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The Carba Mix—In Vitro Investigations of Potential Cocktail Effects in Patch Tests With Rubber Allergens

Ljungberg Silic, Linda LU ; de Ávila, Renato Ivan LU ; Carreira-Santos, Sofía LU ; Merényi, Gábor LU ; Bergendorff, Ola LU and Zeller, Kathrin S. LU orcid (2025) In Contact Dermatitis
Abstract

Background: The carba mix is used to screen rubber chemical allergy and consists of three rubber sensitising chemicals: 1% (w/w) zinc diethyldithiocarbamate (ZDEC), 1% (w/w) zinc dibutyldithiocarbamate (ZDBC) and 1% (w/w) 1,3-diphenylguanidine (DPG), all in petrolatum. However, carba mix patch test results can be difficult to interpret, which may be linked to so-called ‘cocktail’ effects. Objectives: The carba mix was used as a ‘model mixture’ to better understand human reactions observed in clinical patch testing. Methods: We investigated the responses of a human cell model resembling dendritic cells to the carba mix single constituents ZDEC, ZDBC and DPG and to predefined mixtures capturing the molar composition of the carba mix using... (More)

Background: The carba mix is used to screen rubber chemical allergy and consists of three rubber sensitising chemicals: 1% (w/w) zinc diethyldithiocarbamate (ZDEC), 1% (w/w) zinc dibutyldithiocarbamate (ZDBC) and 1% (w/w) 1,3-diphenylguanidine (DPG), all in petrolatum. However, carba mix patch test results can be difficult to interpret, which may be linked to so-called ‘cocktail’ effects. Objectives: The carba mix was used as a ‘model mixture’ to better understand human reactions observed in clinical patch testing. Methods: We investigated the responses of a human cell model resembling dendritic cells to the carba mix single constituents ZDEC, ZDBC and DPG and to predefined mixtures capturing the molar composition of the carba mix using transcriptomic approaches and immunological and biochemical assays. Results: We detected unique cell responses to individual chemicals, where DPG was inducing ROS production and affecting autophagic flux. The combination of ZDEC, ZDBC and DPG induced higher levels of IL-8 secretion than expected based on the IL-8 levels in response to single chemical exposures. Conclusions: The data collected in this study support the hypothesis that the carba mix can give rise to cocktail effects. Considering exposure profiles, patch testing with separate carba mix sensitisers may be more appropriate.

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Please use this url to cite or link to this publication:
author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
allergic contact dermatitis, carba mix, dendritic cell models, rubber accelerators, rubber chemicals, transcriptomic approach
in
Contact Dermatitis
publisher
Wiley-Blackwell
external identifiers
  • scopus:105009840285
  • pmid:40605442
ISSN
0105-1873
DOI
10.1111/cod.14833
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025 The Author(s). Contact Dermatitis published by John Wiley & Sons Ltd.
id
25eb72b3-cd76-42aa-ae4b-922a1e1bdfe2
date added to LUP
2025-08-14 17:32:36
date last changed
2025-08-16 02:54:17
@article{25eb72b3-cd76-42aa-ae4b-922a1e1bdfe2,
  abstract     = {{<p>Background: The carba mix is used to screen rubber chemical allergy and consists of three rubber sensitising chemicals: 1% (w/w) zinc diethyldithiocarbamate (ZDEC), 1% (w/w) zinc dibutyldithiocarbamate (ZDBC) and 1% (w/w) 1,3-diphenylguanidine (DPG), all in petrolatum. However, carba mix patch test results can be difficult to interpret, which may be linked to so-called ‘cocktail’ effects. Objectives: The carba mix was used as a ‘model mixture’ to better understand human reactions observed in clinical patch testing. Methods: We investigated the responses of a human cell model resembling dendritic cells to the carba mix single constituents ZDEC, ZDBC and DPG and to predefined mixtures capturing the molar composition of the carba mix using transcriptomic approaches and immunological and biochemical assays. Results: We detected unique cell responses to individual chemicals, where DPG was inducing ROS production and affecting autophagic flux. The combination of ZDEC, ZDBC and DPG induced higher levels of IL-8 secretion than expected based on the IL-8 levels in response to single chemical exposures. Conclusions: The data collected in this study support the hypothesis that the carba mix can give rise to cocktail effects. Considering exposure profiles, patch testing with separate carba mix sensitisers may be more appropriate.</p>}},
  author       = {{Ljungberg Silic, Linda and de Ávila, Renato Ivan and Carreira-Santos, Sofía and Merényi, Gábor and Bergendorff, Ola and Zeller, Kathrin S.}},
  issn         = {{0105-1873}},
  keywords     = {{allergic contact dermatitis; carba mix; dendritic cell models; rubber accelerators; rubber chemicals; transcriptomic approach}},
  language     = {{eng}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Contact Dermatitis}},
  title        = {{The Carba Mix—In Vitro Investigations of Potential Cocktail Effects in Patch Tests With Rubber Allergens}},
  url          = {{http://dx.doi.org/10.1111/cod.14833}},
  doi          = {{10.1111/cod.14833}},
  year         = {{2025}},
}