title: Efficacy of oral hyposensitization in allergic contact dermatitis caused by nickel.
abstract: BACKGROUND
  Nickel contact allergy remains common in Western countries, and the dermatitis may require prolonged treatment. The development of new strategies aimed at improving the quality of life of affected individuals is needed.
  
  
  OBJECTIVE
  To investigate the efficacy of oral hyposensitization in nickel-allergic individuals and how this affects in vitro T cell responsiveness to the metal.
  
  
  METHODS
  Twenty-eight nickel-allergic patients received a daily dose of 50 µg of elemental nickel (given as NiSO(4) ·6H(2) O) in cellulose capsules for 3 months. Severity of clinical manifestations, in vivo nickel responsiveness and in vitro T cell responses to the metal were assessed after 1 and 3 months.
  
  
  RESULTS
  Twenty-six patients finished the study. In these patients, oral hyposensitization ameliorated clinical manifestations despite continued nickel exposures, and increased the threshold of skin responsiveness to nickel. The 12 enrolled patients in the immunological study showed decreased in vitro T lymphocyte responsiveness to the metal, in terms of both cell proliferation and cytokine release. In the 1-year follow-up, 50% of the patients experienced relapses of the clinical manifestations at sites of topical exposure to nickel.
  
  
  CONCLUSIONS
  Our study suggested therapeutic efficacy of oral hyposensitization in allergic individuals. Placebo-controlled studies are required to confirm the results and determine the optimal therapeutic regimen for prolonged beneficial effects.
authors.affiliation: Section of Dermatology, Department of Internal Medicine, Immunology and Infectious Diseases, University of Bari, 70124 Bari, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Bonamonte
authors.forename: Antonio
authors.initials: A
authors.lastname: Cristaudo
authors.forename: Francesca
authors.initials: F
authors.lastname: Nasorri
authors.forename: Teresa
authors.initials: T
authors.lastname: Carbone
authors.forename: Ornella
authors.initials: O
authors.lastname: De Pità
authors.forename: Gianni
authors.initials: G
authors.lastname: Angelini
authors.forename: Andrea
authors.initials: A
authors.lastname: Cavani
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D018791:CD4 Lymphocyte Count; D049109:Cell Proliferation; D002478:Cells, Cultured; D016207:Cytokines / Q000378:metabolism; D017449:Dermatitis, Allergic Contact / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology*; D003888:Desensitization, Immunologic; D005260:Female; D006801:Humans; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D009532:Nickel / Q000009:adverse effects / Q000276:immunology* / Q000627:therapeutic use*; D010328:Patch Tests; D012008:Recurrence; D012720:Severity of Illness Index; D013601:T-Lymphocytes / Q000166:cytology / Q000276:immunology* / Q000378:metabolism; D050378:T-Lymphocytes, Regulatory; D055815:Young Adult
chemical_list: D016207:Cytokines; D009532:Nickel