which are representing the lowest or the initial values of tumor sizes. In another study, the effects of high voltage irradiation to tumors of the nude mouse are correlated to those found in the corresponding patients.