RESUMEN
BACKGROUND: Persulfates have been reported to cause both delayed-type and immediate skin reactions. They may also cause immediate reactions of the mucous membranes of the bronchial system through inhalation, leading to asthma and rhinitis. Anaphylactic reactions caused by contact with persulfates are rare. The mechanism of immediate reactions caused by persulfates is unclear. OBJECTIVES: To report 2 cases with systemic reactions after skin contact with persulfates, and to propose a test protocol for diagnosing immediate reactions caused by persulfates. METHODS: Prick tests with serial dilutions of ammonium and potassium persulfate were performed. Patch tests were also performed with the two agents. Persulfate-specific IgE was detected with two different IgE immunoblotting techniques. RESULTS: Prick tests were positive with ammonium and potassium persufate, but no specific IgE was detected in the serum. Patch tests showed early positive reactions to both persulfates in 1 patient. CONCLUSIONS: Prick tests and patch tests can be valuable in the testing of patients with a suspicion of an immediate-type reaction caused by persulfates. The mechanism of these reactions remains unclear.
Asunto(s)
Anafilaxia/inducido químicamente , Asma/inducido químicamente , Dermatitis Alérgica por Contacto/inmunología , Blanqueadores del Pelo/efectos adversos , Adulto , Sulfato de Amonio/efectos adversos , Sulfato de Amonio/inmunología , Anafilaxia/inmunología , Asma/inmunología , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Alérgica por Contacto/etiología , Femenino , Humanos , Inmunoglobulina E/sangre , Persona de Mediana Edad , Compuestos de Potasio/efectos adversos , Compuestos de Potasio/inmunología , Pruebas Cutáneas , Sulfatos/efectos adversos , Sulfatos/inmunologíaRESUMEN
Hairdressers are frequently exposed to bleaching powder containing persulfates, a group of compounds that may induce hypersensitivity in the airways. The mechanism causing this reaction is not clear. The aim of this study was to identify changes in the nasal lavage fluid proteome after challenge with potassium persulfate in hairdressers with bleaching powder-associated rhinitis. Furthermore, we aimed to compare their response to that of hairdressers without nasal symptoms, and atopic subjects with pollen-associated nasal symptoms. To study the pathogenesis of persulfate-associated rhinitis, the response in protein expression from the upper airway was assessed by time-dependent proteomic expression analysis of nasal lavage fluids. Samples were prepared by pooling nasal lavage fluids from the groups at different time points after challenge. Samples were depleted of high-abundant proteins, labeled with iTRAQ and analyzed by online 2D-nanoLC-MS/MS. Differences in the protein pattern between the three groups were observed. Most proteins with differentially expressed levels were involved in pathways of lipid transportation and antimicrobial activities. The major finding was increased abundance of apolipoprotein A-1, 20 min postchallenge, detected solely in the group of symptomatic hairdressers. Our results suggest there may be differences between the mechanisms responsible for the rhinitis in the symptomatic and atopic group.
Asunto(s)
Blanqueadores del Pelo/efectos adversos , Líquido del Lavado Nasal/química , Exposición Profesional/efectos adversos , Compuestos de Potasio/inmunología , Proteínas/análisis , Proteoma/inmunología , Rinitis/inducido químicamente , Sulfatos/inmunología , Apolipoproteína A-I/biosíntesis , Femenino , Expresión Génica/inmunología , Humanos , Cinética , Proteoma/análisisRESUMEN
PURPOSE: The aim of this study was to examine the effects of persulphate on the nasal mucosa and on the immune cells in hairdressers suffering from bleaching powder associated rhinitis (BAR) versus subjects with rhinitis not previously exposed to bleaching powder. METHODS: Fifteen hairdressers (S) with BAR, 14 without symptoms (WS) and 12 atopics (A) with rhinitis but without exposure to bleaching powder were studied. Each performed a nasal challenge with persulphates. Effect parameters were symptom score, acoustic rhinometry, albumin in nasal lavage, subpopulations of lymphocytes in blood and specific serum antibodies. RESULTS: The S group had a post-challenge increase in nasal symptoms and nasal lavage albumin. The A group reacted to a lesser intent. The S and A groups showed an increase in Th1 cells. An HLA class II cell expression was noticed in both groups of hairdressers. No evidence of a type 1 reaction (immediate type) to persulphate was noticed. CONCLUSIONS: Persulphate challenge affects hairdressers with BAR, but also atopics. The reaction may be driven by a Th1 cell activation.
Asunto(s)
Alérgenos/inmunología , Preparaciones para el Cabello , Enfermedades Profesionales/diagnóstico , Exposición Profesional/efectos adversos , Compuestos de Potasio/inmunología , Rinitis/diagnóstico , Sulfatos/inmunología , Adulto , Albúminas/análisis , Femenino , Humanos , Recuento de Linfocitos , Líquido del Lavado Nasal/química , Pruebas de Provocación Nasal , Enfermedades Profesionales/inmunología , Rinitis/inmunología , Rinitis/fisiopatología , Pruebas Cutáneas , Células TH1/efectos de los fármacos , Células TH1/inmunologíaRESUMEN
Potassium monopersulfate (MPS) is widely used in spa and pool "shock" treatments, yet contact dermatitis associated with MPS has been rarely reported. A patient presented with a generalized scattered dermatitis from the neck down that worsened after spa use. Patch testing elicited a ++ reaction to ammonium persulfate. Contact with ammonium persulfate was ruled out; however, MPS, which can cross-react with ammonium persulfate, was found to be the active ingredient in the patient's spa shock treatments. The dermatitis cleared after the patient switched to a hydrogen peroxide-based shock treatment.
Asunto(s)
Baños/efectos adversos , Dermatitis Alérgica por Contacto/etiología , Desinfectantes/efectos adversos , Compuestos de Potasio/efectos adversos , Sulfatos/efectos adversos , Sulfato de Amonio/inmunología , Reacciones Cruzadas , Dermatitis Alérgica por Contacto/diagnóstico , Desinfectantes/inmunología , Humanos , Masculino , Persona de Mediana Edad , Pruebas del Parche , Compuestos de Potasio/inmunología , Sulfatos/inmunologíaRESUMEN
Persulfate salts may cause contact urticaria, allergic and irritant contact dermatitis, rhinitis and asthma. The mechanism of the immediate reactions has been unclear. Positive prick test, skin application and nasal and bronchial provocations identify immediate allergy. There is only 1 previous report of specific binding of immunoglobulin E (IgE) to ammonium persulfate demonstrated by radioallergosorbent test (RAST). In the present study, fresh 2% ammonium and potassium persulfate solutions were used for prick testing. Patients with positive prick tests were further evaluated with open skin application, immunospot and RAST. Prick testing with persulfate salts was performed in a total of 138 patients. 7 patients had a positive reaction to at least 1 persulfate salt. 6 of the patients had had skin symptoms, urticaria, eczema or angioedema, because of contact with hair bleaches. Open application on healthy skin was performed in 4 patients, and 3 out of them had urticarial reactions. The sera of 5 patients were investigated with immunospot and RAST. On immunospot, specific binding of IgE to human serum albumin (HSA)-conjugated ammonium and potassium persulfate was found in 2 patients. 1 immunospot-positive patient also had a positive RAST to ammonium persulfate-HSA conjugate. The mechanism of immediate hypersensitivity to persulfates thus seems to be IgE-mediated at least in some patients.
Asunto(s)
Dermatitis Alérgica por Contacto/inmunología , Inmunoglobulina E/metabolismo , Sulfatos/inmunología , Urticaria/inmunología , Adulto , Sulfato de Amonio/efectos adversos , Sulfato de Amonio/inmunología , Dermatitis Alérgica por Contacto/etiología , Dermatitis Profesional/etiología , Dermatitis Profesional/inmunología , Ensayo de Inmunoadsorción Enzimática , Femenino , Preparaciones para el Cabello/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Compuestos de Potasio/efectos adversos , Compuestos de Potasio/inmunología , Prueba de Radioalergoadsorción , Sulfatos/efectos adversos , Urticaria/etiologíaRESUMEN
BACKGROUND: Persulfate salts have been identified as a cause of occupational asthma (OA). The aim of the present study was to describe the clinical characteristics, diagnostic testing results, and follow-up of eight patients with OA that was triggered by these chemical compounds. METHODS: Eight patients with OA due to exposure to persulfate salts were studied. Immunologic, lung function, and specific bronchial challenge tests (SBCTs) were performed in all patients. Once their condition had been diagnosed, the patients were seen every 1, 3, and 6 months for a mean duration of 18 months. RESULTS: The mean time of exposure to persulfate salts up to diagnosis was 15 years (range, 3 to 27 years), and mean time that had elapsed between symptom onset and diagnosis was 38 months (range, 3 to 120 months). Three patients were smokers, six patients presented with rhinitis prior to asthma in relation to persulfate exposure, and three presented with dermatitis. The results of total IgE tests were positive in six patients, and the results of skin-prick tests for detection of persulfate salts were positive in five of these patients. The results of a SBCT was positive in the seven patients in whom it was performed. Symptoms persisted in all but one patient and required medical treatment. CONCLUSIONS: The results suggest that the reliable diagnosis of OA due to persulfate salts must be based on the specific challenge test until further experience has been acquired. Despite avoiding exposure, patients continued with symptoms and required treatment for the control of symptoms. Finally, a dependent IgE mechanism appears to be implicated in the pathogenesis of OA due to exposure to persulfate salts.
Asunto(s)
Asma/inducido químicamente , Enfermedades Profesionales/inducido químicamente , Compuestos de Potasio/efectos adversos , Sulfatos/efectos adversos , Adulto , Asma/diagnóstico , Pruebas de Provocación Bronquial , Erupciones por Medicamentos/etiología , Femenino , Estudios de Seguimiento , Humanos , Inmunoglobulina E/sangre , Persona de Mediana Edad , Enfermedades Profesionales/diagnóstico , Exposición Profesional , Compuestos de Potasio/inmunología , Rinitis/inducido químicamente , Pruebas Cutáneas , Fumar/efectos adversos , Sulfatos/inmunologíaRESUMEN
Ammonium, Potassium, and Sodium Persulfate are inorganic salts used as oxidizing agents in hair bleaches and hair-coloring preparations. Persulfates are contained in hair lighteners at concentrations up to 60%, in bleaches and lighteners at up to 22% and 16%, respectively, and in off-the-scalp products used to highlight hair strands at up to 25%. They are used in professional product bleaches and lighteners at similar concentrations. Much of the available safety test data are for Ammonium Persulfate, but these data are considered applicable to the other salts as well. Acute dermal, oral, and inhalation toxicity studies are available, but only the latter are remarkable, with gross lesions observed in the lungs, liver, stomach, and spleen. In short-term and subchronic feeding studies the results were mixed; some studies found no evidence of toxicity and others found local damage to the mucous membrane in the gastrointestinal tract, but no other systemic effects. Short-term inhalation toxicity was observed when rats were exposed to aerosolized Ammonium Persulfate at concentrations of 4 mg/m3 and greater. Ammonium Persulfate (as a moistened powder) was not an irritant to intact rabbit skin, but was sensitizing (in a saline solution) to the guinea pig. It was slightly irritating to rabbit eyes. Ammonium Persulfate was negative in the Ames test and the chromosomal aberration test. No significant evidence of tumor promotion or carcinogenicity was observed in studies of rats receiving topical applications of Ammonium Persulfate. The persulfates were reported to cause both delayed-type and immediate skin reactions, including irritant dermatitis, allergic eczematous dermatitis, localized contact urticaria, generalized urticaria, rhinitis, asthma, and syncope. The most common causes of allergic dermatitis in hairdressers are the active ingredients in hair dyes, and Ammonium Persulfate has been identified as a frequent allergen. A sensitization study that also examined the incidence of urticarial reactions was performed with 17.5% Ammonium, Potassium, and Sodium Persulfate under occlusive patches. At this concentration and exposure conditions, a mixture of these Persulfates was not sensitizing, and application of Ammonium, Potassium, and Sodium Persulfate did not result in an urticarial reaction. In normal use (i.e., not occluded and rinsed off), it was expected that a concentration greater than 17.5% would also be safe. Given the clinical reports of urticarial reactions, however, manufacturers and formulators should be aware of the potential for urticarial reactions at concentrations of Persulfates greater than 17.5%. Based on the available data, the Cosmetic Ingredient Review (CIR) Expert Panel concluded that Ammonium, Potassium, and Sodium Persulfate are safe as used as oxidizing agents in hair colorants and lighteners designed for brief discontinuous use followed by thorough rinsing from the hair and skin.
Asunto(s)
Sulfato de Amonio/efectos adversos , Preparaciones para el Cabello/efectos adversos , Compuestos de Potasio/efectos adversos , Compuestos de Sodio/efectos adversos , Sulfatos/efectos adversos , Sulfato de Amonio/inmunología , Sulfato de Amonio/toxicidad , Animales , Pruebas de Carcinogenicidad , Seguridad de Productos para el Consumidor/normas , Preparaciones para el Cabello/química , Preparaciones para el Cabello/toxicidad , Humanos , Exposición por Inhalación/efectos adversos , Dosificación Letal Mediana , Músculo Liso/efectos de los fármacos , Pruebas de Mutagenicidad , Neoplasias/inducido químicamente , Compuestos de Potasio/inmunología , Compuestos de Potasio/toxicidad , Enfermedades de la Piel/inducido químicamente , Compuestos de Sodio/inmunología , Compuestos de Sodio/toxicidad , Sulfatos/inmunología , Sulfatos/toxicidad , Pruebas de Toxicidad Aguda , Urticaria/inducido químicamenteRESUMEN
BACKGROUND: Ammonium and potassium persulfates may induce a variety of cutaneous and respiratory diseases. The precise underlying mechanisms, however, are unclear. OBJECTIVE: To describe a hairdresser, who developed contact dermatitis, rhinoconjuntivitis, and bronchial asthma of delayed onset after occupational exposure to hair bleaches containing persulfate salts and to provide evidence for a common T-cell mediated mechanism responsible for the clinical manifestations. METHODS: We performed skin testing, routine histologic and immunohistochemical examination of the skin reaction after prick testing, lymphocyte proliferation analysis, nasal challenge test, and pulmonary function testing. RESULTS: The causative role of bleaching powder and ammonium persulfate was demonstrated by case history, skin tests, and a nasal challenge test. Patch tests produced a delayed cutaneous reaction to ammonium persulfate confirming contact sensitization. Prick tests with bleaching powder and ammonium persulfate were negative at 15 minutes but revealed a late skin reaction with a papule at the prick sites after 24 hours. Histologic examination of this late reaction demonstrated a perivascular infiltration comprising predominantly T lymphocytes. Further, a significant proliferation of T cells to bleaching powder was reproducibly found by a lymphocyte proliferation analysis. Nasal challenge test with bleaching powder showed a significant reduction of air flow after 24 hours. CONCLUSION: Our findings suggest that immunologic mechanism with direct involvement of T cells may not only play an important role in the pathogenesis of the cutaneous but also in the respiratory and rhinoconjunctival reactions.
Asunto(s)
Sulfato de Amonio/efectos adversos , Asma/inmunología , Dermatitis por Contacto/inmunología , Dermatitis Profesional/inmunología , Compuestos de Potasio/efectos adversos , Sulfatos/efectos adversos , Linfocitos T/inmunología , Adulto , Sulfato de Amonio/inmunología , Asma/inducido químicamente , Asma/diagnóstico , Dermatitis Profesional/diagnóstico , Femenino , Humanos , Compuestos de Potasio/inmunología , Sulfatos/inmunologíaRESUMEN
Soluble and insoluble hexavalent chromium (Cr6+) agents are concomitantly released with ozone (O3) during welding. Although pulmonary/immunologic implications from exposure to each agent individually have been investigated, the effects from simultaneous exposure, as occurs under actual working conditions, are unclear. To investigate immunomodulatory effects of inhaled Cr6+, F-344 rats were exposed for 5 h/day, 5 days/week for 2 or 4 weeks to atmospheres containing soluble potassium chromate (K2CrO4) or insoluble barium chromate (BaCrO4), each alone at 360 micrograms Cr/m3 or in combination with 0.3 ppm O3. One day after the final exposure, rats were euthanized, their lungs were lavaged, and pulmonary macrophages (PAM) were recovered for assessment of basal and inducible functions. Rats inhaling K2CrO4-containing atmospheres had greater levels of total recoverable cells, neutrophils, and monocytes in bronchopulmonary lavage compared to rats exposed to insoluble Cr6+ atmospheres, O3 alone, or air; these rats also had a reduced percentage of PAM, although total PAM levels remained unaffected. Although Cr exposure-related changes in PAM functionality were evident, any dependence upon Cr solubility was variable. K2CrO4-containing atmospheres modulated PAM-inducible interleukins-1 and -6, and tumor necrosis factor-alpha production to a greater degree than those containing BaCrO4. Conversely, BaCrO4-containing atmospheres affected PAM basal nitric oxide production and interferon-gamma-primed/zymosan-stimulated reactive oxygen intermediate production to a greater extent than did those containing K2CrO4. In none of the PAM assays did co-inhalation of O3 result in a modulation of the effects obtained with either Cr6+ compound itself. The results indicate that, while immunomodulatory effects of inhaled Cr6+ upon PAM are related to particle solubility, the co-inhalation of O3 apparently does not cause further modifications of the metal-induced effects.