A Clinical Trial of Oral Hyposensitization in Systemic Allergy to Nickel

• Published in: International journal of immunopathology and pharmacology 2006-07, Vol.19 (3), p.593-600
• Main Authors: Schiavino, D., Nucera, E., Alonzi, C., Buonomo, A., Pollastrini, E., Roncallo, C., De Pasquale, T., Lombardo, C., La Torre, G., Sabato, V., Pecora, V., Patriarca, G.
• Format: Article
• Language: English
• Subjects: Administration, Oral; Adolescent; Adult; Aged; Child; Child, Preschool; Desensitization, Immunologic; Female; Humans; Hypersensitivity - therapy; Male; Middle Aged; Nickel - adverse effects; Skin Tests
• ISSN: 0394-6320; 2058-7384
• DOI: 10.1177/039463200601900315

Nickel allergy is the most common contact allergy. Some nickel-sensitive patients present systemic (cutaneous and/or digestive) symptoms related to the ingestion of high nickel-content foods, which significantly improve after a specific low nickel-content diet. The etiopathogenetic role of nickel in the genesis of systemic disorders is, furthermore, demonstrated by the relapse of previous contact lesions, appearance of widespread eczema and generalized urticaria-like lesions after oral nickel challenge test. The aim of this study is to investigate the safety and efficacy of a specific oral hyposensitization to nickel in patients with both local contact disorders and systemic symptoms after the ingestion of nickel-containing foods. Inclusion criteria for the recruitment of these patients were (other than a positive patch test) a benefit higher than 80% from a low nickel-content diet and a positive oral challenge with nickel. Based on the previous experiences, our group adopted a therapeutic protocol by using increasing oral doses of nickel sulfate associated to an elimination diet. Results have been excellent: this treatment has been effective in inducing clinical tolerance to nickel-containing foods, with a low incidence of side effects (gastric pyrosis, itching erythema).