Oral Hyposensitization to Nickel Allergy: Preliminary Clinical Results

Rc, Panzani; Schiavino, Domenico; Nucera, Eleonora; Pellegrino, Stefano; Fais, G; Schinco, G; Patriarca, Giampiero

doi:10.1159/000236994

Cited by 35 publications

(22 citation statements)

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“…edema of the gluteal area and of the major flexures (baboon syndrome) (16)(17) and generalized urticaria (12,(18)(19)(20). Moreover, studies on the histological modifications of the gastrointestinal mucosa have shown a marked inflammatory infiltrate, mainly Iymphoplasmacellular, associated with duodenum villus deformation and deepening of the crypta, in some subjects with delayed allergy to nickel sulfate after oral challenge test (21) and after accidental ingestion of a nickel coin (22).…”

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confidence: 99%

A Clinical Trial of Oral Hyposensitization in Systemic Allergy to Nickel

Schiavino

Nucera

Alonzi

et al. 2006

Int J Immunopathol Pharmacol

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Nickel allergy is the most common contact allergy. Some nickel-sensitive patients present systemic (cutaneous and/or digestive) symptoms related to the ingestion of high nickel-content foods, which significantly improve after a specific low nickel-content diet. The etiopathogenetic role of nickel in the genesis of systemic disorders is, furthermore, demonstrated by the relapse of previous contact lesions, appearance of widespread eczema and generalized urticaria-like lesions after oral nickel challenge test. The aim of this study is to investigate the safety and efficacy of a specific oral hyposensitization to nickel in patients with both local contact disorders and systemic symptoms after the ingestion of nickelcontaining foods. Inclusion criteria for the recruitment of these patients were (other than a positive patch test) a benefit higher than 80% from a low nickel-content diet and a positive oral challenge with nickel. Based on the previous experiences, our group adopted a therapeutic protocol by using increasing oral doses of nickel sulfate associated to an elimination diet. Results have been excellent: this treatment has been effective in inducing clinical tolerance to nickel-containing foods, with a low incidence of side effects (gastric pyrosis, itching erythema).Nickel allergy is the most common contact allergy because nickel is present in various dailyuse accessories and utensils (coins, pots and pans, watches, earrings, etc.) and its widespread use favors sensitization (I). The prevalence of nickel allergy has shown a constant rise in industrialized countries, about 10-15% (with peaks up to 20%) in females, and 4-7% in males (2-4). Female predominance is probably due to a more frequent exposure to metal jewellery and to the higher incidence of allergic diseases in women.Nickel allergy is a delayed, cell-mediated hypersensitivity, presenting with local eczematous lesions after skin contact with nickel and it can be diagnosed by patch tests. Some reports in literature describe how the use of dental and orthopedic prostheses may provoke generalized eczema (5-6) and urticaria (7-8) in nickel-allergic patients.Nickel is an essential element in the diet: its daily intake is about 300 ug, and vegetables are the main source (9-11). Some cases have been described of nickel-sensitized patients with cutaneous systemic disorders correlated to the ingestion of high nickel-content foods: generalized eczema (12-13), recurrent vesicular hand eczema (pompholyx) (14-15), itching erythema with mild

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confidence: 99%

A Clinical Trial of Oral Hyposensitization in Systemic Allergy to Nickel

Schiavino

Nucera

Alonzi

et al. 2006

Int J Immunopathol Pharmacol

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“…At present, there is no immunotherapy available for treating type-IV hypersensitivity, however, the fact that people living in close proximity to nickel factories are less prone to develop nickel allergies than a comparable population living at further distances from the same factories, suggest that tolerance induction to nickel may be possible [6]. Likewise, a few immunotherapeutic clinical trials suggested a possible tolerating effect of oral administration of nickel salts [7,9,[15][16][17].…”

Section: Discussionmentioning

confidence: 99%

Nickel sensitisation in mice: A critical appraisal

Johansen¹,

Wäckerle-Men²,

Senti³

et al. 2010

Journal of Dermatological Science

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“…2). When symptoms, such as chronic urticaria or gastrointestinal disorders unrelated to enzymatic deficiencies or to small bowel bacterial overgrowth, do not seem to be related to a single food, the physician should consider a delayed-type allergy to nickel [9], chrome, cobalt or a latex-fruit syndrome [10]. In case of a positive patch test to nickel, chrome or cobalt, patients should avoid foods containing these metals (a positive response is usually seen at least after 4 weeks of the elimination diet).…”

Section: Diagnostic Testsmentioning

confidence: 99%

Food Allergy: From Diagnosis to Treatment

Scarpellini

Tack²

2012

Dig Dis

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Adverse food reactions, an adverse health effect arising from an immune or nonimmune response that occurs reproducibly on the exposure to a given food, can be divided into toxic and hypersensitivity reactions. When an immunologic mechanism has been shown, hypersensitivity food reactions should be referred to as food allergy that may be IgE- or non-IgE-mediated. Food allergy diagnosis is mainly guided by a correct and accurate history and physical examination, thus leading to prick test and elimination diets. The treatment gold standard is still represented by an elimination diet together with antihistamines and corticosteroid usage in order to reduce the gastrointestinal and potentially life-threatening systemic symptoms. Other treatments are currently under investigation with promising results.

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Oral Hyposensitization to Nickel Allergy: Preliminary Clinical Results

Cited by 35 publications

References 20 publications

A Clinical Trial of Oral Hyposensitization in Systemic Allergy to Nickel

A Clinical Trial of Oral Hyposensitization in Systemic Allergy to Nickel

Nickel sensitisation in mice: A critical appraisal

Food Allergy: From Diagnosis to Treatment

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