Friday, September 25, 2009

Experimental inhalation of fragrance allergens in predisposed subjects: Effects on skin and airways.

Experimental inhalation of fragrance allergens in predisposed subjects: Effects on skin and airways.
Schnuch A, Oppel E, Oppel T, Römmelt H, Kramer M, Riu E, Darsow U, Przybilla B, Nowak D, Jörres RA.
Br J Dermatol. 2009 Sep 22. [Epub ahead of print]
Information Network of Departments of Dermatology (IVDK); University of Göttingen, Göttingen / Germany.
Background: Exposure to fragrances is increasingly encountered in the environment. Some fragrances are known as important skin and potential airway sensitizers.
Objectives: We investigated whether patients with contact allergy to isoeugenol (ISO) or hydroxyisohexyl-3-carboxaldehyde (HICC) would react to inhalation exposure on the level of the airways and skin.
Methods: Eleven patients sensitized to ISO and 10 patients sensitized to HICC were exposed for 60 min to 1000 mug/m(3) of these compounds in an exposure chamber at rest, and to 1000 mug/m(3) geraniol as control. Patients wore protective clothing to prevent skin exposure. Assessments were performed prior to exposures, and immediately, 2, 5, 24 and 72 h afterwards.
Results: There were no significant changes in lung function but a tendency towards an increased bronchial hyperresponsiveness after exposure to any of the compounds. Laboratory parameters of inflammation did not indicate responses. Single patients reported respiratory symptoms unrelated to objective measures. In contrast, the observed skin symptoms corresponded to the patients' specific sensitization. Four patients reported symptoms compatible with a delayed-type hypersensitivity, and two of them demonstrated a flare-up after ISO. Upon re-exposure they did not respond to a lower, more realistic level of ISO.
Conclusion: Inhalation of high concentrations of fragrance contact allergens apparently posed a risk for single patients to develop manifest hematogenic contact dermatitis, while the changes in the respiratory tract were limited to symptoms in some subjects, without objective changes.

PMID: 19772525 [PubMed - as supplied by publisher]

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