Baseline series fragrance markers fail to predict contact allergy

Mann, J.; McFadden, John; White, Jonathan M. L.; White, Ian R.; Banerjee, P.

doi:10.1111/cod.12171

Cited by 66 publications

(77 citation statements)

References 31 publications

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“…Screening for fragrance allergy currently takes the form of patch testing to two mixes of fragrance substances, fragrance mix (FM)I and FMII, a natural substance Myroxylon pereirae and the single synthetic fragrance chemical hydroxyisohexyl 3‐cyclohexene carboxaldehyde (HICC), which is also present in FMII. During 2011 and 2012, we compared the reactions of fragrance screen markers to that of the 26 individual fragrance chemicals that are included in European Union mandatory labelling . We found that reactions to the fragrance screening agents would only detect 57·6% of patients who had reacted to an individual fragrance chemical.…”

mentioning

confidence: 99%

Patch testing with the European baseline series fragrance markers: a 2016 update

Ung

White

et al. 2018

Br J Dermatol

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mentioning

confidence: 99%

Patch testing with the European baseline series fragrance markers: a 2016 update

Ung

White

et al. 2018

Br J Dermatol

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“…Here, 4 persons reacted to a 10% benzyl alcohol preparation (Mann et al 2014 Uter et al 2010). When benzyl alcohol was tested in the clinics of the IVDK in persons with suspected sensitization to preservatives, only a low percentage of reactions occurred, with 0.24% of 23 257 and 0.18% of 17 740 tested persons between 2005 and 2008, 2) The reaction index is defined as the quotient: (a -d -i) / (a + d + i); with: a = number of allergic reactions, d = number of questionable reactions, i = number of irritative reactions (Brasch and Henseler 1992).…”

Section: Allergenic Effectsmentioning

confidence: 99%

Benzyl alcohol [MAK Value Documentation, 2017]

Hartwig

Arand²

2018

The MAK‐Collection for Occupational Health and Safety

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The German Commission for the Investigation of Health Hazards of Chemical Compounds in the Work Area has re‐evaluated benzyl alcohol [ 100‐51‐6 ] to derive a maximum concentration at the workplace (MAK value), considering all toxicological endpoints. Available publications and study reports are described in detail. Benzyl alcohol is irritating to the eyes and the airways. In a 4‐week inhalation study in rats, microscopic lesions in the airways, especially in the lung, occurred at 1072 mg/m 3 . The NAEC is estimated to be 300 mg/m 3 , a concentration at which benzyl alcohol can occur as vapour, corresponding to 67 ml/m 3 . A MAK value of 5 ml/m 3 has been derived. As local effects are critical, benzyl alcohol is classified in Peak Limitation Category I with an excursion factor of 2. In developmental toxicity studies with benzyl alcohol in mice, foetotoxic effects occurred at 750 mg/kg body weight and day in the presence of marked maternal toxicity. The NOAEL was 550 mg/kg body weight and day; however, teratogenicity was not examined. Benzoic acid is the main metabolite of benzyl alcohol. Considering the developmental toxicity studies with sodium benzoate, the differences between the NOAEL for rats, mice, rabbits and hamsters scaled to an inhalation concentration at the workplace and the MAK value are considered so large that damage to the embryo or foetus is unlikely when the MAK value is observed. Therefore, benzyl alcohol is classified in Pregnancy Risk Group C. Benzyl alcohol is not regarded to be genotoxic or carcinogenic. Sensitization is not expected as benzyl alcohol was not a contact sensitizer in a local lymph node assay and there were no conclusive positive clinical findings of sensitizing effects on the skin. Skin contact is expected to contribute significantly to the systemic toxicity. Therefore, benzyl alcohol is designated with an “H”. Completed: October 08, 2015

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“…In 38.8% of cases that are positive for FM I, the test gives negative results if the individual ingredients are tested at the same concentration as in the mix . For this reason, the individual ingredients of FM II are routinely tested at double the concentration present in the mix , and a similar recommendation exists for FM I , to account for the mixture effect, when the individual ingredients are tested. These effects have also been subjected to clinical experimental investigations .…”

Section: Clinical Experiencementioning

confidence: 99%

Immunological, chemical and clinical aspects of exposure to mixtures of contact allergens

et al. 2017

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SummaryAllergic contact dermatitis is one of the most frequent forms of skin inflammation. Very often, we are exposed to mixtures of allergens with varying potencies, doses/areas, and exposure times. Therefore, improved knowledge about immune responses to combinations of contact allergens is highly relevant. In this article, we provide a general introduction to immune responses to contact allergens, and discuss the literature concerning immune responses to mixtures of allergens. According to the existing evidence, increased responses are induced following sensitization with combinations of allergens as compared with single allergens. The response to a mixture of allergens can be both additive and synergistic, depending on the dose and combination of allergens. Importantly, sensitization with combinations of either fragrance allergens or metal salts can result in increased challenge responses to specific allergens within the mixture. Taken together, the immune responses to mixtures of allergens are complex, and further studies are required to obtain the necessary knowledge to improve consumer safety.Key words: fragrances; hair dyes; metals; mixtures of allergens.Contact allergy is very frequent in the European population, as shown by Diepgen et al., who found that 27% were sensitised to common allergens (1). This may lead to allergic contact dermatitis if exposure exceeds the individual threshold of response.The allergic response is frequently directed towards nickel, cobalt, fragrances, hair dye chemicals, or preservatives. Many of these molecules are categorized as weak to moderate allergens -this term will be used throughout the article for (pre/pro)haptens (2). Surprisingly, even 'weak to moderate' allergens do induce allergic contact dermatitis in many people. This indicates that exposure parameters, such as dose and exposure frequency, are critical. Interestingly, consumers are rarely exposed to one isolated allergen, but are more often exposed to mixtures of allergens, for example in the form of metal alloys, cosmetics, and cleaning agents (3, 4). The impact of being exposed to a mixture of allergens instead of a single allergen has not been well studied. Studies from our group have suggested that exposure to mixtures of allergens has a great impact on the immune responses to single allergens within the mixture. In this review, we will discuss the current knowledge on how exposure to mixtures of contact allergens affects the immune system by (i) altering the chemical properties of single allergens in the mixtures, (ii) changing the inflammatory response, and (iii) affecting T cell activation, proliferation, and differentiation. Furthermore, we will discuss other factors, such as the presence of irritants, a disrupted skin barrier, local skin inflammation, and local skin memory, that could increase the response to allergens. Finally, we will discuss the clinical impact of

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Baseline series fragrance markers fail to predict contact allergy

Abstract: These findings confirm that the standard fragrance markers fail to identify patients with contact allergies to the 26 fragrances.

Cited by 66 publications

References 31 publications

Patch testing with the European baseline series fragrance markers: a 2016 update

Patch testing with the European baseline series fragrance markers: a 2016 update

Benzyl alcohol [MAK Value Documentation, 2017]

Immunological, chemical and clinical aspects of exposure to mixtures of contact allergens

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