Advanced

Unexpected positive patch test reactions to sesquiterpene lactones in patients sensitized to the glucose sensor FreeStyle Libre

Herman, Anne ; Mowitz, Martin LU ; Aerts, Olivier ; Pyl, Jeroen ; de Montjoye, Laurence ; Goossens, An ; Bruze, Magnus LU and Baeck, Marie (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.

(Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
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
Federation of European Neuroscience Societies and Blackwell Publishing Ltd
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
2020-01-16 04:03:59
@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},
  language     = {eng},
  month        = {06},
  number       = {5},
  pages        = {354--367},
  publisher    = {Federation of European Neuroscience Societies and Blackwell Publishing Ltd},
  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},
}