National Allergy Research Centre, Department of Dermatology and Allergy, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark.
Department of Occupational Dermatology, Sahlgrenska University Hospital, Gothenburg, Sweden.
Contact Dermatitis. 2019 Apr;80(4):208-216. doi: 10.1111/cod.13168. Epub 2018 Dec 12.
Contact allergy to oxidized limonene, with hydroperoxides of limonene (Lim-OOHs) as the main allergens, is common. However, high proportions of weak positive and doubtful patch test reactions have been reported.
To determine the clinical relevance, elicitation threshold and dose-response relationship of Lim-OOHs in individuals with a positive or doubtful patch test reaction to standard Lim-OOHs 0.3% pet.
A multicentre 3-week double-blind vehicle-controlled repeated open application test (ROAT) study with a simulated fine fragrance containing Lim-OOHs at 1260, 420 and 140 ppm, equal to a dose/area per application of Lim-OOHs of 3.0, 0.99 and 0.33 μg/cm , was performed.
Among 11 subjects allergic to Lim-OOHs, 11 (100%), 7 (64%), and 3 (27%), respectively, reacted to the applied doses. No reactions were seen in 17 healthy controls exposed to the highest dose. This difference in reactivity was statistically significant (P < 0.0001). Among 13 subjects with doubtful patch test reactions to Lim-OOHs, two (15%) had positive ROAT reactions to the highest Lim-OOH dose applied (P = 0.36 as compared with controls).
Contact allergy to Lim-OOHs is of clinical relevance in patients with positive patch test reactions. A doubtful patch test reaction to Lim-OOHs 0.3% pet. can be of clinical relevance.
接触氧化柠檬烯引起的过敏反应，其主要过敏原是柠檬烯过氧化物（Lim-OOHs），较为常见。然而，有报道称，阳性和可疑斑贴试验反应的比例较高。
确定标准 Lim-OOHs 0.3% pet 阳性或可疑斑贴试验反应个体中 Lim-OOHs 的临床相关性、激发阈值和剂量反应关系。
进行了一项为期 3 周的多中心、双盲、载体对照、重复开放应用测试（ROAT）研究，其中包含模拟精细香料的 Lim-OOHs，浓度分别为 1260、420 和 140 ppm，相当于每次应用的 Lim-OOHs 剂量/面积分别为 3.0、0.99 和 0.33μg/cm。
在 11 名对 Lim-OOHs 过敏的受试者中，分别有 11（100%）、7（64%）和 3（27%）对应用剂量产生反应。在接触最高剂量的 17 名健康对照者中未观察到反应。这种反应性差异具有统计学意义（P<0.0001）。在 13 名对 Lim-OOHs 可疑斑贴试验反应的受试者中，有 2 名（15%）对应用的最高 Lim-OOH 剂量有阳性 ROAT 反应（与对照组相比，P=0.36）。
对 Lim-OOHs 的接触过敏在阳性斑贴试验反应的患者中具有临床相关性。对 Lim-OOHs 0.3% pet 的可疑斑贴试验反应可能具有临床相关性。
