Wahlberg J E, Lidén C
Department of Occupational and Environmental Dermatology, Stockholm County Council, Stockholm, Sweden.
Am J Contact Dermat. 2000 Mar;11(1):42-8. doi: 10.1016/s1046-199x(00)90031-9.
The relevance of patch-test reactivity to chemicals on cross-challenge is hard to state, but it is generally assumed that the patient might risk a relapse of contact dermatitis when exposed to the cross-reacting compound(s).
To study relevance by using the repeated open application test (ROAT) and applying the inducing allergen cobalt chloride (CoCl(2)) or nickel sulfate (NiSO(4)) as well as the possibly cross-reacting compound (NiSO(4) or CoCl(2)) topically to guinea pigs.
Animals were induced according to the guinea pig maximization test (GPMT) method, patch tested and then treated for 10 days using ROATs. Sensitivity thresholds were determined with serial dilution tests.
Guinea pigs induced with CoCl(2) reacted in patch testing (100%) and in ROATs to CoCl(2) (93%) but not to NiSO(4). Animals induced with NiSO(4) reacted in patch testing to NiSO(4) (100%) but not to CoCl(2), and in the ROATs to NiSO(4) (41%) and less to CoCl(2).
Our results support the assumption that the concomitant patch test reactivity is due to multiple sensitizations rather than cross-reactivity. We previously found that animals induced with palladium chloride (PdCl(2)) also reacted to NiSO(4) on patch testing but not in the ROATs, indicating that the results from patch testing might overestimate the risk of a relapse. ROATs in patients with solitary and/or concomitant sensitivity to CoCl(2), NiSO(4) or PdCl(2) are desirable.
斑贴试验对化学物质的反应性与再次接触时的相关性难以确定,但一般认为患者接触交叉反应性化合物时可能有接触性皮炎复发的风险。
通过重复开放涂抹试验(ROAT),将诱导性变应原氯化钴(CoCl₂)或硫酸镍(NiSO₄)以及可能的交叉反应性化合物(NiSO₄或CoCl₂)局部应用于豚鼠,研究其相关性。
按照豚鼠最大化试验(GPMT)方法诱导动物,进行斑贴试验,然后使用ROATs治疗10天。通过系列稀释试验确定敏感性阈值。
用CoCl₂诱导的豚鼠在斑贴试验(100%)和ROATs中对CoCl₂有反应(93%),但对NiSO₄无反应。用NiSO₄诱导的动物在斑贴试验中对NiSO₄有反应(100%),但对CoCl₂无反应,在ROATs中对NiSO₄有反应(41%),对CoCl₂反应较弱。
我们的结果支持这样的假设,即同时出现的斑贴试验反应性是由于多重致敏而非交叉反应。我们之前发现,用氯化钯(PdCl₂)诱导的动物在斑贴试验中对NiSO₄也有反应,但在ROATs中无反应,这表明斑贴试验的结果可能高估了复发风险。对于对CoCl₂、NiSO₄或PdCl₂有单独和/或同时敏感性的患者,进行ROATs是有必要的。