RESUMO
AIMS: To quantify the anti-inflammatory potency of topical corticosteroids and topical calcineurin inhibitors by measuring the contact allergic response to a diphenylcyclopropenone (DPCP) challenge in de novo sensitized human volunteers. METHODS: Two randomized, double-blind, vehicle-controlled studies were performed encompassing 76 volunteers: 29 in the first and 47 in the second study. Topical drugs were applied pre- and/or post-treatment in block designs. The compounds were tested simultaneously under occluded patch tests covering DPCP-induced dermatitis. Inhibitory responses were assessed by visual scoring and measurements of the oedema thickness with ultrasound. RESULTS: When applied both before and after the DPCP challenge, significant anti-inflammatory effects were seen in descending order for tacrolimus 0.1% ointment, clobetasol propionate ointment, betamethasone valerate ointment and hydrocortisone butyrate ointment, while pimecrolimus cream, hydrocortisone ointment and vehicles had no significant effect. Only tacrolimus ointment (P < 0.01) demonstrated a consistent significant pre-treatment inhibitory effect compared with an untreated DPCP control. CONCLUSIONS: This human testing method in which the inflammation of experimentally induced allergic patch test reactions is quantified by objective measurement allows an analysis of the anti-inflammatory potency of not only topical corticosteroids, but also of drugs that have no effect on vasoconstriction. The method allowed comparison of the potencies of four topical corticosteroids and two calcineurin inhibitors.
Assuntos
Anti-Inflamatórios/administração & dosagem , Inibidores de Calcineurina/administração & dosagem , Dermatite Alérgica de Contato/tratamento farmacológico , Fármacos Dermatológicos/administração & dosagem , Glucocorticoides/administração & dosagem , Administração Cutânea , Adulto , Ciclopropanos/administração & dosagem , Ciclopropanos/imunologia , Dermatite Alérgica de Contato/diagnóstico por imagem , Dermatite Alérgica de Contato/imunologia , Método Duplo-Cego , Feminino , Voluntários Saudáveis , Humanos , Masculino , Pomadas/administração & dosagem , Índice de Gravidade de Doença , Pele/irrigação sanguínea , Pele/diagnóstico por imagem , Pele/efeitos dos fármacos , Pele/imunologia , Resultado do Tratamento , Ultrassonografia , Vasoconstrição/efeitos dos fármacos , Adulto JovemRESUMO
The gene expression time-course of repeated challenge of contact allergy (CA) remains largely unknown. Therefore, using diphenylcyclopropenone (DPCP) as model allergen in healthy humans we set out to examine: (i) the monotonous and complex gene expression time-course trajectories following repeated DPCP challenges to find the predominant gene expression pattern, (ii) the time-course of cell infiltration following repeated DPCP challenges and (iii) the transcriptome of a repeated CA exposure model. We obtained punch biopsies from control and DPCP-exposed skin from ten DPCP sensitized individuals at 5-6 monthly elicitation challenges. Biopsies were used for microarray gene expression profiling, histopathology and immunohistochemical staining. Validation of microarray data by qRT-PCR was performed on 15 selected genes. Early gene expression time points were also validated in an independent data set. An increasing and decreasing trend in gene expression followed by a plateau was predominantly observed during repeated DPCP challenges. Immune responses reached a plateau after two challenges histopathologically, immunohistochemically and in the time-course gene expression analysis. Transcriptional responses over time revealed a Th1/Th17 polarization as three upstream regulators (IFN-γ, IL-1 and IL-17) activated most of the top upregulated genes. Of the latter genes, 9 of 10 were the same throughout the time course. Excellent correlations between array and PCR data were observed. The transcriptional responses to DPCP over time followed a monotonous pattern. This response pattern confirms and supports the newly reported clinical time-course observations in de novo-sensitized individuals showing a plateau response, and thus, there is concordance between clinical response, histopathology, immunohistochemistry and microarray gene expression in volunteers de novo-sensitized to DPCP.
Assuntos
Dermatite Alérgica de Contato/genética , Dermatite Alérgica de Contato/imunologia , Expressão Gênica , Pele/metabolismo , Transcriptoma , Adulto , Biópsia , Ciclopropanos , Dermatite Alérgica de Contato/etiologia , Dermatite Alérgica de Contato/patologia , Feminino , Perfilação da Expressão Gênica , Voluntários Saudáveis , Humanos , Interferon gama/metabolismo , Interleucina-1/metabolismo , Interleucina-17/metabolismo , Masculino , Análise de Sequência com Séries de Oligonucleotídeos , Reação em Cadeia da Polimerase em Tempo Real , Pele/patologia , Células Th1/imunologia , Células Th17/imunologia , Fatores de Tempo , Adulto JovemRESUMO
BACKGROUND: Oak moss absolute, an extract from the lichen Evernia prunastri, is a valued perfume ingredient but contains extreme allergens. OBJECTIVES: To compare the elicitation properties of two preparations of oak moss absolute: 'classic oak moss', the historically used preparation, and 'new oak moss', with reduced contents of the major allergens atranol and chloroatranol. PATIENTS/MATERIALS/METHODS: The two preparations were compared in randomized double-blinded repeated open application tests and serial dilution patch tests in 30 oak moss-sensitive volunteers and 30 non-allergic control subjects. RESULTS: In both test models, new oak moss elicited significantly less allergic contact dermatitis in oak moss-sensitive subjects than classic oak moss. The control subjects did not react to either of the preparations. CONCLUSIONS: New oak moss is still a fragrance allergen, but elicits less allergic contact dermatitis in previously oak moss-sensitized individuals, suggesting that new oak moss is less allergenic to non-sensitized individuals.
Assuntos
Alérgenos , Benzaldeídos , Dermatite Alérgica de Contato/diagnóstico , Testes do Emplastro/métodos , Perfumes/química , Resinas Vegetais , Terpenos , Alérgenos/administração & dosagem , Benzaldeídos/administração & dosagem , Dermatite Alérgica de Contato/etiologia , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Perfumes/efeitos adversos , Resinas Vegetais/administração & dosagem , Resinas Vegetais/efeitos adversos , Resinas Vegetais/química , Medição de Risco , Terpenos/administração & dosagem , Terpenos/efeitos adversos , Terpenos/químicaAssuntos
Anti-Infecciosos/efeitos adversos , Síndrome da Ardência Bucal/diagnóstico , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/etiologia , Eugenol/efeitos adversos , Estomatite/induzido quimicamente , Idoso , Dermatite Alérgica de Contato/complicações , Diagnóstico Diferencial , Feminino , Humanos , Especiarias/efeitos adversos , Língua Fissurada/complicaçõesRESUMO
BACKGROUND: Patch test preparations of volatile substances may evaporate during storage, thereby giving rise to reduced patch test concentrations. OBJECTIVES: To investigate the stability of selected acrylates/methacrylates and fragrance allergens in three different test chambers under different storage conditions. METHODS: Petrolatum samples of methyl methacrylate (MMA), 2-hydroxyethyl methacrylate (2-HEMA), 2-hydroxypropyl acrylate (2-HPA), cinnamal and eugenol in patch test concentrations were stored in three different test chambers (IQ chamber™, IQ Ultimate™, and Van der Bend® transport container) at room temperature and in a refrigerator. The samples were analysed in triplicate with high-performance liquid chromatography. RESULTS: The decrease in concentration was substantial for all five allergens under both storage conditions in IQ chamber™ and IQ Ultimate™, with the exception of 2-HEMA during storage in the refrigerator. For these two chamber systems, the contact allergen concentration dropped below the stability limit in the following order: MMA, cinnamal, 2-HPA, eugenol, and 2-HEMA. In the Van der Bend® transport container, the contact allergens exhibited acceptable stability under both storage conditions, whereas MMA and 2-HPA required cool storage for maintenance of the limit. CONCLUSION: The Van der Bend® transport container was the best device for storage of samples of volatile contact allergens.