Unexpected positive patch test reactions to sesquiterpene lactones in patients sensitized to the glucose sensor FreeStyle Libre
(2019) In Contact Dermatitis 81(5). p.354-367- Abstract
Background: Most diabetic patients sensitized to FreeStyle Libre react to isobornyl acrylate (IBOA), with a considerable number of them also showing unexpected positive patch test reactions to sesquiterpene lactone (SL) mix (SLM) tested in the baseline series. Objectives: To compile patch test results of subjects affected, and provide potential explanations for this association. Patients and Methods: Fifty-three Freestyle Libre-allergic patients were patch tested with IBOA and/or SLM, and several were also patch tested with the components of SLM. Chromatographic analyses were performed on the glucose sensor, IBOA, and the components of SLM. Results: Thirty-three patients reacted positively to the components of SLM, and 11 of 27 patients... (More)
Background: Most diabetic patients sensitized to FreeStyle Libre react to isobornyl acrylate (IBOA), with a considerable number of them also showing unexpected positive patch test reactions to sesquiterpene lactone (SL) mix (SLM) tested in the baseline series. Objectives: To compile patch test results of subjects affected, and provide potential explanations for this association. Patients and Methods: Fifty-three Freestyle Libre-allergic patients were patch tested with IBOA and/or SLM, and several were also patch tested with the components of SLM. Chromatographic analyses were performed on the glucose sensor, IBOA, and the components of SLM. Results: Thirty-three patients reacted positively to the components of SLM, and 11 of 27 patients reacted positively to alantolactone, in particular. Gas chromatography-mass spectrometry (GC-MS) analyses did not detect these chemicals in the different parts of the glucose sensor, or in IBOA. Conclusion: Significant co-sensitizations between SLs on the one hand and the glucose sensor FreeStyle Libre and/or isobornyl acrylate on the other hand exist, without evidence of the presence of SLs via GC-MS analysis. Cross-reactions between them seem improbable. As a possible hypothesis, a common precursor for both, such as camphene, may exist. Highlights: Of the diabetic patients sensitized to the glucose sensor FreeStyle Libre and/or IBOA, 62.3% reacted positively to SLM. Cross-reactions between IBOA and the three components of SLM (alantolactone, costunolide, and dehydrocostus lactone) seem unlikely, because of their different spatial structures. Co-sensitization between IBOA and SLS can be explained by the fact that there is a common precursor, such as camphene, between these two molecules.
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- author
- Herman, Anne ; Mowitz, Martin LU ; Aerts, Olivier ; Pyl, Jeroen ; de Montjoye, Laurence ; Goossens, An ; Bruze, Magnus LU and Baeck, Marie
- organization
- publishing date
- 2019-06-05
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- allergic contact dermatitis, chemical analysis, diabetes mellitus, FreeStyle Libre, GC-MS, glucose sensor, isobornyl acrylate, medical device, sesquiterpene lactones, simultaneous reactions
- in
- Contact Dermatitis
- volume
- 81
- issue
- 5
- pages
- 354 - 367
- publisher
- Wiley-Blackwell
- external identifiers
-
- scopus:85069855868
- pmid:31166016
- ISSN
- 0105-1873
- DOI
- 10.1111/cod.13330
- language
- English
- LU publication?
- yes
- id
- 2455fc63-e539-4bbd-9124-42ab883d9579
- date added to LUP
- 2019-08-26 15:44:19
- date last changed
- 2024-04-16 18:38:42
@article{2455fc63-e539-4bbd-9124-42ab883d9579,
abstract = {{<p>Background: Most diabetic patients sensitized to FreeStyle Libre react to isobornyl acrylate (IBOA), with a considerable number of them also showing unexpected positive patch test reactions to sesquiterpene lactone (SL) mix (SLM) tested in the baseline series. Objectives: To compile patch test results of subjects affected, and provide potential explanations for this association. Patients and Methods: Fifty-three Freestyle Libre-allergic patients were patch tested with IBOA and/or SLM, and several were also patch tested with the components of SLM. Chromatographic analyses were performed on the glucose sensor, IBOA, and the components of SLM. Results: Thirty-three patients reacted positively to the components of SLM, and 11 of 27 patients reacted positively to alantolactone, in particular. Gas chromatography-mass spectrometry (GC-MS) analyses did not detect these chemicals in the different parts of the glucose sensor, or in IBOA. Conclusion: Significant co-sensitizations between SLs on the one hand and the glucose sensor FreeStyle Libre and/or isobornyl acrylate on the other hand exist, without evidence of the presence of SLs via GC-MS analysis. Cross-reactions between them seem improbable. As a possible hypothesis, a common precursor for both, such as camphene, may exist. Highlights: Of the diabetic patients sensitized to the glucose sensor FreeStyle Libre and/or IBOA, 62.3% reacted positively to SLM. Cross-reactions between IBOA and the three components of SLM (alantolactone, costunolide, and dehydrocostus lactone) seem unlikely, because of their different spatial structures. Co-sensitization between IBOA and SLS can be explained by the fact that there is a common precursor, such as camphene, between these two molecules.</p>}},
author = {{Herman, Anne and Mowitz, Martin and Aerts, Olivier and Pyl, Jeroen and de Montjoye, Laurence and Goossens, An and Bruze, Magnus and Baeck, Marie}},
issn = {{0105-1873}},
keywords = {{allergic contact dermatitis; chemical analysis; diabetes mellitus; FreeStyle Libre; GC-MS; glucose sensor; isobornyl acrylate; medical device; sesquiterpene lactones; simultaneous reactions}},
language = {{eng}},
month = {{06}},
number = {{5}},
pages = {{354--367}},
publisher = {{Wiley-Blackwell}},
series = {{Contact Dermatitis}},
title = {{Unexpected positive patch test reactions to sesquiterpene lactones in patients sensitized to the glucose sensor FreeStyle Libre}},
url = {{http://dx.doi.org/10.1111/cod.13330}},
doi = {{10.1111/cod.13330}},
volume = {{81}},
year = {{2019}},
}