IgE-mediated hypersensitivity to chlorhexidine among first-year dental students
- 6 Downloads
To investigate immunoglobulin E (IgE)-mediated hypersensitivity to chlorhexidine (CHX), and association between CHX exposure and serum specific IgE (SIgE) levels, among first-year dental students.
Participants completed a questionnaire on medical health, history of allergies/hypersensitivities and CHX exposure. A sample of venous blood (3 mL) was drawn and subjected to SIgE test to CHX; sensitisation defined as SIgE level of ≥0.10 kUA/L.
Fifty-eight (98.3%) participants, consisting of 69% (n = 40) female with a mean age of 21, were recruited; three quarters (84%) reported no known health issue, and over half had no history of allergies (57%); less than 20% reported having had exposure to CHX-containing products with the majority from toothpaste (9%) and mouthwash (12%). The CHX SIgE test showed that 8.6% (n = 5) were sensitised. No association between CHX exposure history and the level of SIgE antibody was noted.
Although most participants reported no known exposure to CHX, 8.6% showed CHX sensitisation suggesting unknown exposure and the potential risk of developing hypersensitivity and adverse reactions in the future.
KeywordsImmunoCAP test IgE-mediated Occupational health Sensitisation Serum specific
American Association of Anaesthesiologists
Fundamental Research Grant Scheme
International Islamic University Malaysia
Institute of Medical Research
IIUM Research Ethics Committee
Medicines and Healthcare Products Regulatory Agency
Serum specific IgE
We would like to thank the Allergy and Immunology Research Centre, Institute of Medical Research (IMR), Kuala Lumpur, Malaysia, for the use of their allergy laboratory.
This study was funded by Fundamental Research Grant Scheme (FRGS/1/2015/SKK14/UKM/02/1).
Compliance with ethical guidelines
Conflict of interest
S.M. Khazin, D. Abdullah, A.K.C. Liew, N.A. Harun, N. Abdullah and B.S. Chong declare that they have no competing interests.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the International Islamic University Malaysia (IIUM) Research Ethics Committee (IREC no.: 770) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
- 3.Calogiuri GF, Di Leo E, Trautmann A, Nettis E, Ferrannini A, Vacca A. Chlorhexidine hypersensitivity: a critical and updated review. J Allergy Ther. 2013;4:1–7.Google Scholar
- 5.Medicines and Healthcare products Regulatory Agency (MHRA). Drug safety update: Chlorhexidine: reminder of potential for hypersensitivity. London: Department of Health. 2012. https://www.gov.uk/drug-safety-update/chlorhexidine-reminder-of-potential-for-hypersensitivity. Accessed 03.2019.Google Scholar
- 8.Thermo Fisher Scientific. Quality aspects on IgE antibody testing your results—our priority. Uppsala: ImmunoDiagnostics; 2016.Google Scholar
- 10.Hamilton RG, Matsson PNJ, Adkinson NF Jr, Chan S, Hovanec-Burns D, Kleine-Tebbe-J, Magnusson C, Renz HVCM. Analytical performance characteristics, quality assurance, and clinical utility of immunological assays for human immunoglobulin E antibodies of defined allergen specificities. 3rd ed. Wayne: Clinical and Laboratory Standards Institute; 2017. ILA20.Google Scholar
- 17.Opstrup MS, Poulsen LK, Malling HJ, Jensen BM, Garvey LH. Dynamics of plasma levels of specific IgE in chlorhexidine allergic patients with and without accidental re-exposure Experimental Allergy. Clin Exp Allergy. 2016;00:1–7.Google Scholar
- 20.Australasian Society of Clinical Immunology and Allergy Limited (ASCIA). Chlorhexidine allergy. 2017. https://www.allergy.org.au/patients/drug-allergy/chlorhexidine-allergy. Accessed 01.2019.Google Scholar
- 22.Rani L. Sterilization protocols in dentistry—A review. Int J Pharm Sci Res. 2016;8:558–64.Google Scholar