Systemic Nickel Allergy: Oral Desensitization and Possible Role of Cytokines Interleukins 2 and 10

Nickel ingested with food can elicit either systemic cutaneous or gastrointestinal symptoms causing a systemic nickel allergy syndrome (SNAS) that can be treated with tolerance by oral ingestion of the metal. It has been suggested that interleukins 2 (IL-2) and 10 (IL-10) are involved in the mechanisms underlying oral tolerance. We evaluated the clinical efficacy of oral desensitization therapy in SNAS consisting in the administration of nickel sulphate. Because nickel allergy prevalently affects women, only female subjects (N = 22) were recruited. Oral nickel desensitizing therapy was associated with low-nickel diet for three months. Before and after therapy, clinical conditions were evaluated, and circulating cytokines IL-2 and IL-10 were measured. After the two-year treatment, visual analogue scale (VAS) scores for symptoms were significantly reduced (P < 0.001). Patients were released by either cutaneous or gastrointestinal symptoms and by tolerating nickel-containing food. At the end of the treatment, nickel oral challenge test was negative in 18 patients, and IL-2 level in the serum was significantly reduced while IL-10 was increased, although this datum was not statistically significant. Our study confirms the clinical efficacy of nickel oral immunotherapy and focuses on the mechanisms triggered by oral tolerance indicating that reduction of IL-2 can be associated with success of oral nickel desensitizing therapy.

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Eosinophilic oesophagitis (in nickel-allergic patient) regressed after nickel oral desensitization: A case report

International Journal of Immunopathology and Pharmacology ◽

10.1177/2058738419827771 ◽

2019 ◽

Vol 33 ◽

pp. 205873841982777 ◽

Cited By ~ 1

Author(s):

Eleonora Nucera ◽

Raffaella Chini ◽

Angela Rizzi ◽

Domenico Schiavino ◽

Alessandro Buonomo ◽

...

Keyword(s):

Contact Allergy ◽

Topical Steroid ◽

Allergic Patient ◽

Oral Immunotherapy ◽

Eosinophilic Oesophagitis ◽

Nickel Allergy ◽

Cutaneous Manifestations ◽

Inflammatory Parameters ◽

First Case ◽

Oral Desensitization

The eosinophilic oesophagitis (EoE) is a chronic immune/antigen disorder of the oesophagus clinically characterized by dysphagia and pathologically by mucosa eosinophilic infiltration. Th2-type allergic reactions are considered having important roles in the aetiopathogenesis of EoE. Avoidance of food allergens, administration of steroidal anti-inflammatory medications and dilation of the oesophagus are the most important treatments. ‘Systemic nickel allergy syndrome’ (SNAS) interests about 20% of patients with nickel contact allergy which could present systemic cutaneous manifestations (urticaria, oedema, etc.) and also respiratory and digestive symptoms (meteorism, abdominal pain, diarrhoea, etc.). In the literature, it is demonstrated that nickel oral immunotherapy is effective in reducing symptoms of SNAS and in modulating inflammatory parameters. We describe the case of a 48-year-old woman suffering from EoE not responsive to the topical steroid administration and diagnosis of SNAS. The patient started nickel oral desensitization according to the literature protocol continuing nickel-free diet. After 1 year from the beginning of the treatment, during the maintenance dose (500 ng three times a week), she decreased gradually the dosage of immunotherapy and reintroduced all the culprit foods. After the immunotherapy interruption, during the free diet, she repeated the oesophagogastroscopy with a complete macroscopic and histological resolution. We showed the first case of an EoE in a patient affected by SNAS responsive to the nickel-free diet and the oral immunotherapy.

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Retracted: Randomised clinical trial: the clinical efficacy and safety of an alginate-antacid (Gaviscon Double Action) versus placebo, for decreasing upper gastrointestinal symptoms in symptomatic gastroesophageal reflux disease (GERD) in China

Alimentary Pharmacology & Therapeutics ◽

10.1111/apt.13334 ◽

2015 ◽

Vol 42 (7) ◽

pp. 845-854 ◽

Cited By ~ 20

Author(s):

J. Sun ◽

C. Yang ◽

H. Zhao ◽

P. Zheng ◽

J. Wilkinson ◽

...

Keyword(s):

Clinical Trial ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Clinical Efficacy ◽

Reflux Disease ◽

Gastrointestinal Symptoms ◽

Randomised Clinical Trial ◽

Efficacy And Safety ◽

Upper Gastrointestinal Symptoms ◽

Upper Gastrointestinal

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Clinical efficacy and immune regulation with peanut oral immunotherapy

Journal of Allergy and Clinical Immunology ◽

10.1016/j.jaci.2009.05.022 ◽

2009 ◽

Vol 124 (2) ◽

pp. 292-300.e97 ◽

Cited By ~ 451

Author(s):

Stacie M. Jones ◽

Laurent Pons ◽

Joseph L. Roberts ◽

Amy M. Scurlock ◽

Tamara T. Perry ◽

...

Keyword(s):

Clinical Efficacy ◽

Immune Regulation ◽

Oral Immunotherapy

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Oral challenge test for the diagnosis of gingival hypersensitivity to apple: A case report

Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology ◽

10.1016/j.tripleo.2005.07.005 ◽

2006 ◽

Vol 101 (3) ◽

pp. 317-321 ◽

Cited By ~ 3

Author(s):

Onur Ozcelik ◽

M. Cenk Haytac

Keyword(s):

Case Report ◽

Challenge Test ◽

Oral Challenge ◽

Oral Challenge Test

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Screening for Cow Milk Allergy in Infants and Preschool Children

QJM ◽

10.1093/qjmed/hcab113.064 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Zeinab Awad El-Sayed ◽

Hanan Mohamed Abdel-Lateef ◽

Rasha Hassan El-Owaidy ◽

Shady Sarwat Shaker

Keyword(s):

Preschool Children ◽

Challenge Test ◽

Cow Milk ◽

Diagnostic Tools ◽

Milk Allergy ◽

Cross Sectional ◽

Oral Challenge Test ◽

Egyptian Children ◽

Cow Milk Allergy ◽

History Of

Abstract Background Cow milk allergy (CMA) is the third most common food allergy that triggers anaphylactic reactions. Lactose intolerence, infantile colic and gastroesophageal reflux are the most common conditions which overlap with CMA causing both over and underdiagnosis. There are no wide population based epidemiological studies for the prevalence of CMA among Egyptian children. We sought to evaluate the prevalence of CMA among infants and preschool children and to correlate the parental reporting of CMA to the available diagnostic tools. Methods We conducted a cross sectional study that included 800 Egyptian children aged 3 months -5 years, who were enrolled consecutively from the primary care units and outpatient clinics of Children’s Hospital, Ain Shams University. Detailed history taking and clinical examination were done and those with suggestive history of CMA were subjected to further evaluation including skin prick test (SPT) and oral challenge test (OCT). Results The study comprised 390 girls (48.8%) and 410 boys (51.2%). Their weight centiles ranged between 5th and 97th percentiles, with median (IQR)=25(5-50) percentiles and mean(SD)=36.1(31.9). CM was introduced at age of 1-12 months, mean (SD): 9 (6) months with median (IQR): 12 (9-12) months. Forty (5%) subjects had suggestive history of CMA, 32 of whom completed their evaluation. The diagnosis of cow milk allergy was confirmed in 8/40 children (20%), comprising 1 % of the whole study sample. CMA was probably excluded at the time of the study in 21 subjects (52.5%), while diagnosis remained undetermined in 11/40 cases (27.5%) (8 refused to undergo SPT & OCT while 3 were lost to follow up). Conclusion The prevalence of CMA in Egyptian infants and preschool children is estimated to be around 1 % with possible overestimation of cow milk allergy diagnosis according to parental reports.

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Oral immunotherapy–induced gastrointestinal symptoms and peripheral blood eosinophil responses

Journal of Allergy and Clinical Immunology ◽

10.1016/j.jaci.2016.09.053 ◽

2017 ◽

Vol 139 (4) ◽

pp. 1388-1390.e4 ◽

Cited By ~ 19

Author(s):

Michael R. Goldberg ◽

Arnon Elizur ◽

Liat Nachshon ◽

Michael Y. Appel ◽

Michael B. Levy ◽

...

Keyword(s):

Peripheral Blood ◽

Gastrointestinal Symptoms ◽

Oral Immunotherapy ◽

Blood Eosinophil ◽

Peripheral Blood Eosinophil

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Profile of patients with anti-inflammatory hypersensitivity submitted to oral challenge test with alternative drug

World Allergy Organization Journal ◽

10.1016/j.waojou.2020.100243 ◽

2020 ◽

Vol 13 (8) ◽

pp. 100243

Author(s):

Claudia Bernhardt ◽

Phelipe Souza ◽

Thais Bernhardt ◽

Paula Bernhardt ◽

Johanna Wiegert

Keyword(s):

Challenge Test ◽

Oral Challenge ◽

Oral Challenge Test ◽

Alternative Drug ◽

Anti Inflammatory

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Study on the clinical efficacy and mechanism of octreotide combined with thrombin in patients with liver

Journal of Clinical and Nursing Research ◽

10.26689/jcnr.v1i1.99 ◽

1970 ◽

Vol 1 (1) ◽

Author(s):

Zhang Xiuqin

Keyword(s):

Liver Cirrhosis ◽

Liver Function ◽

Clinical Efficacy ◽

Effective Rate ◽

Control Group ◽

Observation Group ◽

Before And After ◽

Octreotide Treatment ◽

The Difference ◽

Treatment Observation

Objective:Â To observe the clinical efficacy of octreotide andÂ thrombin in the treatment of patients with liver cirrhosis, and toÂ explore the mechanism of octreotide and thrombin. Methods:Â 53 patients with cirrhosis were randomly divided into controlÂ group and observation group from January 2014 to JanuaryÂ 2016. The control group of 26 patients, given octreotide treatment. Observation group of 27 cases, given octreotide andÂ thrombin combination therapy. Comparison of two groups ofÂ patients with clinical efficacy and changes in liver function before and after treatment.Â Results: The effective rate (88.89%)Â in the observation group was significantly higher than that inÂ the control group (65.38%), the difference was statistically significant (p < 0.05). Before treatment, the difference of liverÂ function between the two groups was not statistically significant (p > 0.05). After treatment, the liver function indexes ofÂ the two groups were improved, and the observation group wasÂ superior to the control group, the difference was statisticallyÂ significant (p < 0.05).

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Oral Desensitization in Papular Urticaria in Children

Tropical Doctor ◽

10.1177/004947550203200307 ◽

2002 ◽

Vol 32 (3) ◽

pp. 142-145 ◽

Cited By ~ 2

Author(s):

Susana Giraldi ◽

Ramón Ruiz-Maldonado ◽

Lourdes Tamayo ◽

Cristina Sosa-de-Martínez

Keyword(s):

Vaccine Efficacy ◽

Oral Vaccine ◽

Effective Means ◽

Controlled Study ◽

Double Blind ◽

Double Blind Placebo ◽

Before And After ◽

Insect Bites ◽

Oral Desensitization

Papular urticaria (PU) is among the commonest skin ailments in children. Induced specific desensitization to insect bites is theoretically an effective means of prevention of PU. In this double blind placebo controlled study, an oral vaccine prepared from insect saliva was compared with placebo (stable vaccine solvent). Vaccine and placebo effectiveness were tested by counting active PU lesions, serum eosinophils, and IgE, before and after 4 months of treatment. Statistically significant differences between oral vaccine and placebo were not found in the clinical or the immunological variables tested. We conclude that, although a lack of oral vaccine efficacy was suspected, larger study samples are needed to strengthen our conclusion.

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