Sensitizing Capacities and Cross-Reactivity Patterns of Some Diisocyanates and Amines Using the Guinea-Pig Maximization Test. Can p-phenylenediamine be Used as a Marker for Diisocyanate Contact Allergy?

Abstract

Background:Isocyanates are mainly considered respiratory allergens but can also cause contact allergy. Diphenylmethane-4,4′-diamine (4,4′-MDA) has been considered a marker for diphenylmethane-4,4′-diisocyanate (4,4′-MDI) contact allergy. Furthermore, overrepresentation of positive patch-test reactions top-phenylenediamine (PPD) in 4,4′-MDA positive patients have been reported.Objectives:To investigate the sensitizing capacities of toluene-2,4-diisocyanate (2,4-TDI) and PPD and the cross-reactivity of 4,4′-MDA, 2,4-TDI, dicyclohexylmethane-4,4′-diamine (4,4′-DMDA), dicyclohexylmethane-4,4′-diisocyanate (4,4′-DMDI), 4,4′-MDI and PPD.Methods:The Guinea Pig Maximization Test (GPMT) was used.Results:PPD was shown to be a strong sensitizer (p<0.001). Animals sensitized to PPD showed cross-reactivity to 4,4′-MDA (p<0.001). Animals sensitized to 4,4′-MDA did not show cross-reactivity to PPD. 8 animals sensitized to 2,4-TDI were sacrificed due to toxic reactions at the induction site and could thus not be fully evaluated.Conclusion:PPD was shown to be a strong sensitizer. However, it cannot be used as a marker for isocyanate contact allergy. On the other hand, positive reactions to 4,4′-MDA could indicate a PPD allergy. The intradermal induction concentration of 2,4-TDI (0.70% w/v) can induce strong local toxic reactions in guinea-pigs and should be lowered.