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Biomedical subjects

Magnus Bruze

Publications and source records attributed to Magnus Bruze.

52 records · Page 3Linked to original sources

Deodorants: an experimental provocation study with cinnamic aldehyde.

BACKGROUND: Axillary dermatitis is common and overrepresented in individuals with contact allergy to fragrances. Many individuals suspect their deodorants to be the incriminating products. OBJECTIVE: Our aim was to investigate the significance of cinnamic aldehyde in deodorants for the development of axillary dermatitis when used by individuals with and without contact allergy to cinnamic aldehyde. METHODS: Patch tests with deodorants and ethanol solutions with cinnamic aldehyde, and repeated open application tests with roll-on deodorants without and with cinnamic aldehyde at different concentrations, were performed in 37 patients with dermatitis, 20 without and 17 with contact allergy to cinnamic aldehyde. RESULTS: A repeated open application test with positive findings was noted only in patients hypersensitive to cinnamic aldehyde (P <.001) and only in the axilla to which the deodorants containing cinnamic aldehyde had been applied (P <.001). CONCLUSION: Deodorants containing cinnamic aldehyde in the concentration range 0.01% to 0.32%, used twice daily on healthy skin, can elicit axillary dermatitis within a few weeks.

Acrolein↗

Chloroatranol, an extremely potent allergen hidden in perfumes: a dose-response elicitation study.

Oak moss absolute is a long-known, popular natural extract widely used in perfumes. It is reported as the cause of allergic reactions in a significant number of those with perfume allergy. Oak moss absolute has been the target of recent research to identify its allergenic components. Recently, chloroatranol, a hitherto unknown fragrance allergen, was identified in oak moss absolute. The objective was to assess the clinical importance of chloroatranol as a fragrance allergen by characterizing its elicitation profile. 13 patients previously showing a positive patch test to oak moss absolute and chloroatranol were included, together with a control group of 10 patients without sensitization to either of the 2 materials. A serial dilution patch test was performed on the upper back with concentrations ranging from 200 to 0.0063 p.p.m. of chloroatranol in ethanol. Simultaneously, the participant performed an open test simulating the use of perfumes on the volar aspect of the forearms in a randomized and double-blinded design. A solution with 5 p.p.m. chloroatranol was used for 14 days, and, in case of no reaction, the applications were continued for another 14 days with a solution containing 25 p.p.m. All test subjects (13/13) developed an allergic reaction at the site of application of the solution containing chloroatranol. Among them, 12/13 (92%) gave a positive reaction to the 5 p.p.m. solution and 1 to 25 p.p.m. None of the controls reacted (P < 0.001). The use test was terminated at median day 4. The dose eliciting a reaction in 50% of the test subjects at patch testing was 0.2 p.p.m. In conclusion, the hidden exposure to a potent allergen widely used in perfumes has caused a highly sensitized cohort of individuals. Judged from the elicitation profile, chloroatranol is the most potent allergen present in consumer products today.

Adult↗

Late patch-test reactions to budesonide need not be a sign of sensitization induced by the test procedure.

Patch-test sensitization may be suspected when a flare-up is seen at a test site at least 10 days after the test application. We describe two patients allergic to budesonide who were only diagnosed at patch-test readings on day 10 and day 13, respectively. The patients were patch-tested to a standard series including two corticosteroid mixes and their three constituents in petrolatum, namely, budesonide, tixocortol pivalate, and hydrocortisone-17-butyrate, at differing concentrations. In both patients, positive reactions to the mixes were seen on day 6 or day 7, but positive reactions to the budesonide preparations at 0.1% and 0.002% were not seen on the first or second ordinary reading day, day 3 or 4, and day 6 or 7, but no positive reactions to both budesonide preparations were seen on day 10 and on day 13, respectively. Not all late patch-test reactions represent patch-test sensitization, at least not to budesonide.

Adult↗

Rheumatoid arthritis, gold therapy, contact allergy and blood cytokines.

OBJECTIVE: To study the clinical and biochemical effects of a low starting dose for gold therapy in rheumatoid arthritis patients with a contact allergy to gold. METHODS: Serum cytokines were assayed before and 24 h after the first injection of gold sodium thiomalate (GSTM). RESULTS: Contact allergy to gold was found in 4 of 19 patients. Compared to gold-negative patients (starting dose: 10 mg GSTM), there was a larger increase in serum TNFalpha (p < 0.05), sTNF-R1 (NS), and IL-1 ra (p < 0.05) in gold-allergic patients. CONCLUSIONS: Cytokines are released in blood by GSTM in RA patients with gold allergy. To minimize the risk of acute adverse reactions the starting dose of GSTM should be lowered to 5 mg. Alternatively, patients should be patch-tested before gold therapy; in test-positive cases, 5 mg is recommended as the first dose.

Adult↗

Sensitizing capacity of some trimers in p-tert-butylphenol-formaldehyde resin.

Contact allergy to p-tert-butylphenol formaldehyde resin (PTBP-F-R) is not rare. This resin consists of a large number of substances, most of which are still unknown. For diagnostic and preventive reasons the chemical identity of the sensitizers should be known, as well as their sensitizing capacities, cross-reaction patterns and presence in the environment. The aims of this study were to investigate the sensitizing capacities and potential cross-reacting patterns for 4-tert-butyl- 2,6-bis-(5-tert-butyl-2-hydroxy-3-hydroxymethyl-benzyloxymethyl)-phenol (XIII), 4-tert-butyl-2- (5 - tert - butyl - 2 - hydroxy-benzyloxymethyl) - 6 - (5 - tert - butyl - 2 - hydroxy - 3 - hydroxymethyl-benzyloxy methyl)-phenol (XIVa) and 7,15,23-tri-tert-butyl-25,26,27-trihydroxy-2,3,10,11,18,19-hexahomo-3,11,19-trioxacalix(3)arene (XVIII) by the guinea pig maximization test. 4-tert-Butyl-2,6-bis-hydroxymethyl-phenol, 4-tert-butylbenzene-1,2-diol, 4-tert-butyl-2-hydroxymethyl-phenol, 4-tert-butyl-phenol, 4-tert-butyl-2-(5-tert-butyl-2-hydroxy-3-hydroxymethyl-benzyloxymethyl)-6-hydroxymethyl-phenol, 4-tert-butyl-2-[5-tert-butyl-3-(5-tert-butyl-2-hydroxy-3-hydroxymethyl-benzyloxymethyl) - 2 -hydroxy-benzyloxymethyl] - 6 - (5 - tert-butyl- 2 -hydroxy- 3 -hydroxymethyl-benzyloxymethyl)- phenol and were used as potential cross-reacting substances. In this study it is strongly indicated that the linear trimer XIII has a sensitizing capacity in the guinea pig which was significant when compared to the controls (p = 0.024). No cross-reactions were detected in animals induced with the linear trimer XIII. The linear trimer XIVa and the cyclic trimer XVIII failed to induce sensitization.

Allergens↗

Contact allergy to the monomers in p-tert-butylphenol-formaldehyde resin.

In many adhesive formulations p-tert-butylphenol-formaldehyde resin (PTBP-F-R) is used as a binder. Contact allergy to this resin is not rare. In patients hypersensitive to PTBP-F-R, and butylphenol derivatives therein, it is for diagnostic and preventive reasons necessary to know the nature of the primary sensitizing substances, as well as the cross-reaction patterns for these. The aim of this study was to investigate contact allergy to monomers in PTBP-F-R and potential cross-reacting substances. 12 patients hypersensitive to PTBP-F-R were patch tested with 2 monomers, the raw materials formaldehyde and p-tert-butylphenol, and 3 closely related substances. High pressure liquid chromatography (HPLC) was used to investigate the purity of the test substances. It was shown that the monomers 2-methylol p-tert-butylphenol and 2,6-dimethylol p-tert-butylphenol could elicit allergic reactions in humans hypersensitive to PTBP-F-R. No simultaneous reactions or cross-reactions were shown to formaldehyde, p-tert-butylphenol, p-tert-butylcatechol, 2(3)-tert-butyl-4-hydroxyanisole (BHA) or 3,5-di-tert-butyl-4-hydroxytoluene (BHT). It was also shown that low amounts of contaminants in the test substances, if not taken into account, could influence the conclusions drawn from the test results obtained.

Allergens↗

Contact allergy to the Asteraceae plant Ambrosia artemisiifolia L (ragweed) in sesquiterpene lactone-sensitive patients in southern Sweden.

Ambrosia artemisiifolia L. a classical cause of ragweed dermatitis in North America, is also found in Europe. 17 patients with contact allergy to sesquiterpene lactone (SL) mix were recalled for patch testing with extracts of North American and Swedish ragweed, the latter harvested in summer and autumn. 8/17 patients were test-positive to the American extract, 14/17 to the Swedish summer extract and 15/17 to the autumn extract. All patients except 1 were found to have a chronic hand eczema of the pompholyx type. 5/16 hand eczema patients had a flare-up of their pompholyx at patch testing. We concluded that patients with SL mix allergy are allergic to American as well as to Swedish ragweed. Pompholyx seems to be a frequent clinical picture in patients with SL mix allergy.

Adult↗

Contact allergy to o-cresol--a sensitizer in phenol-formaldehyde resin.

BACKGROUND: In patients hypersensitive to phenol formaldehyde resin (PFR) it is, for therapeutic and preventive reasons, important to know the identity of the primary sensitizing substances, their sensitizing capacity, as well as their cross-reaction patterns. When elucidating the issue of cross reactivity in patients with contact allergy to simple methylol phenols (MP), o-cresol was shown to be a contact sensitizer. Besides cross reactivity, contamination of one or more MP(s) in o-cresol as well as o-cresol being a sensitizer of its own in PFR were possible explanations of the simultaneous positive patch test reactions to MP and o-cresol. OBJECTIVE: The aim of this study was to investigate if the simultaneous allergic reactions to PFR and o-cresol could be explained by the presence of this substance in PFR. METHODS: Patch testing, high-pressure liquid chromatography (HPLC), nuclear magnetic resonance spectrometry (NMR), gas chromatography (GC), and mass spectrometry (MS) were used. RESULTS: o-Cresol was isolated from the specific PFR used in our standard patch test series and identified. The concentration in the resin was 0.066% wt/wt. CONCLUSION: The current study establishes o-cresol as a contact sensitizer in a PFR. The observed reactions to o-cresol could be on the basis of cross reactivity or primary sensitization.

Allergens↗

Low-molecular-weight contact allergens in p-tert-butylphenol-formaldehyde resin.

BACKGROUND: p-tert-Butylphenol-formaldehyde resin (PTBPFR) is a contact allergen that is included in most standard patch test series. This resin consists of a large number of substances most of which are unknown. OBJECTIVE: The aim of this study was to investigate if allergens in PTBPFR are molecules mainly of low (MW < 250), medium, or high molecular weight (MW > 1,000); to isolate and identify some of the low molecular weight components of the resin; and for new substances to determine if these were allergens. METHODS: Gel permeation chromatography, patch testing, high-pressure liquid chromatography, mass spectrometry, and nuclear magnetic resonance spectrometry were used. RESULTS: Patch test reactions indicated allergens in low-, medium-, and high-molecular-weights fractions. The strongest patch test reactivity was seen to a medium molecular weight fraction constituting only 6% wt/wt of the resin for 4 of the patients. Two patients reacted positively to low molecular weight fractions, and one of these patients reacted only to these fractions. The following substances were isolated: 4-tert-butyl-[1,2]benzoquinone, 4-tert-butyl-2,6-bis-hydroxymethyl-phenol, 4-tert-butylbenzene-1,2-diol, 4-tert-butyl-2-hydroxymethyl-phenol, 5-tert-butyl-2-hydroxy-3-hydroxymethyl-benzaldehyde, 4-tert-butyl-2-hydroxymethyl-6-methoxymethyl-phenol, and p-tert-butylphenol. Patients reacted positively to 5-tert-butyl-2-hydroxy-3-hydroxymethyl-benzaldehyde and 4-tert-butyl-2-hydroxymethyl-6-methoxymethyl-phenol but not to 4-tert-butyl-[1,2]benzoquinone. CONCLUSION: Two new allergens in PTBPFR were found: 5-tert-butyl-2-hydroxy-3-hydroxymethyl-benzaldehyde and 4-tert-butyl-2-hydroxymethyl-6-methoxymethyl-phenol.

Allergens↗

Allergic contact dermatitis in response to budesonide reactivated by inhalation of the allergen.

BACKGROUND: Up to 5% of patients with dermatitis who are consecutively patch tested are allergic to one or more corticosteroids. However, few reports of allergic mucosal and skin symptoms in patients with asthma and rhinitis caused by inhaled corticosteroids exist. OBJECTIVE: Our purpose was to determine whether inhalation of budesonide would result in reactivation of patch test reactions caused by budesonide. METHODS: The study, which was randomized, double-blind, and placebo-controlled, was ethically reviewed by the Medical Faculty, University of Lund, Sweden. Fifteen nonasthmatic patients who were initially given a diagnosis of budesonide hypersensitivity on patch testing from less than 1 up to 8 years before the study were provoked with budesonide or placebo by inhalation 6 weeks after they had been patch tested with budesonide, its R and S diastereomers, and potentially cross-reacting substances. Lung function was studied by using spirometry and repeated peak expiratory flow measurements. RESULTS: In 4 of 7 patients who inhaled budesonide, reactivation of previously positive patch test reactions was noted within 24 hours, in contrast to 0 of 8 patients who inhaled placebo (P =.026). No adverse pulmonary responses could be detected. CONCLUSION: This study shows that allergic skin reactions may occur in patients with contact allergy to budesonide when inhaled forms of the drug are used.

Administration, Inhalation↗

Contact allergy to gold is correlated to dental gold.

Questionnaire studies have indicated that patients with dental gold will more frequently have contact allergy to gold. This study aimed at investigating the relationship between contact allergy to gold and the presence and amount of dental gold alloys. A total of 102 patients were referred for patch testing because of suspicion of contact allergy. Patch tests were performed with gold sodium thiosulphate 2% and 5%. The patients underwent an oral clinical and radiological examination. Contact allergy to gold was recorded in 30.4% of the patients, and of these 74.2% had dental gold (p=0.009). A significant correlation was found between the amount of gold surfaces and contact allergy to gold (p=0.008), but there was no statistical relationship to oral lesions. It is concluded that there is a positive relationship between contact allergy to gold and presence and amount of dental gold alloys.

Adult↗

Sensitizing capacity of two monomeric aldehyde components in p-tert-butylphenol-formaldehyde resin.

Contact allergy to p-tert-butylphenol-formaldehyde resin is not rare. This resin consists of a large number of substances, most of which are unknown. For diagnostic and preventive reasons, the chemical identity of the sensitizers should be known as well as their sensitizing capacities, cross-reaction patterns and presence in the environment. The aim of this study was to investigate the sensitizing capacities and cross-reaction patterns for 5-tert-butyl-2-hydroxy-3-hydroxymethyl-benzaldehyde and 5-tert-butyl-2-hydroxy-benzaldehyde in the guinea pig maximization test. 2,6-Dimethylol p-tert-butylphenol, p-tert-butylcate chol, 2-methylol p-tert-butylphenol, p-tert-butylphenol, 4-tert-butyl-2-(5-tert-butyl-2-hydroxy-3-hydroxymethyl-benzyloxymethyl)-6-hydroxymethyl-phenol and 4-tert-butyl-2-(5-tert-butyl-2-hydroxy-benzyloxymethyl)-phenol were used as potential cross-reacting substances. 5-tert-Butyl-2-hydroxy-3-hydroxymethyl-benzaldehyde was shown to be a sensitizer (p = 0.041). In animals induced with this compound no cross-reactions to the putative cross-reacting substances were seen. In contrast, 5-tert-butyl-2-hydroxy-benzaldehyde failed to induce sensitization and no cross-reactions were detected.

Allergens↗

Gold concentration in blood in relation to the number of gold restorations and contact allergy to gold.

Previous studies have demonstrated an association between gold allergy and the presence of dental gold restorations. The aim of the present study was to investigate the relationship between the concentration of gold in blood (B-Au) and the number of tooth surfaces with gold alloys in subjects with and without contact allergy to gold. In 80 patients referred for patch testing because of eczematous disease, blood samples were taken and analyzed for B-Au using inductively coupled plasma mass spectrometry. The detection limit for the Au determination was 0.04 microg/L. In addition, a dentist made a clinical and radiological examination of the patients and registered the number of dental gold surfaces. Patients with dental gold restorations had a statistically significantly higher B-Au in Mann-Whitney U test (P = 0.025), (range < 0.04-1.07 microg/L) than patients without (range < 0.04-0.15 microg/L). Furthermore, a positive correlation was found between B-Au and the number of dental gold surfaces (P < 0.01). There was no statistically significant difference in B-Au between persons with and without contact allergy to gold. The study thus indicates that gold is released from dental restorations and taken tip into the circulation.

Acrylic Resins↗