Immunoreactivity to Cocoa and Nickel in Atopic and Allergic Contact Dermatitis
Celso Eduardo Olivier *
Instituto Alergoimuno de Americana, Brazil.
Daiana Guedes Pinto
Instituto Alergoimuno de Americana, Brazil.
Ana Paula Monezzi Teixeira
Instituto Alergoimuno de Americana, Brazil.
Cibele Silva Miguel
Instituto Alergoimuno de Americana, Brazil.
Jhéssica Letícia Santos Santana
Instituto de Ensino e Pesquisa do Hospital de Amor de Barretos, Brazil.
Regiane Patussi Santos Lima
Lavoisier Laboratórios, São Paulo, Brazil.
Nicole Sartoreto Rocha
Faculdade de Americana, São Paulo, Brazil.
Raquel Acácia Pereira Gonçalves Santos
Instituto Alergoimuno de Americana, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Background: Cocoa is one of the foods more consistently associated with high nickel content, a metal that functions as a hapten responsible for various non–IgE-mediated symptomatic hypersensitivities.
Aim: The present study is a proof-of-concept that hypothesizes that LAIT and the TTP may differentiate diverse degrees of cellular and humoral immunoreactivity against cocoa extract and a nickel solution, as well to verify some sort of cross-reactivity between them in patients suffering from non–IgE-mediated Atopic and Allergic Contact Dermatitis.
Methodology: We examined the medical charts of two cohorts of patients clinically diagnosed with Intrinsic Atopic Dermatitis and Allergic Contact Dermatitis, who were simultaneously investigated with cocoa extract and nickel solution with the help of TTP or LAIT. The registered results of the semi-quantitative serum TTP against cocoa extract and nickel solution, as well as the registered results of the Leukocyte Adherence Inhibition (LAI) percentage promoted by the ex vivo challenges against a cocoa extract and a nickel solution, were distributed in ranges through a cascade distribution chart to outline the variability of the results inside the cohorts.
Results: The mean for the TTP for the cocoa extract was estimated at 1:385; the median at 1:512; and the SD at 1:180. The mean or the TTP for the nickel was estimated at 1:309; the median was 1:256; the SD was estimated at 1:199. The mean for for the Leukocyte Adherence Inhibition (LAI) the cocoa extract was 51.9%; the median was 56%; the SD was 26.3%. The mean for the LAI for nickel solution was 33%; the median was 33%; the SD was 26,6%. The Pearson correlation indicated that there is a significant medium positive relationship between TTP results between Cocoa (x-axis) and Nickel (y-axis), r(98) = .335; p < .001. The Pearson correlation indicated that there is a significant medium positive relationship between LAIT results between Cocoa (x-axis) and Nickel (y-axis), r(98) = .425; p < .001.
Conclusion: The results demonstrated a more significant immunoreactivity from the tests performed with cocoa extract than obtained with the nickel solution. These findings state that cocoa possesses other allergens responsible for cellular immunoreactivity besides nickel. This means that if a patient presents cellular immunoreactivity against cocoa, he/she will not necessarily present immunoreactivity against nickel; however, reciprocation is less probable.
Keywords: Cocoa, dermatitis, endotype, hypersensitivity, leukocyte adherence inhibition test, nickel, non–ige-mediated immunoreactivity, precipitins