Environmental Exposure to Heavy Metals, Nanoparticles, and Emergent Contaminants and Risk of Allergic Diseases

NCT ID: NCT06529913

Last Updated: 2024-08-01

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

280 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-10-01

Study Completion Date

2026-12-31

Brief Summary

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The goal of this clinical trial is to collect environmental, bio-humoral, and clinical data derived from patients with allergic contact dermatitis (ACD) and systemic metal allergic syndromes related to the exposure to heavy metals, nanoparticles, and emergent contaminants and from healthy subjects.

The main question it aims to answer is: are environmental, bio-humoral, and clinical data derived from patients with ACD and systemic metal allergic syndromes, related to the exposure to heavy metals, nanoparticles, and emergent contaminants, different from ones obtained by healthy subjects? Researchers will compare serum and urine concentration of heavy metals and nanoparticles, patch test to metals, within-breath analysis of oscillometry parameters, serum zonulin, and serum levels of protein oxidation products among patients with systemic allergic syndrome (1st study group), patients with ACD (2nd study group) and healthy subjects (3rd study group).

Participants will undergo:

* measurement of exposure to heavy metals and nanoparticles including nickel, cobalt, chromium, palladium, molybdenum, aluminium, and copper, through serum and urine measurement of concentration.
* Patch test to before mentioned metals.
* Within-breath analysis of oscillometry parameters.
* Measurement of serum zonulin (related to gastro-intestinal exposure).
* Measurement of serum levels of protein oxidation products (as markers of systemic oxidative stress).

Detailed Description

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Heavy metals \[nickel (Ni), cobalt (Co), chromium (Cr), palladium, molybdenum, aluminium, and copper\] are environmental contaminants able to impact on host cells of humans and various organisms, potentially causing serious damage. These metals can be present also in form of nanoparticles.

Nanoparticles are tiny particles between 1 and 100 nanometres in size. Nanoparticles have applications in a wide range of fields, including medicine, electronics, energy, and environmental remediation. However, the potential environmental and health risks associated with nanoparticles are also focus of global research.

The research on metal allergies in exposed subjects is challenging since the exposures are common both at the workplace and outside.

Environmental exposures are important for development of allergic contact dermatitis (ACD).

ACD is a common skin disorder caused by contact with an exogenous substance that elicits a hypersensitivity response in susceptible individuals.

Among workers exposed to such irritants and allergens at work, ACD is a common occupational health problem with a significant incidence. According to the most recent scientific studies, the overall prevalence of ACD between 1996 and 2019 is estimated at 10.5 per cent.

In some individuals, the ingestion of Ni-rich foods causes systemic skin disorders (urticaria/angioedema, erythema, eczema) and extracutaneous multi-organ symptoms (heartburn, meteorism, abdominal pain, alvo, oral aphthosis, headache, respiratory disorders, recurrent infections, fibromyalgia), expressed singularly or in variable association in some particularly sensitive subjects. This clinical picture is known as Systemic Nickel Allergy Syndrome (SNAS), which occurs in approximately 20% of ACD individuals.

Researchers will collect environmental, bio-humoral, and clinical data derived from patients with ACD and systemic metal allergic syndromes related to the exposure to heavy metals, nanoparticles, and emergent contaminants, and compare with ones obtained from healthy subjects to identify susceptibility / risk factors for these diseases.

Patients with systemic allergic syndrome (1st study group) and patients with ACD (2nd study group) will undergo the measurement of exposure to heavy metals and nanoparticles including Ni, Co, Cr, palladium, molybdenum, aluminium, and copper. Furthermore, putative effect biomarkers (patch test to metals, within-breath analysis of oscillometry parameters, and serum zonulin, related to cutaneous, respiratory, and gastro-intestinal exposure, respectively, and serum levels of protein oxidation products, as markers of systemic oxidative stress) and exposure biomarkers (serum and urinary metal concentrations) will be researched in both groups. The same investigation will be conducted on healthy subjects (3rd study group).

Conditions

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Allergic Contact Dermatitis Metal Allergy Food Allergy Nickel Sensitivity Nickel; Eczema Aluminum Allergy Chromium; Eczema Functional Gastrointestinal Disorders Respiratory Injury Pollution; Exposure Pollution Related Respiratory Disorder Environmental Exposure Environment Related Disease Environmental Illness Oxidative Stress Risk Reduction

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Allergic contact dermatitis to metals

Patients with allergic contact dermatitis due to metal exposure (nickel, cobalt, chromium, palladium, molybdenum, aluminium, and copper).

Group Type EXPERIMENTAL

Collection of environmental, biological, and clinical data

Intervention Type DIAGNOSTIC_TEST

All enrolled patients/healthy volunteers will undergo:

* measurement of serum and urine concentration of metals (nickel, cobalt, chromium, palladium, molybdenum, aluminium, and copper).
* Patch test to metals.
* Within-breath analysis of oscillometry parameters.
* Measurement of serum zonulin.
* Measurement of serum levels of protein oxidation products.

Systemic allergic syndromes to metals

Patients with systemic allergic syndrome due to metal exposure (nickel, cobalt, chromium, palladium, molybdenum, aluminium, and copper).

Group Type EXPERIMENTAL

Collection of environmental, biological, and clinical data

Intervention Type DIAGNOSTIC_TEST

All enrolled patients/healthy volunteers will undergo:

* measurement of serum and urine concentration of metals (nickel, cobalt, chromium, palladium, molybdenum, aluminium, and copper).
* Patch test to metals.
* Within-breath analysis of oscillometry parameters.
* Measurement of serum zonulin.
* Measurement of serum levels of protein oxidation products.

Healthy volunteers

Healthy volunteers without metal exposure (nickel, cobalt, chromium, palladium, molybdenum, aluminium, and copper).

Group Type EXPERIMENTAL

Collection of environmental, biological, and clinical data

Intervention Type DIAGNOSTIC_TEST

All enrolled patients/healthy volunteers will undergo:

* measurement of serum and urine concentration of metals (nickel, cobalt, chromium, palladium, molybdenum, aluminium, and copper).
* Patch test to metals.
* Within-breath analysis of oscillometry parameters.
* Measurement of serum zonulin.
* Measurement of serum levels of protein oxidation products.

Interventions

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Collection of environmental, biological, and clinical data

All enrolled patients/healthy volunteers will undergo:

* measurement of serum and urine concentration of metals (nickel, cobalt, chromium, palladium, molybdenum, aluminium, and copper).
* Patch test to metals.
* Within-breath analysis of oscillometry parameters.
* Measurement of serum zonulin.
* Measurement of serum levels of protein oxidation products.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* adult subjects (over 18 years of age).
* Subjects suffering from allergic contact dermatitis due to metals.
* Subjects with systemic allergic syndrome due to metals.
* Adult healthy subjects.
* Subjects able to give written informed consent.

Exclusion Criteria

* Subjects under the age of 18years.
* Pregnant/breastfeeding women.
* Subjects suffering from chronic renal failure requiring replacement treatment.
* Subjects suffering from other systemic pathologies related to exposure to metals.
* Subjects suffering from gastrointestinal diseases such as celiac disease, chronic inflammatory intestinal diseases, tumors, other skin diseases.
* Subjects unable to express written informed consent.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Bologna

OTHER

Sponsor Role collaborator

Fondazione Policlinico Universitario Agostino Gemelli IRCCS

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Angela Rizzi, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Fondazione Policlinico Universitario A. Gemelli, IRCCS

Locations

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Università di Bologna

Bologna, , Italy

Site Status

Fondazione Policlinico Universitario A. Gemelli IRCCS

Roma, , Italy

Site Status

Countries

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Italy

Central Contacts

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Angela Rizzi, MD, PhD

Role: CONTACT

+390630154952

Raffaella Chini, MD

Role: CONTACT

+390630154952

Facility Contacts

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Pierpaolo Palumbo, PhD

Role: primary

Angela Rizzi, MD

Role: primary

+390630154952

Raffaella Chini, MD

Role: backup

+390630154952

References

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Rizzi A, Lo Presti E, Chini R, Gammeri L, Inchingolo R, Lohmeyer FM, Nucera E, Gangemi S. Emerging Role of Alarmins in Food Allergy: An Update on Pathophysiological Insights, Potential Use as Disease Biomarkers, and Therapeutic Implications. J Clin Med. 2023 Apr 4;12(7):2699. doi: 10.3390/jcm12072699.

Reference Type BACKGROUND
PMID: 37048784 (View on PubMed)

Rizzi A, Chini R, Porcari S, Settanni CR, Persichetti E, Mora V, Fanali C, Leonetti A, Parrinello G, Lohmeyer FM, Inchingolo R, Mele MC, Gasbarrini A, Nucera E. Datterino Trial: A Double Blind, Randomized, Controlled, Crossover, Clinical Trial on the Use of Hydroponic Cultivated Tomato Sauce in Systemic Nickel Allergy Syndrome. J Clin Med. 2022 Sep 16;11(18):5459. doi: 10.3390/jcm11185459.

Reference Type BACKGROUND
PMID: 36143107 (View on PubMed)

Nucera E, Rizzi A, Chini R, Giangrossi S, Lohmeyer FM, Parrinello G, Musca T, Miggiano GAD, Gasbarrini A, Inchingolo R. Diet Intervention Study through Telemedicine Assistance for Systemic Nickel Allergy Syndrome Patients during the COVID-19 Pandemic. Nutrients. 2021 Aug 23;13(8):2897. doi: 10.3390/nu13082897.

Reference Type BACKGROUND
PMID: 34445054 (View on PubMed)

Rizzi A, Chini R, Inchingolo R, Carusi V, Pandolfi F, Gasbarrini A, Nucera E. Nickel allergy in lipid transfer protein sensitized patients: Prevalence and clinical features. Int J Immunopathol Pharmacol. 2020 Jan-Dec;34:2058738420974895. doi: 10.1177/2058738420974895.

Reference Type BACKGROUND
PMID: 33242297 (View on PubMed)

Rizzi A, Di Rienzo A, Buonomo A, Aruanno A, Carusi V, Ricci AG, Centrone M, Mezzacappa S, Romeo L, Schiavino D, Inchingolo R, Gasbarrini A, Nucera E. Impact of nickel oral hyposensitization on quality of life in systemic nickel allergy syndrome. Int J Immunopathol Pharmacol. 2020 Jan-Dec;34:2058738420934629. doi: 10.1177/2058738420934629.

Reference Type BACKGROUND
PMID: 32567420 (View on PubMed)

Rizzi A, Nucera E, Laterza L, Gaetani E, Valenza V, Corbo GM, Inchingolo R, Buonomo A, Schiavino D, Gasbarrini A. Irritable Bowel Syndrome and Nickel Allergy: What Is the Role of the Low Nickel Diet? J Neurogastroenterol Motil. 2017 Jan 30;23(1):101-108. doi: 10.5056/jnm16027.

Reference Type BACKGROUND
PMID: 28049864 (View on PubMed)

Campanale M, Nucera E, Ojetti V, Cesario V, Di Rienzo TA, D'Angelo G, Pecere S, Barbaro F, Gigante G, De Pasquale T, Rizzi A, Cammarota G, Schiavino D, Franceschi F, Gasbarrini A. Nickel free-diet enhances the Helicobacter pylori eradication rate: a pilot study. Dig Dis Sci. 2014 Aug;59(8):1851-5. doi: 10.1007/s10620-014-3060-3. Epub 2014 Mar 5.

Reference Type BACKGROUND
PMID: 24595654 (View on PubMed)

Patriarca G, Schiavino D, Pecora V, Lombardo C, Pollastrini E, Aruanno A, Sabato V, Colagiovanni A, Rizzi A, De Pasquale T, Roncallo C, Decinti M, Musumeci S, Gasbarrini G, Buonomo A, Nucera E. Food allergy and food intolerance: diagnosis and treatment. Intern Emerg Med. 2009 Feb;4(1):11-24. doi: 10.1007/s11739-008-0183-6. Epub 2008 Aug 16.

Reference Type BACKGROUND
PMID: 18709496 (View on PubMed)

Veneroni C, Gobbi A, Pompilio PP, Dellaca R, Fasola S, La Grutta S, Leyva A, Porszasz J, Stornelli SR, Fuso L, Valach C, Breyer-Kohansal R, Breyer MK, Hartl S, Contu C, Inchingolo R, Hodgdon K, Kaminsky DA. Reference Equations for Within-Breath Respiratory Oscillometry in White Adults. Respiration. 2024;103(9):521-534. doi: 10.1159/000539532. Epub 2024 Jun 7.

Reference Type BACKGROUND
PMID: 38843786 (View on PubMed)

Other Identifiers

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PNC-PNRRDARE-PNC0000002

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

6628

Identifier Type: -

Identifier Source: org_study_id

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