Inflamed skin predisposes to sensitization to less potent allergens

Kohli, Nita; Nedorost, Susan T.

doi:10.1016/j.jaad.2016.03.010

Cited by 56 publications

(38 citation statements)

References 17 publications

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“…It has been proposed that patients with severe AD are less susceptible to sensitisation to potent allergens, as there is a threshold beyond which exposure through chronically defective skin barrier leads to tolerance. 2,37,38 Additionally, because AD is considered to be immunologically driven by a Th2 response, it may be anticipated that affected individuals are less susceptible to develop contact allergy, which is primarily Th1-driven. [10][11][12] Sensitisation to contact allergens via the Th2 rather than the Th1 route has been suggested in individuals with AD, 10 and this could explain differences in sensitisation.…”

Section: Discussionmentioning

confidence: 99%

Allergic contact dermatitis in atopic individuals: Results of a 30‐year retrospective study

et al. 2019

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Background: The association between atopic dermatitis (AD) and contact allergy, remains unclear, with studies to date showing conflicting results.Objectives: To investigate the prevalence of contact allergy in AD individuals compared to those without AD.Methods: Results of 46 250 patients patch tested in a single centre over a span of 30 years were reviewed, comparing those with AD with those without AD. Collected data were analysed with corrections for multiple confounding variables, including date of patch testing to account for changes in allergens tested over the period.Results: Nine allergens showed a statistically significant difference between the two groups. Contact allergy to nickel, cobalt and primin was less likely to arise in those with AD, whilst substances found in topical dermatological products were more likely to be associated with AD.Conclusions: This is the largest single centre study of contact sensitization in atopy reported to date. The previously reported association between contact allergy to sesquiterpene lactone and AD is reinforced. The decreased incidence of metal allergy suggests distinct immunological effector mechanisms in sensitization to these allergens. In keeping with previous publications, exposure to topical treatments for AD can result in sensitisation and contact allergy and clinicians should consider patch testing in AD individuals who report worsening of their skin despite continued treatment with topical medicaments.

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Section: Discussionmentioning

confidence: 99%

Allergic contact dermatitis in atopic individuals: Results of a 30‐year retrospective study

et al. 2019

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“…The discrepancies in the various experimental, clinical and epidemiological studies have recently been discussed and argued that multiple allergen and host factors may affect the association between AD and contact sensitization including Th‐2 cytokine milieu in AD which might lower the risk of contact sensitization, difference in exposure pattern to allergens between AD patients and healthy individuals and a higher prevalence of false‐positive patch test reactions in AD, particularly in the case of metal allergens . Interestingly, Kohli and Nedorost found that AD predisposes to sensitization only to less potent allergens arguing that potent sensitizers are often strong irritants that damage the skin barrier and trigger innate immune response needed for the induction of allergic response. Consistently, Koppes et al reported that a strong contact allergen methyl⁄chloromethylisothiazolinone known for its corrosive and irritant properties causes remarkable alterations of the corneocyte surface topography and reduction in NMF, similarly to SLS.…”

Section: Impaired Skin Barrier As a Risk Factor For Contact Dermatitismentioning

confidence: 99%

The role of skin barrier in occupational contact dermatitis

Jakaša

Thyssen

Kežić

2018

Experimental Dermatology

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Skin diseases represent one of the most common work-related diseases and may have a detrimental effect on social, personal and occupational aspects of life. Contact dermatitis (CD), which comprises predominately irritant contact dermatitis (ICD) and allergic contact dermatitis (ACD), accounts for vast majority of occupational skin diseases, especially in occupations associated with frequent skin contact with irritants and contact allergens. Although ICD and ACD have similar clinical manifestation, their pathophysiology and the role of the skin barrier are different. In ICD, perturbation of the skin barrier is the primary event which sets into motion diverse metabolic processes and triggers activation of innate immunity without the involvement of adaptive immune system. In ACD, a type IV hypersensitivity reaction induced by contact allergens, the skin barrier impairment may evoke innate signalling pathways during the sensitization phase required for the activation of T-cell adaptive response. Thus, skin barrier impairment may increase the risk of ICD or ACD not only because of enhanced permeability and ingress of irritants and allergens but also by the generation of innate immune signal needed for the induction of allergic response. Hence, an efficient way to prevent CD is to avoid skin barrier damage in the workplace. This review focuses on the skin barrier, how it is affected by skin irritants and how its impairment contributes to the development of ICD and ACD.

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“…[23][24][25] Based on human and animal studies, it is also well-known that an impaired skin barrier facilitates penetration of substances, and that skin sensitization is enhanced by exposure of inflamed skin (eg, dermatitis) and occluded skin (eg, by diapers and gloves). 26,27 The higher occurrence of having a parent born outside Sweden, Norway, Denmark, or Finland among participants without the assessed FLG mutations in our study may be explained by the fact that other types of FLG mutations are prevalent outside Europe, while our study assessed the mutations most common here. 28 Association between FLG mutation and nickel allergy among adults in the general population has been studied with conflicting results; two studies based on selected participants (an enriched sample with atopic diseases in Germany, and a small subsample of non-pierced individuals in Denmark, respectively) indicated an association.…”

Section: Discussionmentioning

confidence: 73%

Filaggrin gene mutations in relation to contact allergy and hand eczema in adolescence

et al. 2019

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Background: Filaggrin is an important protein for structure and function of the skin barrier. Filaggrin gene (FLG) mutations are known to result in dry skin, impaired skin barrier, and increased risk for atopic dermatitis. However, it is not clear whether these mutations are associated with contact allergy or hand eczema in adolescence.Objectives: The purpose of this study was to investigate whether FLG mutations are associated with contact allergy, self-reported hand eczema, or dry skin in adolescence.Methods: We used data from the 16-year follow-up in the BAMSE cohort, information obtained from a Web-based questionnaire including questions on hand eczema and dry skin, from FLG mutation analysis (R501X, R2447X, 2282del4), and patch testing (n = 1822).Results: Logistic regression analyses showed no statistically significant associations between FLG mutations and contact allergy (any contact allergy, nickel allergy, or fragrance allergy) according to patch test, or self-reported hand eczema at 16 years, or hand eczema ever. However, FLG mutations were associated with self-reported dry skin at 16 years.Conclusions: FLG mutations are associated with self-reported dry skin at 16 years.However, in this study no consistent associations were found between FLG mutations and contact allergy or hand eczema at 16.

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Inflamed skin predisposes to sensitization to less potent allergens

Cited by 56 publications

References 17 publications

Allergic contact dermatitis in atopic individuals: Results of a 30‐year retrospective study

Allergic contact dermatitis in atopic individuals: Results of a 30‐year retrospective study

The role of skin barrier in occupational contact dermatitis

Filaggrin gene mutations in relation to contact allergy and hand eczema in adolescence

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