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. 2022 Feb 16;33(2):161–175. doi: 10.1097/DER.0000000000000854

Weight of Evidence Approach for Skin Sensitization Potency Categorization of Fragrance Ingredients

Mihwa Na 1, Devin O'Brien 1, Maura Lavelle 1, Isabelle Lee 1, G Frank Gerberick 2, Anne Marie Api 1
PMCID: PMC8929305  PMID: 35170517

Background

Reliable human potency data are necessary for conducting quantitative risk assessments, as well as development and validation of new nonanimal methods for skin sensitization assessments. Previously, human skin sensitization potency of fragrance materials was derived primarily from human data or the local lymph node assay.

Objectives

This study aimed to define skin sensitization potency of fragrance materials via weight of evidence approach, incorporating all available human, animal, in vitro, in chemico, and in silico data.

Methods

All available data on 106 fragrance materials were considered to assign each material into 1 of the 6 defined potency categories (extreme, strong, moderate, weak, very weak, and nonsensitizer).

Results

None of the 106 materials were considered an extreme sensitizer, whereas a total of 6, 23, 41, and 26 materials were categorized as strong, moderate, weak, and very weak sensitizers, respectively. Ten materials lacked evidence for the induction of skin sensitization.

Conclusions

Skin sensitization potency categorization of the 106 fragrance materials based on the described weight of evidence approach can serve as a useful resource in evaluation of nonanimal methods, as well as in risk assessment.


Some fragrance materials have been identified as contact allergens, and they are known to express varying degrees of sensitizing potency.1 For consumers, clinicians, industry, and regulatory authorities, this allergenic potency is of considerable interest and importance. Determining the potency of skin allergens quantitatively is critical for assessing their risk of inducing skin sensitization in consumer products. The potency range of known allergens can encompass at least 5 orders of magnitude. This is consistent with the range of human no observed effect levels (NOELs) and EC3 values from the local lymph node assays (LLNAs).2,3 Dose per unit area is the well-established dose metric for skin sensitization,4,5 which is expressed as the total amount of allergen, typically in micrograms of allergen per square centimeter of the exposed skin. There are known allergens capable of inducing sensitization at exposure levels less than 1 μg/cm2, whereas others require exposure up to 10,000 μg/cm2.1,6 Historically, categorization of the sensitization potency of chemicals was based primarily on LLNA data, precisely the EC3 value.79 The EC3 value, calculated from the LLNA dose-response curve, is the concentration required to induce a positive threshold response, that is, a stimulation index (SI) of 3.8 The rationale for using EC3 values for potency categorization is that a reasonable degree of correlation has been shown between LLNA potency data and the available predictive human data.1014 In addition to LLNA data, other data may exist, including human data, which, when taken into consideration, can significantly improve the accuracy of determining the potency categorization of skin allergens.15,16

The level of topical exposure to a chemical required to induce skin sensitization is needed for risk assessment purposes. That threshold level of exposure is driven by the skin sensitization potency of the chemical, which is the quantity of chemical needed to induce sensitization.5 The concept of a risk assessment approach that relies on establishing a threshold level for the induction of skin sensitization has been described previously.12,1720 In 2008, a first methodological scheme for a skin sensitization quantitative risk assessment (QRA) of fragrance materials was published and subsequently implemented.21,22 Recently, an improved approach has been published, which is commonly referred to as QRA2.23 A solid understanding of a chemical's skin sensitization potency is critical to conducting sound risk assessments.23,24 The QRA process for skin sensitization involves deriving a no expected sensitization induction level (NESIL) and applying sensitization assessment factors to the NESIL to account for various areas of uncertainty to determine an acceptable exposure level. At this level, the risk of inducing skin sensitization is negligible. To establish the NESIL of a skin sensitizer, a human NOEL from a well-conducted human repeated insult patch test (HRIPT) is required.23 Beginning in 2020, the acronym CNIH (confirmation of no induction in humans) was suggested and implemented in place of HRIPT to highlight the confirmatory nature of HRIPTs conducted by the Research Institute for Fragrance Materials (RIFM).16 When CNIH data on a given skin sensitizer are unavailable, a read-across analog can be used to derive the NESIL, where available.25,26 In the absence of an appropriate read-across analog, the exposure is benchmarked to the dermal sensitization threshold. If the current exposure exceeds the dermal sensitization threshold, the generation of additional data is recommended.25

The goal of this article is to use a weight of evidence (WoE) approach to set skin sensitization potency categories (extreme, strong, moderate, weak, very weak, and nonsensitizer) for well-tested fragrance materials using all available data that could be evaluated to infer the chemical's skin sensitization potency. To achieve this goal, a great deal of expert judgment is required to analyze the available data. The decision-making process and the data considered are described in this article. Herein, 106 fragrance materials were assigned skin sensitization potency categories based on the review of all available information, including human, LLNA, in silico chemistry predictions, in chemico, and in vitro data. In some instances, other historical in vivo data (guinea pig), exposure use levels, and/or human diagnostic patch test data were used as secondary input data to aid in assigning an appropriate skin sensitization potency category.

Previous efforts have focused on the categorization of fragrance ingredients using primarily LLNA or human data.13,6,9 Human testing is never used to identify the skin sensitization hazard of fragrance materials. It is also not used to identify “the lowest observed effect level (LOEL),” a threshold level at which a material induces skin sensitization. Rather, human testing is typically conducted at a single dose to confirm a NOEL, and the NOEL can be close or well below the threshold of the induction of sensitization. A historical LOEL, in addition to NOEL, can help derive the threshold, but LOELs are not always available. For this reason, the NOELs from human studies alone may not correlate well with the actual potency of a given material.

It is the authors' opinion that using a WoE approach, which considers and evaluates all available skin sensitization data, is a more robust and accurate way for determining the potency categorization of fragrance ingredients for humans. This comprehensive WoE categorization approach may also aid in development of new alternative methods (in vitro, in silico, in chemico) for determining the skin sensitization potency of new or existing chemicals.

MATERIALS AND METHODS

The Data Set

Human, animal, in vitro, in chemico, and in silico data on 106 fragrance materials were evaluated to allocate each material a WoE potency category. These materials were chosen based on the availability of existing in vivo data. One hundred of these materials are discrete chemicals with known structure, whereas 6 are natural complex substances (NCSs). Natural complex substances are fragrance ingredients of botanical origin such as essential oils and absolutes. These are essentially complex mixtures of multiple chemicals.

Table 2 shows the data set evaluated in this study, which includes data that were available before December 2019 in the RIFM Database (consisting of publicly available and proprietary data, https://rifmdatabase.rifm.org), as well as in publicly available information sources such as ECHA (https://echa.europa.eu/) and PubMed (https://www.ncbi.nlm.nih.gov/pubmed).

Human NOELs obtained from CNIHs and/or human maximization tests (HMTs) were available for all assessed materials. These NOELs represent maximum levels tested without inducing skin sensitization in participating subjects but may not be the highest threshold levels at which skin sensitization is not induced. When available, higher weight was given to CNIHs conducted according to the standard protocol described hereinafter, because they involved more subjects.27 In addition, the ethanol-based vehicles were used in the CNIHs, which is more relevant to the typical use of fragrance materials than other vehicles. Human LOELs obtained from CNIHs and/or HMTs were available for 35 materials, and these were approximately 1.2- to 13-fold higher than the respective NOELs. It should be noted that no new human data were generated for the current work.

Local lymph node assay data were available for 105 materials. Positive responses were noted for 66 materials, and their EC3 values were considered for potency categorization. It should also be noted that no new animal data were generated for the current work.

The induction of skin sensitization is initiated by covalent binding of the substance to skin proteins. Based on the chemical structure, protein binding alerts of 100 materials and their mechanistic domains of the reactivity were predicted using an in silico tool, Organization for Economic Cooperation and Development (OECD) QSAR toolbox 4.2 (http://www.qsartoolbox.org) and OASIS TIMES-SS (http://www.oasis-lmc.org). The chemical reactivity predictions were not available for the remaining 6 materials, because they are NCSs.

In chemico and in vitro data are also summarized (Table 2). Direct peptide reactivity assay (DPRA), KeratinoSens, and h-CLAT data were available on 104, 106, and 104 materials, respectively.

TABLE 2.

Weight of Evidence Categorization of the Fragrance Materials and the Summary of Main Data Considered

CAS Number Chemical Name Category Call Based on WoE Human NOEL*, μg/cm2 Human LOEL†, μg/cm2 LLNA, EC3, μg/cm2 DPRA, Peptide Reactivity KeratinoSens h-CLAT Protein Binding Alerts for Skin Sensitization, Toolbox 4.2 Parent Prediction, TIMES-SS Metabolite Prediction, TIMES-SS
6728-26-3 Hexen-2-al Strong 18 236 1012 [2] High Positive Positive Michael Addition Strong sensitizer Nonsensitizer
111-80-8 Methyl-2-nonynoate Strong 24 118 <1250, estimated 625 High Positive Positive Michael Addition Strong sensitizer Nonsensitizer
111-12-6 Methyl heptine carbonate Strong 118 194 112.5; <125; NC (250) High Positive Positive Michael Addition Strong sensitizer Nonsensitizer
358331-95-0 5,6,7-Trimethylocta-2,5-dien-4-one Strong 250 N/A 400 Inconclusive Positive Positive Nucleophilic addition
Michael Addition
Strong sensitizer
93893-89-1 3-Methyl-5-phenylpent-2-enenitrile Strong 275 N/A 192.5 Minimal Negative Positive No alert found Nonsensitizer Nonsensitizer
17373-89-6 2-Hexylidene cyclopentanone Strong 300 500 600 No data Positive No data Michael Addition
1604-28-0 6-Methyl-3,5-heptadien-2-one Moderate 118 1299 NC (1250) Low Positive Positive Michael Addition Strong sensitizer Strong sensitizer
93-51-6 2-Methoxy-4-methylphenol Moderate 118 N/A 1450 Minimal Negative Positive No alert found Nonsensitizer Strong sensitizer
97-54-1 Isoeugenol Moderate 250 775 500 [48] High Positive Negative No alert found Nonsensitizer Strong sensitizer
84650-60-2 Tea leaf absolute Moderate 480 N/A NC (1250) High Negative Positive N/A N/A N/A
68991-97-9 1,2,3,4,5,6,7,8-Octahydro-8,8-dimethyl-2-naphthaldehyde Moderate 550 N/A 1050 Minimal Negative Positive Schiff base formation Weak sensitizer Weak sensitizer
3658-77-3 4-Hydroxy-2,5-dimethyl-3(2H)-furanone Moderate 591 1181 450 High Negative Positive No alert found Nonsensitizer Weak sensitizer
122-78-1 Phenylacetaldehyde Moderate 591 1181 962 [2] Moderate Positive Positive Schiff base formation Strong sensitizer Nonsensitizer
104-55-2 Cinnamic aldehyde Moderate 591 775 262 [22] High Positive Positive Schiff base formation Strong sensitizer Nonsensitizer
33662-58-7 Methyl 2,4-dihydroxy-m-toluate Moderate 620 N/A 2200 Inconclusive Positive Positive No alert found Nonsensitizer Strong sensitizer
7493-74-5 Allyl phenoxyacetate Moderate 709 N/A 775 Minimal Positive Negative SN2 Strong sensitizer Strong sensitizer
2111-75-3 p-Mentha-1,8-dien-7-al Moderate 709 2760 2175 [2] Moderate Positive Positive Schiff base formation Michael Addition Strong sensitizer Nonsensitizer
90028-67-4 Treemoss, treemoss absolute Moderate 700 1417 2162.5 [2] High Positive Positive N/A N/A N/A
17369-59-4 3-Propylidenephthalide Moderate 945 2760 350; <1250 Low Negative Positive Acylation Strong sensitizer
1885-38-7 Cinnamyl nitrile Moderate 1063 1250 NC (2500) Minimal Positive Positive No alert found Nonsensitizer Strong sensitizer
68683-20-5 Menthadiene-7-methyl formate Moderate 1063 6900 NC (2500) Low Positive Positive No alert found Nonsensitizer Weak sensitizer
18127-01-0 p-tert-Butyldihydrocinnamaldehyde Moderate 1181 N/A 1075 Low Negative Positive Schiff base formation Weak sensitizer Nonsensitizer
5392-40-5 Citral Moderate 1417 3876 1414 [11] High Positive Positive Schiff base formation Strong sensitizer Nonsensitizer
8022-96-6 Jasmine absolute (grandiflorum) Moderate 1400 2069 1475 Low Positive Positive N/A N/A N/A
8006-81-3 Ylang-ylang Moderate 1771 N/A 1700 Minimal Positive Positive N/A N/A N/A
105-13-5 Anisyl alcohol Moderate 1771 N/A 1475 High Negative Positive No alert found Nonsensitizer Strong sensitizer
103-50-4 Dibenzyl ether Moderate 2362 N/A 1575 Minimal Positive Positive No alert found Nonsensitizer Weak sensitizer
90028-68-5 Oakmoss absolute, low atranol Moderate 700 N/A 3775 [6]; NC (7500); NC (12,500); NC (625) High Positive Positive N/A N/A N/A
56973-85-4 1-(5,5-Dimethyl-1-cyclohexen-1-yl)pent-4-en-1-one Moderate 2500 N/A 747 Minimal Positive Positive Michael Addition Strong sensitizer
100-52-7 Benzaldehyde Weak 590 2760 NC (6250) Minimal Positive Positive No alert found Nonsensitizer Nonsensitizer
122-03-2 Cuminic aldehyde Weak 1181 N/A NC (2500) Low Negative Borderline Schiff base formation Weak sensitizer Weak sensitizer
7775-00-0 3-(p-Isopropylphenyl)propionaldehyde Weak 1111 N/A <6250, estimated 4650 Minimal Negative Positive Schiff base formation Weak sensitizer Weak sensitizer
6658-48-6 p-Isobutyl-α-methyl hydrocinnamaldehyde Weak 2362 N/A <2500, estimated 2375 Minimal Negative Positive Schiff base formation Weak sensitizer Nonsensitizer
107898-54-4 3,3-Dimethyl-5-(2,2,3-trimethyl-3-cyclopenten-1-yl)-4-penten-2-ol Weak 2598 5000 NC (5000) Low Negative Positive No alert found Nonsensitizer N/A
86803-90-9 Methoxy dicyclopentadiene carboxaldehyde Weak 2500 12500 NC (2500) Low Positive Positive Schiff base formation Weak sensitizer Nonsensitizer
6784-13-0 β,4-Dimethylcyclohex-3-ene-1-propan-1-al Weak 5510 5510‡ 5675 [2] Minimal Positive Positive Schiff base formation Weak sensitizer Weak sensitizer
941-98-0 1-(1-Naphthyl)ethanone Weak 2598 N/A 2500 Inconclusive Negative Positive No alert found Nonsensitizer Nonsensitizer
6485-40-1 R-Carvone Weak 2657 18898 2950 [2] Low Positive Positive Michael Addition Strong sensitizer No metabolites predicted
4602-84-0 Farnesol Weak 2755 6897 1200 [2] Minimal Positive Positive No alert found Nonsensitizer Weak sensitizer
3155-71-3 2-Methyl-4-(2,6,6-trimethylcyclohex-1-en-1-yl)-2-butenal Weak 2953 N/A 2975 High Negative Positive Michael Addition Strong sensitizer Nonsensitizer
104-54-1 Cinnamic alcohol Weak 2953 4724 5250 Low Positive Positive No alert found Nonsensitizer Strong sensitizer
122760-84-3 Tricyclo[3.3.1.1.(3.7)]decan-2-ol, 4-methyl-8-methylene- Weak 3000 N/A NC (7500) Low Positive Positive No alert found Nonsensitizer
406488-30-0 Butanamide, 2-ethyl-N-methyl-N-(3-methylphenyl)- Weak 3250 N/A 6250 Minimal Negative Positive No alert found Nonsensitizer Nonsensitizer
123-11-5 p-Methoxybenzaldehyde Weak 3543 4724 NC (6250) Moderate Negative Positive No alert found Nonsensitizer Nonsensitizer
101-39-3 α-Methylcinnamaldehyde Weak 3543 N/A 1125 Low Positive Positive Michael Addition Strong sensitizer Nonsensitizer
2442-10-6 1-Octen-3-yl acetate Weak 3543 6900 NC (7500) Minimal Negative Negative SN2 Weak sensitizer Nonsensitizer
58567-11-6 Formaldehyde cyclododecyl ethyl acetal Weak 3543 N/A 6275 Minimal Negative Positive No alert found Nonsensitizer Weak sensitizer
82654-98-6 Vanillyl butyl ether Weak 3543 N/A 3645 Low Positive Positive No alert found Nonsensitizer Strong sensitizer
475-20-7 Longifolene Weak 3543 N/A 3545 [3] Minimal Positive Positive No alert found Nonsensitizer Nonsensitizer
91-64-5 Coumarin Weak 3543 8858 NC (12,500) Minimal Positive Negative No alert found Nonsensitizer Nonsensitizer
18794-84-8 β-Farnesene§ Weak 3700 6350 NC (7500) Minimal Positive Positive No alert found Nonsensitizer Weak sensitizer
68527-77-5 2,4,6-Trimethly-3-cyclohexene-1-methanol Weak 3800 5000 NC (6250) Minimal Negative Positive No alert found Nonsensitizer Weak sensitizer
31906-04-4 3- and 4-(4-hydroxy-4-methylpentyl)-3-cyclohexene-1-carboxaldehyde§ Weak 4000 6259 4275 Low Positive Positive Schiff base formation Weak sensitizer Nonsensitizer
80-54-6 p-t-Butyl-α-methylhydrocinnamic aldehyde Weak 4125 29528 2454 [7] Low Negative Positive Schiff base formation Weak sensitizer Nonsensitizer
103-41-3 Benzyl cinnamate Weak 4724 N/A 4600 Minimal Positive Negative Michael Addition Weak sensitizer Nonsensitizer
107-75-5 Hydroxycitronellal Weak 4960 5814 5553 [18] Low Positive Positive Schiff base formation Weak sensitizer Nonsensitizer
4180-23-8 trans-Anethole Weak 5509 N/A 675 Inconclusive Negative Positive No alert found Nonsensitizer Weak sensitizer
515-69-5 α-Bisabolol Weak 5510 N/A 4593 [2] Low Negative Positive No alert found Nonsensitizer Weak sensitizer
16251-77-7 3-Phenylbutanal Weak 5905 12500 N/A Low Positive Positive Schiff base formation Weak sensitizer Nonsensitizer
19009-56-4 2-Methyldecanal Weak 5905 N/A 5900 Low Negative Positive Schiff base formation Weak sensitizer Nonsensitizer
100-51-6 Benzyl alcohol Weak 5905 8858 NC (12,500) Minimal Positive/Negative Positive No alert found Nonsensitizer Nonsensitizer
5462-06-6 4-Methoxy-α-methyl benzenepropanal Weak 5905 N/A 5900 Minimal Positive Positive Schiff base formation Weak sensitizer Weak sensitizer
62439-41-2 6-Methoxy-2,6-dimethylheptan-1-al Weak 5905 N/A NC (12,500); 6000 Low Positive Positive Schiff base formation Weak sensitizer Nonsensitizer
15760-18-6 3-(4-Methyl-3-cyclohexenyl)butanol Weak 5905 N/A 5000 Minimal Positive Positive No alert found Nonsensitizer Weak sensitizer
68039-49-6 2,4-Dimethyl-3-cyclohexen-1-carboxaldehyde§ Weak 5905 N/A 3468 [5]; NC (6250) Low Positive Positive Schiff base formation Weak sensitizer Nonsensitizer
97-53-0 Eugenol Weak 5906 N/A 2703 [6] Low Negative Positive No alert found Nonsensitizer Weak sensitizer
1335-66-6 Isocyclocitral§ Weak 7087 N/A 1825 Moderate Negative Positive Schiff base formation Weak sensitizer Weak sensitizer
106-23-0 Citronellal Weak 7086 N/A NC (7500) Minimal Positive Positive Schiff base formation Weak sensitizer Weak sensitizer
82356-51-2 3-Methylcyclopentadecenone Weak 10000 N/A 1425 Low Negative Positive Nucleophilic addition Weak sensitizer
122-40-7 Amyl cinnamic aldehyde Weak 23622 N/A 2513 [4] Minimal Positive Positive Schiff base formation Weak sensitizer Nonsensitizer
470-82-6 Eucalyptol Very weak 590 N/A 16475 Minimal Positive Positive No alert found Nonsensitizer Nonsensitizer
28940-11-6 7-Methyl-2H-benzo-1,5-dioxepin-3(4H)-one Very weak 1000 N/A NC (7500) Low Positive Positive No alert found Nonsensitizer Nonsensitizer
1708-34-5 2-Hexyl-1,3-dioxolane Very weak 2777 N/A 16245 Minimal Negative No data No alert found Nonsensitizer Nonsensitizer
101-85-9 Amylcinnamyl alcohol Very weak 3543 N/A NC (7500); NC (6250) Minimal Negative Positive No alert found Nonsensitizer Weak sensitizer
121-33-5 Vanillin Very weak 5314 N/A NC (12,500) Minimal Negative Negative No alert found Nonsensitizer Weak sensitizer
106-02-5 Ω-Pentadecalactone Very weak 5509 N/A NC (12,500); 5187 [2] Minimal Negative Positive No alert found Nonsensitizer Nonsensitizer
119-36-8 Methyl salicylate Very weak 5517 N/A 8829 [3], NC (1250), NC (6250), NC (5000) Minimal Negative Negative No alert found Nonsensitizer Nonsensitizer
91770-14-8 Jasmine absolute (sambac) Very weak 8800 N/A 9100 Minimal Positive Positive N/A N/A N/A
103694-68-4 β,β,3-Trimethyl benzenepropanol Very weak 9917 N/A NC (25,000); NC (7500); 7300 Minimal Positive Positive No alert found Nonsensitizer Nonsensitizer
259854-70-1 5-Cyclotetradecen-1-one, 3-methyl-,(5E)- Very weak 10000 N/A 4100 Minimal Negative Positive Nucleophilic addition Weak sensitizer
3910-35-8 1,1,3-Trimethyl-3-phenylindane Very weak 10000 N/A 10,825 Minimal Positive Inconclusive results (solubility) No alert found Nonsensitizer Nonsensitizer
1205-17-0 α-Methyl-1,3-benzodioxole-5-propionaldehyde Very weak 11810 16667 4100 Moderate Positive Positive Schiff base formation Weak sensitizer Weak sensitizer
4707-47-5 Methyl atrarate Very weak 11810 N/A 4750; NC (6250) Inconclusive Positive Positive No alert found Nonsensitizer Weak sensitizer
131766-73-9 Tetrahydro-4-methyl-2-propyl-2H-pyran-4-yl acetate Very weak 11019 N/A NC (7500) Minimal Negative Positive No alert found Nonsensitizer Nonsensitizer
23911-56-0 1-(3-Methyl-2-benzofuranyl)ethanone Very weak 11019 N/A NC (7500) Minimal Positive Positive No alert found Nonsensitizer Nonsensitizer
106-24-1 Geraniol Very weak 11811 N/A 4063 [6] Minimal Positive Positive No alert found Nonsensitizer Weak sensitizer
33704-61-9 6,7-Dihydro-1,1,2,3,3-pentamethyl-4(5H)-indanone Very weak 12121 N/A 8250 Minimal Negative Positive Nucleophilic addition Weak sensitizer
118-58-1 Benzyl salicylate Very weak 17715 N/A 725 Minimal Positive Negative SN2
Acylation
Strong sensitizer Nonsensitizer
13828-37-0 cis-4-(Isopropyl)cyclohexanemethanol Very weak 17715 N/A 11,000 Minimal Negative Positive No alert found Nonsensitizer Nonsensitizer
13257-44-8 2-Nonyn-1-al dimethyl acetal Very weak 23622 N/A NC (5000) Minimal Positive Positive No alert found Nonsensitizer Nonsensitizer
101-86-0 Hexyl cinnamic aldehyde Very weak 23622 N/A 2425 [21] Minimal Positive Negative Schiff base formation Weak sensitizer Nonsensitizer
106-22-9 Citronellol Very weak 29525 N/A 10875; NC (20,000) Low Negative Positive No alert found Nonsensitizer Weak sensitizer
6259-76-3 Hexyl salicylate Very weak 35430 N/A 45 Minimal Positive Positive No alert found Nonsensitizer Nonsensitizer
54464-57-2 1-(1,2,3,4,5,6,7,8-Octahydro-2,3,8,8-tetramethyl-2-naphthalenyl)ethanone§ Very weak 47244 N/A 3783 [3] High; low Negative Positive Nucleophilic addition Weak sensitizer Weak sensitizer
120-51-4 Benzyl benzoate Very weak 59050 N/A 4250; NC (12,500) Minimal Positive Negative SN2 Weak sensitizer no metabolites predicted
127-51-5 α-iso-Methylionone§ Very weak 70860 N/A 5450 Minimal Negative Positive Michael Addition Weak sensitizer
5989-27-5 d-Limonene NS 10000 N/A 9215 [5] Minimal; low Negative Positive No alert found Nonsensitizer Weak sensitizer
78-70-6 Linalool NS 14998 N/A 8883 [3] Minimal Negative Positive No alert found Nonsensitizer Weak sensitizer
124-07-2 Octanoic acid NS 690 N/A NC (12,500) Minimal Negative Positive No alert found Nonsensitizer Nonsensitizer
478695-70-4 Propanedioic acid, 1-(3,3-dimethylcyclohexyl) ethyl, ethyl ester NS 2000 N/A Neg up to 100% Minimal Negative Positive No alert found Nonsensitizer Nonsensitizer
69300-15-8 2-Methyldecanenitrile NS 2250 N/A Neg up to 100% Minimal Negative Positive No alert found Nonsensitizer Nonsensitizer
63500-71-0 2-Isobutyl-4-methyltetrahydro-2H-pyran-4-ol NS 4408 N/A NC (7500) Minimal Negative Positive No alert found Nonsensitizer
18479-58-8 Dihydromyrcenol NS 5000 N/A NC (6250) Minimal Negative Positive No alert found Nonsensitizer
125-12-2 Isobornyl acetate NS 6495 N/A NC (6250) Minimal Negative Positive No alert found Nonsensitizer Nonsensitizer
24851-98-7 Methyl dihydrojasmonate NS 10000 N/A NC (10,000) Minimal Negative Positive No alert found Nonsensitizer Nonsensitizer
105-95-3 Ethylene brassylate NS 23600 N/A NC (7500) Minimal Negative Positive No alert found Nonsensitizer Nonsensitizer

When more than 1 LLNA data are available, the average of EC3 from all studies was listed. The number of studies is noted in brackets. The data are indicated as not calculated (highest tested dose); the LLNA was negative up to the highest tested dose.

*Skin sensitization reactions were observed in the CNIH when 0.1% tocopherol was used as a stabilizer with β,4-dimethylcyclohex-3-ene-1-propan-1-al. However, no reactions were observed in a study where 0.1% BHT was used as a stabilizer.

†The LOELs were based on CNIHs for 24 materials and on HMT for 7 materials.

‡The NOELs for 104 materials were based on the CNIH studies. Most CNIH studies cited in this work were conducted according to the protocol published by Politano and Api,27 but other studies with minor variations in the protocol were also included. The NOELs for methyl salicylate (CAS 119-36-8) and octanoic acid (CAS 124-07-2) were derived from HMTs, because no CNIH studies were available on these 2 materials.

§The samples were commercial mixtures of structural isomers.

N/A, not available; NC, not calculated; NS, no evidence of skin sensitization exists.

Human Testing Methods

Confirmation of No Induction in Humans

The HRIPT was introduced in the 1950s.2831 Since the publication of these early articles, there have been efforts over the intervening years to develop more robust scientific protocols for the performance and interpretation of the HRIPT.15,27,3234 The factors critical in the conduct and interpretation of an HRIPT include understanding the vehicle/matrix effects, amount of test material applied, patch type/technique, test subject number, and what is known about the allergenic potency of the test materials being evaluated.15 Human repeated insult patch testing is conducted primarily as a confirmatory test focused on selecting test material concentrations that are not expected to induce a skin sensitization response. The term CNIH was proposed to refer to the HRIPTs conducted specifically for confirmatory purposes. The CNIH studies are conducted after receiving institutional review board approval. Most CNIH studies cited in this work were conducted according to the protocol published by Politano et al,27 but other studies with minor variations in the protocol were also included. Throughout the study, 0.3 mL (liquid) of test material in a vehicle of 1:3 ethanol:diethyl phthalate was applied to occlusive 25-mm Hill Top Chamber patches. The test fragrance material concentration used in CNIH depends on detailed preceding toxicological evaluation and is always built on a WoE approach, but for most substances reported herein, it has depended on relative potency information from the LLNA.22,24,27 The amount of fragrance material per unit area of skin is used to quantify the dosage in these studies, as it has been previously shown to be the most relevant metric to skin sensitization.5 The dose per unit area can be easily calculated by dividing the amount of test material by the size of the patch used. For instance, in a study with α-amyl cinnamic aldehyde (Table 2), 0.3 mL (almost equal to 3.0 × 105 μg) of 20% fragrance material was applied using a Hill Top Chamber. An area of 2.54 cm2 was covered by the fragrance material using this patch system. The dose per unit area in this study was calculated as follows:

0.2×3.0×105μg2.54cm2=23622μg/cm2

In addition to the test material, saline and/or vehicle control patches were applied in parallel. Induction patches were applied to skin between the scapula and spinal midline for 24 hours, followed by a 24-hour rest period, and retreatment of the same site for a total of 9 induction applications over 3 weeks. A 2-week rest period followed the final induction patching. The challenge phase consisted of a single 24-hour patch to a naive test site; the site was scored 24, 48, and 72/96 hours after application. The interpretation of the results is done according to the interpretation guidelines described by McNamee et al.15 Typically, intense erythema, papules, and/or edema covering the entire test area that persist throughout the challenge scoring phase are considered skin sensitization reactions. Occasionally, a rechallenge may be needed to confirm the nature of questionable skin reactions. Typically, at least 100 subjects must finish the study for the data to be considered sufficient. More than a dozen inclusion/exclusion criteria were used to identify appropriate volunteers, and they are described by Politano et al.27 The CNIH data were used to establish a NOEL and, in some cases, a LOEL. The CNIH data used in this article were sourced from the RIFM Database, a comprehensive source of regulatory, identity, and toxicological data on more than 6000 materials, including 3000 fragrance materials, and publications such as the studies by Api et al1 and Na et al.16

Human Maximization Tests

Human maximization tests as published by Kligman35,36 are conducted by applying a test material in a vehicle (usually petrolatum) under occlusion to the same site on the volar aspects of the forearms of approximately 25 volunteers for 5 alternate-day, 48-hour periods. Patch sites may be pretreated for 24 hours with aqueous sodium lauryl sulfate under occlusion. After a 10- to 14-day rest period, challenge patches are applied under occlusion to fresh sites for 48 hours. Challenge applications may be preceded by 60-minute applications of sodium lauryl sulfate under occlusion. Challenge scoring occurs upon patch removal and 24 hours thereafter.

Animal Testing Method

Local Lymph Node Assay

Local lymph node assays were typically conducted according to OECD 429 and Good Laboratory Practice guidelines.37 In some instances, a dose-range-finding pretest was completed. For the main study, groups of mice (n = 5) were dosed topically on the dorsum of each ear with 25 μL of test material in a vehicle, usually 1:3 ethanol:diethyl phthalate. Each group received a selected test concentration or vehicle or positive control, typically α-hexylcinnamaldehyde. During the induction phase, 25 μL of test material or vehicle or α-hexylcinnamaldehyde was applied to each ear for 3 consecutive days. After 2 days of rest, each animal received a single intravenous injection of 250 μL of saline containing 20 μCi of 3H-TdR. Approximately 5 hours later, auricular lymph nodes were excised and lymphocyte proliferation quantified by beta scintillation counting. The SI was obtained by calculating the ratio of disintegrations per minute of the treated group divided by the disintegrations per minute of the vehicle control group. In cases where none of the selected concentrations produce an SI greater or equal to 3, the response is considered negative up to the highest concentration tested. If the SI is equal to or greater than 3, the result is considered positive. Linear interpolation of the dose-response data was used to derive the estimated concentration that is needed to elicit an SI value of 3 (EC3). If a test material has multiple EC3 values, the average of the values is used even if there is a difference in protocol among the studies, which provided the EC3 values. Data were sourced from the RIFM database and publications, such as Api et al.3,14,38

In Chemico and In Vitro Test Methods

Direct Peptide Reactivity Assay

The DPRA has been previously described39,40 and addresses the first key event of the skin sensitization adverse outcome pathway (AOP).41 The assay is based on the link between skin protein reactivity and skin sensitization. The DPRA has been validated and formally adopted by the OECD as Testing Guideline 442C.42 The DPRA data were collected from the RIFM Database and other publications.9,39,4348 Generally, the DPRA quantifies the remaining concentration of cysteine- or lysine-containing peptide after a 24-hour incubation with the test chemical at 25°C ± 2.5°C. For each test chemical, an overall average peptide depletion is calculated using the means of cysteine and lysine depletion, and the distinction of sensitizers from nonsensitizers is made based on a decision tree model.40 Chemicals with a mean of cysteine depletion and lysine depletion less than 6.37% are considered to have minimal reactivity, those with a mean peptide depletion between 6.37% and 22.62% are considered to have low reactivity, between 22.62% and 42.27% are assigned moderate reactivity, and greater than 42.47% are assigned high reactivity. Minimal reactivity chemicals are grouped as nonsensitizers, whereas low, moderate, and high reactivity chemicals are all grouped as sensitizers.

The KeratinoSens Assay

The KeratinoSens assay is generally conducted as described by Emter et al49 and addresses the second key event of the skin sensitization AOP. This assay measures keratinocyte activation by assessing Nrf2-mediated activation of antioxidant response element–dependent genes, with the help of the luciferase reporter gene. KeratinoSens underwent validation and has been adopted by the OECD as Testing Guideline 442D.50 KeratinoSens data were collected from the RIFM Database and other publications.9,45,48,49,51 Generally, cells are grown for 24 hours in 96-well plates, after which the medium is replaced with medium containing the test chemical and a final level of 1% dimethyl sulfoxide. Each chemical is tested at 12 concentrations ranging from 0.98 μM to 2 mM in 3 replicate plates, and a fourth plate is tested simultaneously to determine cytotoxicity. Cells are incubated for 48 hours with the test agent, after which luciferase activity and cytotoxicity are determined. This entire experiment is repeated at least 2 times for each chemical. Gene induction for cells treated with the test reagent is then compared with dimethyl sulfoxide controls to determine induction over a 1.5 threshold. Chemicals with a significant gene induction greater than 1.5-fold, at a concentration at which the cells maintain at least 70% viability in a minimum of 2 experiments, are rated positive.

The Human Cell Line Activation Test

The human cell line activation test (h-CLAT)52,53 addresses the third key event of skin sensitization AOP. Dendritic cell activation is assessed by measuring induction of expression of cell surface markers CD54 and CD86 after 24-hour treatment with a test substance relative to parallel vehicle controls in human monocytic leukemia cells, THP-1 cells, as a surrogate of dendritic cells. The h-CLAT has been validated by the OECD and adopted as Test Guideline 442E.54 The h-CLAT data were collected from RIFM Database and other publications.9,45,47,48,51,55 A 2-fold induction of the CD54 expression and/or 1.50-fold induction of CD86 expression at relative cell viabilities of at least 50% is rated positive for dendritic cell–activating potential of a test substance.

The WoE Approach for Potency Categorization

Potency categories were assigned based on the WoE approach, considering human, animal, in silico, in chemico, and in vitro data (Fig. 1). Human data were prioritized over all nonhuman data. Human NOELs were used first in the WoE approach for potency categorization. The potency categories were assigned using ranges adapted from Api et al1 (Table 1). Human LOELs were considered next, where available, followed by the LLNA data. The EC3 values from LLNAs are known to be robust predictors of skin sensitization potency. They were found to correlate well with the human NOEL, except for a few materials such as hexen-2-al (CAS 6728-26-3).14 The potency based on EC3 was determined using the ranges adapted from European Centre for Ecotoxicology and Toxicology of Chemicals Technical Report 87 (Table 1).56 The EC3 percentage values were converted to dose per unit area of skin, so they could be compared with the available human data. The LLNA potency was used as a guide to determine whether a material could be categorized as a weaker sensitizer compared with the potency based on the existing human NOEL. In addition, the in chemico, in silico, and in vitro data were used in combination to determine whether a given material has the potential to induce each of the key events for induction of skin sensitization. The absence of structural features that are reactive to skin proteins and the inability to activate the key events would indicate that the material is a very weak or nonsensitizer.

Figure 1.

Figure 1

Data considered for the WoE potency categorization for induction.

TABLE 1.

Potency Categories and Their Dose Range

Potency Category Dose Range,* μg/cm2 LLNA EC3 Dose Range,† μg/cm2
Extreme <25 <25
Strong 25–500 25–<250
Moderate 500–2500 250–<2500
Weak >2500–10,000 2500–25,000
Very weak >10,000
Nonsensitizer Negative

*Adapted from Api et al.1

†Defined based on the guidance from European Center for Ecotoxicology and Toxicology of Chemicals Technical Report 87.56

The potency decisions were made for all analyzed materials, mainly using the data listed previously. In some cases, other data were considered on a case-by-case basis to assist in the WoE decision. These supporting factors included guinea pig studies and exposure data for the material coupled with available diagnostic patch test data.

If a material lacked any positive in vivo data, lacked protein binding alerts in silico, and was predicted to be negative in 2 of the 3 in chemico and in vitro assays, the material was categorized as a nonsensitizer.

RESULTS

The WoE potency categories determined for 106 fragrance materials evaluated are summarized in Figure 2. None were considered extreme sensitizers (that is, zero of the 106 fragrance materials) whereas six were strong, twenty three were moderate, forty one were weak and 26 were very weak sensitizers, respectively. In addition, 10 materials were considered non-sensitizers, because they lacked evidence for induction of skin sensitization (Fig. 2).

Figure 2.

Figure 2

Number of materials placed in each of 6 potency categories based on the WoE approach.

The category assignment for each material and main data set considered are listed in Table 2.

Of the 106 fragrance materials, 82 materials have been previously categorized by Api et al,1 primarily using human data. For 71% of these 82 materials, the WoE categories were the same categories as previously assigned (Fig. 3). Consideration of other available data led to a change in potency categories for the remaining 29%, compared with the previous categorization; weaker potency categories were assigned for 20.5%, whereas stronger categories were assigned for 8.5% (Fig. 3).

Figure 3.

Figure 3

Comparison of the WoE-based potency categories to the potency categories in the study by Api et al.1

A few examples from Table 2 are described hereinafter to demonstrate how WoE categories were determined based on the existing data. These categories were decided based on the available evidence at the time of this study. Upon availability of new information and/or additional data, the potency category would be re-evaluated.

Cinnamic aldehyde (CAS 104-55-2) has a human NOEL and a human LOEL of 591 and 775 μg/cm2, respectively. The NOEL can be considered a good representation of the potency, because it is close to the LOEL (1.3-fold difference). Therefore, cinnamic aldehyde was categorized as a moderate sensitizer based on the category ranges in Table 1. Cinnamic aldehyde was predicted to be a sensitizer in chemico, in vitro, and in silico. The LLNA data also support the moderate sensitizer category.

Methyl-2-nonyoate (CAS 111-80-8) was categorized as a strong sensitizer. It has a CNIH NOEL of 24 μg/cm2, which is at the upper end of the extreme category. However, the LOEL for this material is 5-fold higher, suggesting that the true maximum NOEL might be higher than 24 μg/cm2. It is also possible that true LOEL is lower than the available value. The EC3 from LLNA was estimated to be 625 μg/cm2 (2.5%), supporting categorization of methyl-2-nonyoate to the strong category. In line with these in vivo data, methyl-2-nonyoate was predicted to be a strong sensitizer in the DPRA and was positive in KeratinoSens and h-CLAT. In addition, methyl-2-nonyoate was predicted to be a strong sensitizer in silico.

2-Methoxy-4-methylphenol (CAS 93-51-6) was placed in a moderate category. The CNIH NOEL is 110 μg/cm2, which is in the strong sensitizer range. There was no human LOEL. The EC3 value of 1450 μg/cm2 (5.8%) indicated that the maximum human NOEL could be higher than 110 μg/cm2. The DPRA and KeratinoSens did not predict 2-methoxy-4-methylphenol to be a skin sensitizer, whereas h-CLAT predicted it to be a sensitizer, suggesting that 2-methoxy-4-methylphenol might not be a strong sensitizer. In silico analysis showed that no protein binding alerts were identified for the parent material, whereas its potential metabolite (2,5-cyclohexadien-1-one, 2-methoxy-4-methylene-) was predicted to be a strong sensitizer. In a guinea pig maximization test, 2-methoxy-4-methylphenol was shown to be a moderate sensitizer, supporting the moderate category.

Ylang-ylang (CAS 8006-81-3) was categorized as a moderate sensitizer. The CNIH NOEL of 1771 μg/cm2 and the EC3 of 1700 μg/cm2 (6.8%) values support the moderate category. In addition, ylang-ylang was predicted to be a sensitizer in KeratinoSens and h-CLAT, whereas it was negative in DPRA.

Benzyl alcohol (CAS 100-51-6) was categorized as a weak sensitizer, mainly based on a human NOEL of 5900 μg/cm2 and a similar LOEL of 8858 μg/cm2. The negative LLNA data and the lack of protein binding alerts suggest that benzyl alcohol is not a strong sensitizer. There are positive diagnostic patch test data in the literature. For instance, in a patch test study by Schnuch et al,57 1% benzyl alcohol led to skin reactions in 0.3% in 2166 patients. In another study by Hausen,58 patch testing 102 patients with 5% benzyl alcohol led to skin reactions in 7.8% of the tested patients. However, considering the high volume of use as a fragrance ingredient in consumer products (International Fragrance Association, 2015 Volume of Use Survey), combined with the fact that benzyl alcohol is used ubiquitously in consumer products that come in close contact with the skin such as facial scrub and face wash (Creme-RIFM Aggregate Exposure Model, V3.1.3), benzyl alcohol is a weak sensitizer.

Tetrahydro-4-methyl-2-propyl-2H-pyran-4-yl acetate (CAS 131766-73-9) was categorized as a very weak sensitizer. It has a human NOEL of 11,000 μg/cm2, whereas its human LOEL is not known. The LLNA was negative with the highest tested dose of 7500 μg/cm2 (30%). Two of the 3 in chemico and in vitro tests did not predict 2-methoxy-4-methylphenol to be a skin sensitizer (Table 2). In silico, no protein binding alerts were identified on the parent or its possible metabolites. No diagnostic patch test data were available, despite its apparent use in skin-applicable products such as fine fragrances and bar soap (Creme-RIFM Aggregate Exposure Model, Version 3.1.3). These data suggested that tetrahydro-4-methyl-2-propyl-2H-pyran-4-yl acetate may be a nonsensitizer. However, evidence of induction of skin sensitization was observed in a guinea pig maximization test.59 Therefore, the potency category of tetrahydro-4-methyl-2-propyl-2H-pyran-4-yl acetate was adjusted to the very weak category.

Methyl salicylate (CAS 119-36-8) was categorized as a very weak sensitizer. It has limited existing human data, because no CNIH study has been conducted according to the standard protocol.27 The HMT NOEL of 5520 μg/cm2 is considered instead, which falls in the weak sensitizer range. No human LOEL is available for methyl salicylate. Four separate LLNAs showed that methyl salicylate is a skin sensitizer, with an average EC3 of 7341 μg/cm2 (29.4%), whereas 3 other studies showed that it was not sensitizing at the maximum tested concentrations. In a separate study, no significant increase in B Cell Marker, B220, was observed in mice treated with methyl salicylate, suggesting that reactions observed at high doses are indicative of irritant rather than a skin sensitizer.60 None of the 3 in chemico and in vitro tests or in silico predictions indicate that methyl salicylate is a sensitizer. However, sensitization reactions have been observed in diagnostic patch tests. In a study on diagnostic patch tests with 1825 patients using 2% methyl salicylate in petrolatum, 0.4% of patients exhibited skin sensitization reactions.61 In another study, 0.11% of 4600 patients in total showed sensitization reactions when patched with 2% methyl salicylate in petrolatum.62 Considering the positive data from LLNAs and the rare, but positive, reactions observed in diagnostic patch test studies, methyl salicylate is categorized as a very weak sensitizer.

1-(3-Methyl-2-benzofuranyl)ethenone (CAS 23911-56-0) was categorized as a very weak sensitizer. There are no positive in vivo data to suggest that this material is a sensitizer. It has a CNIH NOEL of 11,019 μg/cm2, and a human LOEL is not available. In an LLNA, 1-(3-methyl-2-benzofuranyl)ethenone did not induce skin sensitization when tested up to 30%, 7500 μg/cm2. Moreover, in a guinea pig maximization test, no reactions indicative of skin sensitization were observed.63 In a diagnostic patch test study, no reactions indicative of skin sensitization were observed in the 48 subjects.64 In line with in vivo data, 1-(3-methyl-2-benzofuranyl)ethenone is not predicted to be reactive to skin proteins in silico. However, it was predicted to be a skin sensitizer in KeratinoSens and h-CLAT, supporting the potency category of a very weak sensitizer rather than a nonsensitizer.

2-Methyldecanenitrile (CAS 69300-15-8) was categorized as a nonsensitizer. It has a CNIH NOEL of 2250 μg/cm2, which falls into the moderate sensitizer range. No human LOEL is available. In an LLNA, it did not induce skin sensitization when tested up to 100%, indicating that it may not be a skin sensitizer. 2-Methyldecanenitrile was predicted to be a nonsensitizer in the DPRA and KeratinoSens, but a sensitizer in h-CLAT. In silico, it was not predicted to be reactive to skin proteins directly or through its metabolites. Moreover, 2-methyldecanenitrile did not lead to skin sensitization reactions in a guinea pig maximization test and a Buehler test.65,66 Given the absence of positive data in human and animal tests, 2-methyldecanenitrile was placed in the nonsensitizer category. This category was supported by the negative prediction in the DPRA and KeratinoSens. This example demonstrates that a human NOEL alone does not indicate the actual potency of the tested material.

Octanoic acid (CAS 124-07-2) was categorized as a nonsensitizer. Limited human data are available for octanoic acid. Its HMT NOEL is 690 μg/cm2, in the moderate sensitizer range. In an LLNA, it did not induce skin sensitization when tested up to 12,500 μg/cm2 (50%), which is in the weak range. Octanoic acid was not predicted to be a sensitizer in DPRA and KeratinoSens, but it was predicted to be a sensitizer in h-CLAT. In silico, it was not predicted to be reactive to skin proteins directly or through its metabolites.

Linalool (CAS 78-70-6) and limonene (CAS 5989-27-5) were categorized as nonsensitizers. The human NOELs on both materials are greater than 10,000 μg/cm2, in the very weak sensitizer range. Both materials have multiple LLNA data, with EC3 values greater than 2500 μg/cm2. Some studies suggest that the positive results obtained from the LLNA are false-positives caused by irritation at high concentrations.67 In these studies, B-cell activation marked by an increase in B220 expression is quantified to differentiate the skin irritants from skin sensitizers. In these studies, mice treated with the test articles showed B220 expression in line with a reference skin irritant, benzalkonium chloride, but different from that of a reference skin sensitizer, 1-chloro-2,4-dinitrobenzene. In additional animal studies, the oxidation products, specifically hydroperoxides of linalool and limonene were identified as key skin sensitizers.57,68,69 In a series of experiments using guinea pig test methods conducted in parallel with analytical measurement of sample quality, Karlberg et al70 have demonstrated that under low level of oxidation, high purity d-limonene is nonsensitizing, whereas oxidized d-limonene is a contact allergen. Similar findings were reported for linalool.68 In vitro, linalool was predicted to be a nonsensitizer in a DPRA and KeratinoSens, but a sensitizer in h-CLAT. Mixed DPRA results were available on limonene; 1 DPRA study was negative, whereas another study was positive. Limonene was predicted to be nonsensitizer in KeratinoSens but positive in h-CLAT. Based on chemical structure, both materials are predicted in silico not to be reactive directly to skin proteins, but their metabolites are predicted to be weak sensitizers. Both linalool and limonene are used in products that come in close contact with skin, such as fine fragrances (Creme-RIFM Aggregate Exposure Model, V3.1.3). Despite the widespread use, the occurrence of positive responses in diagnostic patch tests is low.71

DISCUSSION

A systematic WoE approach has been undertaken to assign skin sensitization potency categories for 100 fragrance ingredients and 6 NCSs. The goal was to develop an approach that uses an expert assessment of all available data to categorize the skin sensitization potency of these materials. The available human data were given the highest priority in this study. Still, it is clear that all data were important in making the most accurate categorization for each of the fragrance materials. The results show that none of the 106 fragrance materials were categorized as extreme sensitizer, whereas 6, 23, 41, and 26 materials were categorized as strong, moderate, weak, and very weak sensitizers, respectively. Ten materials were categorized as nonsensitizers. Many of the chemicals were easily placed in a potency category based on available human data, specifically CNIH data (eg, cinnamic aldehyde). However, in other cases, it was more challenging and required a careful review of all available data (eg, tetrahydro-4-methyl-2-propyl-2H-pyran-4-yl acetate).

The process of reviewing and determining a material's skin sensitization potency and placing it in a category requires expert judgment. It is likely that for most materials examined in this article, other skin sensitization experts would agree with the potency categorizations presented here. However, it is expected that for a few of these materials, especially materials with mixed or borderline results, other experts might place the materials in different categories but most likely with only one category difference. What is most important is the transparency of the process and availability of the data used to make specific judgments.

In this article, we used 5 potency category ranges plus the nonsensitizer category that were previously published.1 The potency category names and their exposure ranges compared with the LLNA EC3 ranges are presented in Table 1. Other publications present different exposure ranges for the potency categories.9,12,72 However, the range differences are not large among the various publications. The purpose of establishing these categories is not for regulatory purposes but to conduct sound risk assessments. Currently, NESILs for the fragrance materials are derived only when a NOEL has been confirmed through a well-conducted CNIH.25 For most compounds in this data set, a specific NESIL can be established based on available CNIH to conduct a QRA (eg, citral, p-mentha-1,8-dien-7-al, cinnamic aldehyde). In other cases, it may not be possible to calculate a specific NESIL because of lack of sufficient human data. In cases where sufficiency in the human data is lacking (eg, study conducted with less than 100 subjects), the potency category can be determined based on the WoE approach.27 An option would be to use a default value for the NESIL based on the lowest value of the potency category range. For example, if a material is categorized as a moderate sensitizer, 500 μg/cm2 is the default NESIL in the QRA.

As mentioned, human data from previously conducted studies were used as the primary source for potency categorization. The CNIH is currently an essential component in the conduct of skin sensitization QRA where it is used to establish a NESIL.23,24 Of course, even with a deep understanding of the allergenic potency of the tested materials, there is still a risk for the test subjects to become sensitized. Therefore, studies must be reviewed and approved by an ethical review board to ensure that the subjects are fully informed. The proportion of those becoming sensitized to fragrance materials is only 0.03%, based on only 3 positive subjects of 9854 subjects over the last 11 years.16 If ethical and relevant human data are available, they should be used in establishing potency categorization for use in risk assessment to help protect consumers and workers from developing allergic contact dermatitis.

Currently, the value of using data from nonanimal methods, either alone or in combination, is still under development. No individual validated nonanimal methods are currently viewed as a standalone test for hazard identification, so attempts have been made to develop combination strategies (Integrated Approaches to Testing and Assessment and Defined Approaches) that seek to bring together information from various sources to enhance the accuracy with which skin sensitization hazards are identified as well as to gain insight into the potency of a compound.72,73 In recent years, there has been substantial progress in providing guidance in deriving a NESIL from in silico, in chemico, and/or in vitro data.7476 The details of how these nonanimal methods will fit into the determination of a NESIL, including how they will impact the uncertainties associated with such determination, remain to be seen and form part of ongoing work programs within the fragrance industry (eg, https://www.ideaproject.info/news-events/idea-workshop-on-qra-based-on-nams-building-trust.) A few recently described nonanimal methods have been designed to help with predicting sensitizer potency to support risk assessment, including the SENS-IS assay,77,78 the Genomic Allergen Rapid Detection assay,79 and the kinetic DPRA.80,81 Other approaches using data from multiple nonanimal methods have also been proposed.46,8285

This article demonstrates the benefits of using a WoE approach to evaluate all available human, animal, and nonanimal data to assess a material's skin sensitization potency. For all of these fragrance materials, CNIH data were available that allowed an expert call on the material's skin sensitization potency and assignment to a category. Although the available CNIH data carried the most weight when assigning a potency category, all data were evaluated for consistency with the assessment. Using all available background data improved our ability to substantiate the sensitization category decisions made. Human diagnostic patch test data were rarely used because they inform mostly on prevalence of an allergen and not its potency. However, there are some instances in which consideration of clinical patch test results are critical to classifying a material as a sensitizer versus a nonsensitizer. The use of robust data sets that include existing human data supported by in vivo and/or nonanimal data will be very beneficial for evaluating new, innovative nonanimal approaches. The addition of nonfragrance material data sets (eg, dental materials, artificial nail monomers, hair dyes, preservatives) should be included in the evaluation, so any analysis is not overrepresented with a limited set of materials.86 No doubt that this is a considerable challenge and requires careful consideration in extrapolating human, animal, and nonanimal approaches for the purpose of determining a NESIL and conducting sound skin sensitization risk assessment.

ACKNOWLEDGMENTS

The authors thank Dr. David A. Basketter and Dr. Cindy A. Ryan for the valuable discussions and suggestions.

Footnotes

G.F.G. received financial compensation for the time spent in the preparation of this publication. At the time of this work, all other authors were fully paid employees of the Research Institute for Fragrance Materials.

Contributor Information

Mihwa Na, Email: mna@rifm.org.

Devin O'Brien, Email: dev3189@gmail.com.

Maura Lavelle, Email: mlavelle@rifm.org.

Isabelle Lee, Email: ILee@rifm.org.

G. Frank Gerberick, Email: gf3consultancy@gmail.com.

REFERENCES

  • 1.Api AM Parakhia R OʼBrien D, et al. Fragrances categorized according to relative human skin sensitization potency. Dermatitis 2017;28(5):299–307. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2.Gerberick GF Ryan CA Kern PS, et al. A chemical dataset for evaluation of alternative approaches to skin-sensitization testing. Contact Dermatitis 2004;50(5):274–288. [DOI] [PubMed] [Google Scholar]
  • 3.Kern PS Gerberick GF Ryan CA, et al. Local lymph node data for the evaluation of skin sensitization alternatives: a second compilation. Dermatitis 2010;21(1):8–32. [PubMed] [Google Scholar]
  • 4.Friedmann PS. The relationships between exposure dose and response in induction and elicitation of contact hypersensitivity in humans. Br J Dermatol 2007;157(6):1093–1102. [DOI] [PubMed] [Google Scholar]
  • 5.Kimber I Dearman RJ Basketter DA, et al. Dose metrics in the acquisition of skin sensitization: thresholds and importance of dose per unit area. Regul Toxicol Pharmacol 2008;52(1):39–45. [DOI] [PubMed] [Google Scholar]
  • 6.Basketter DA Alepee N Ashikaga T, et al. Categorization of chemicals according to their relative human skin sensitizing potency. Dermatitis. 2014;25(1):11–21. [DOI] [PubMed] [Google Scholar]
  • 7.Basketter DA Lea LJ Dickens A, et al. A comparison of statistical approaches to the derivation of EC3 values from local lymph node assay dose responses. J Appl Toxicol 1999;19(4):261–266. [DOI] [PubMed] [Google Scholar]
  • 8.Basketter DA, Gerberick F, Kimber I. The local lymph node assay and the assessment of relative potency: status of validation. Contact Dermatitis 2007;57(2):70–75. [DOI] [PubMed] [Google Scholar]
  • 9.Hoffmann S Kleinstreuer N Alepee N, et al. Non-animal methods to predict skin sensitization (I): the Cosmetics Europe database. Crit Rev Toxicol 2018;48(5):344–358. [DOI] [PubMed] [Google Scholar]
  • 10.Ryan CA Gerberick GF Cruse LW, et al. Activity of human contact allergens in the murine local lymph node assay. Contact Dermatitis 2000;43(2):95–102. [DOI] [PubMed] [Google Scholar]
  • 11.Gerberick GF Robinson MK Ryan CA, et al. Contact allergenic potency: correlation of human and local lymph node assay data. Am J Contact Dermat 2001;12(3):156–161. [DOI] [PubMed] [Google Scholar]
  • 12.Griem P, Goebel C, Scheffler H. Proposal for a risk assessment methodology for skin sensitization based on sensitization potency data. Regul Toxicol Pharmacol 2003;38(3):269–290. [DOI] [PubMed] [Google Scholar]
  • 13.Schneider K, Akkan Z. Quantitative relationship between the local lymph node assay and human skin sensitization assays. Regul Toxicol Pharmacol 2004;39(3):245–255. [DOI] [PubMed] [Google Scholar]
  • 14.Api AM, Basketter D, Lalko J. Correlation between experimental human and murine skin sensitization induction thresholds. Cutan Ocul Toxicol 2015;34(4):298–302. [DOI] [PubMed] [Google Scholar]
  • 15.McNamee PM Api AM Basketter DA, et al. A review of critical factors in the conduct and interpretation of the human repeat insult patch test. Regul Toxicol Pharmacol 2008;52(1):24–34. [DOI] [PubMed] [Google Scholar]
  • 16.Na M Ritacco G O'Brien D, et al. Fragrance skin sensitization evaluation and human testing: 30-year experience. Dermatitis 2021;32:339–352. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 17.Farage MA Bjerke DL Mahony C, et al. Quantitative risk assessment for the induction of allergic contact dermatitis: uncertainty factors for mucosal exposures. Contact Dermatitis 2003;49(3):140–147. [DOI] [PubMed] [Google Scholar]
  • 18.Felter SP Robinson MK Basketter DA, et al. A review of the scientific basis for uncertainty factors for use in quantitative risk assessment for the induction of allergic contact dermatitis. Contact Dermatitis 2002;47(5):257–266. [DOI] [PubMed] [Google Scholar]
  • 19.Felter SP Ryan CA Basketter DA, et al. Application of the risk assessment paradigm to the induction of allergic contact dermatitis. Regul Toxicol Pharmacol 2003;37(1):1–10. [DOI] [PubMed] [Google Scholar]
  • 20.Gerberick GF Robinson MK Felter SP, et al. Understanding fragrance allergy using an exposure-based risk assessment approach. Contact Dermatitis 2001;45(6):333–340. [DOI] [PubMed] [Google Scholar]
  • 21.Api AM. The use of human data when conducting dermal sensitization quantitative risk assessments for fragrance ingredients. Skin sensitization in chemical risk assessment. Geneva, Switzerland: World Health Organization, International Programme on Chemical, Safety; Regul Toxicol Pharmacol 2008;50:163–165. [Google Scholar]
  • 22.Api AM, Vey M. Implementation of the dermal sensitization quantitative risk assessment (QRA) for fragrance ingredients. Regul Toxicol Pharmacol 2008;52(1):53–61. [DOI] [PubMed] [Google Scholar]
  • 23.Api AM Basketter D Bridges J, et al. Updating exposure assessment for skin sensitization quantitative risk assessment for fragrance materials. Regul Toxicol Pharmacol 2020;118:104805. [DOI] [PubMed] [Google Scholar]
  • 24.Api AM Basketter DA Cadby PA, et al. Dermal sensitization quantitative risk assessment (QRA) for fragrance ingredients. Regul Toxicol Pharmacol 2008;52(1):3–23. [DOI] [PubMed] [Google Scholar]
  • 25.Api AM Belsito D Bruze M, et al. Criteria for the Research Institute for Fragrance Materials, Inc. (RIFM) safety evaluation process for fragrance ingredients. Food Chem Toxicol 2015;82(suppl):S1–S19. [DOI] [PubMed] [Google Scholar]
  • 26.Date MS O'Brien D Botelho DJ, et al. Clustering a chemical inventory for safety assessment of fragrance ingredients: identifying read-across analogs to address data gaps. Chem Res Toxicol 2020;33(7):1709–1718. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 27.Politano VT, Api AM. The Research Institute for Fragrance Materials' human repeated insult patch test protocol. Regul Toxicol Pharmacol 2008;52(1):35–38. [DOI] [PubMed] [Google Scholar]
  • 28.Schwartz L. The skin testing of new cosmetics. J Soc Cosmet Chem 1951;2:321–324. [Google Scholar]
  • 29.Schwartz L. Twenty-two years' experience in the performance of 200,000 prophetic patch tests. South Med J 1960;53:478–483. [DOI] [PubMed] [Google Scholar]
  • 30.Shelanski HA, Shelanski MV. A new technique of human patch tests. Proc Sci Sect Toilet Goods Assoc 1953;19(46):4–7. [Google Scholar]
  • 31.Shelanski H. Experience with and considerations of the human patch test method. J Cosmet Sci 1951;2(5):324–331. [Google Scholar]
  • 32.Marzulli FN, Maibach HI. Contact allergy: predictive testing in man. Contact Dermatitis 1976;2(1):1–17. [DOI] [PubMed] [Google Scholar]
  • 33.Marzulli FN, Maibach HI. Further studies of effects of vehicles and elicitation concentration in experimental contact sensitization testing in humans. Contact Dermatitis 1980;6(2):131–133. [DOI] [PubMed] [Google Scholar]
  • 34.Stotts J. Planning, conduct and interpretation of human predictive sensitization patch tests. Curr Concepts Cut Toxic 1980;41:41–53. [Google Scholar]
  • 35.Kligman AM. The identification of contact allergens by human assay. 3. The maximization test: a procedure for screening and rating contact sensitizers. J Invest Dermatol 1966;47(5):393–409. [DOI] [PubMed] [Google Scholar]
  • 36.Kligman AM, Epstein W. Updating the maximization test for identifying contact allergens. Contact Dermatitis 1975;1(4):231–239. [DOI] [PubMed] [Google Scholar]
  • 37.OECD . Test No. 429: Skin Sensitisation: Local Lymph Node Assay. OECD Guidelines for the Testing of Chemicals, Section 4. Paris, France: OECD Publishing; 2010.
  • 38.Gerberick GF Ryan CA Kern PS, et al. Compilation of historical local lymph node data for evaluation of skin sensitization alternative methods. Dermatitis. 2005;16(4):157–202. [PubMed] [Google Scholar]
  • 39.Gerberick GF Vassallo JD Bailey RE, et al. Development of a peptide reactivity assay for screening contact allergens. Toxicol Sci 2004;81(2):332–343. [DOI] [PubMed] [Google Scholar]
  • 40.Gerberick GF Vassallo JD Foertsch LM, et al. Quantification of chemical peptide reactivity for screening contact allergens: a classification tree model approach. Toxicol Sci 2007;97(2):417–427. [DOI] [PubMed] [Google Scholar]
  • 41.OECD . The Adverse Outcome Pathway for Skin Sensitisation Initiated by Covalent Binding to Proteins. OECD Series on Testing and Assessment, No168. Paris, France: OECD Publishing; 2014.
  • 42.OECD . Test No. 442C: In Chemico Skin Sensitisation. OECD Guidelines for the Testing of Chemicals, Section 4. Paris, France: OECD Publishing; 2021. [Google Scholar]
  • 43.Natsch A Gfeller H Rothaupt M, et al. Utility and limitations of a peptide reactivity assay to predict fragrance allergens in vitro. Toxicol In Vitro 2007;21(7):1220–1226. [DOI] [PubMed] [Google Scholar]
  • 44.Natsch A, Gfeller H. LC-MS-based characterization of the peptide reactivity of chemicals to improve the in vitro prediction of the skin sensitization potential. Toxicol Sci 2008;106(2):464–478. [DOI] [PubMed] [Google Scholar]
  • 45.Natsch A Ryan CA Foertsch L, et al. A dataset on 145 chemicals tested in alternative assays for skin sensitization undergoing prevalidation. J Appl Toxicol 2013;33(11):1337–1352. [DOI] [PubMed] [Google Scholar]
  • 46.Takenouchi O Fukui S Okamoto K, et al. Test battery with the human cell line activation test, direct peptide reactivity assay and DEREK based on a 139 chemical data set for predicting skin sensitizing potential and potency of chemicals. J Appl Toxicol 2015;35(11):1318–1332. [DOI] [PubMed] [Google Scholar]
  • 47.Bauch C Kolle SN Ramirez T, et al. Putting the parts together: combining in vitro methods to test for skin sensitizing potentials. Regul Toxicol Pharmacol 2012;63(3):489–504. [DOI] [PubMed] [Google Scholar]
  • 48.Urbisch D Mehling A Guth K, et al. Assessing skin sensitization hazard in mice and men using non-animal test methods. Regul Toxicol Pharmacol 2015;71(2):337–351. [DOI] [PubMed] [Google Scholar]
  • 49.Emter R, Ellis G, Natsch A. Performance of a novel keratinocyte-based reporter cell line to screen skin sensitizers in vitro. Toxicol Appl Pharmacol 2010;245(3):281–290. [DOI] [PubMed] [Google Scholar]
  • 50.OECD . Test No. 442D: In Vitro Skin Sensitisation: ARE-Nrf2 Luciferase Test Method. OECD Guidelines for the Testing of Chemicals, Section 4. Paris, France: OECD Publishing; 2018.
  • 51.Otsubo Y Nishijo T Miyazawa M, et al. Binary test battery with KeratinoSens and h-CLAT as part of a bottom-up approach for skin sensitization hazard prediction. Regul Toxicol Pharmacol 2017;88:118–124. [DOI] [PubMed] [Google Scholar]
  • 52.Ashikaga T Yoshida Y Hirota M, et al. Development of an in vitro skin sensitization test using human cell lines: the human Cell Line Activation Test (h-CLAT). I. Optimization of the h-CLAT protocol. Toxicol In Vitro 2006;20(5):767–773. [DOI] [PubMed] [Google Scholar]
  • 53.Ashikaga T Sakaguchi H Sono S, et al. A comparative evaluation of in vitro skin sensitisation tests: the human cell-line activation test (h-CLAT) versus the local lymph node assay (LLNA). Altern Lab Anim 2010;38(4):275–284. [DOI] [PubMed] [Google Scholar]
  • 54.OECD . Test No. 442E: In Vitro Skin Sensitisation assays addressing the Key Event on activation of dendritic cells on the Adverse Outcome Pathway for Skin Sensitisation. OECD Guidelines for the Testing of Chemicals, Section 4. Paris, France: OECD Publishing; 2018.
  • 55.Nukada Y Ashikaga T Sakaguchi H, et al. Predictive performance for human skin sensitizing potential of the human cell line activation test (h-CLAT). Contact Dermatitis 2011;65(6):343–353. [DOI] [PubMed] [Google Scholar]
  • 56.ECETOC . Contact Sensitization: Classification According to Potency Technical Report No. 87. Brussels, Belgium: European Centre for Ecotoxicology & Toxicology of Chemicals; 2003. [Google Scholar]
  • 57.Schnuch A Uter W Geier J, et al. Sensitization to 26 fragrances to be labelled according to current European regulation. Results of the IVDK and review of the literature. Contact Dermatitis 2007;57(1):1–10. [DOI] [PubMed] [Google Scholar]
  • 58.Hausen BM. Contact allergy to balsam of Peru. II. Patch test results in 102 patients with selected balsam of Peru constituents. Am J Contact Dermat 2001;12(2):93–102. [PubMed] [Google Scholar]
  • 59.RIFM . Skin Sensitization in the Guinea-Pig of Clarycet. 1992.
  • 60.Gerberick GF Cruse LW Ryan CA, et al. Use of a B cell marker (B220) to discriminate between allergens and irritants in the local lymph node assay. Toxicol Sci 2002;68(2):420–428. [DOI] [PubMed] [Google Scholar]
  • 61.de Groot AC Coenraads PJ Bruynzeel DP, et al. Routine patch testing with fragrance chemicals in the Netherlands. Contact Dermatitis 2000;42(3):184–185. [PubMed] [Google Scholar]
  • 62.Romaguera C, Grimalt F. Statistical and comparative study of 4600 patients tested in Barcelona (1973–1977). Contact Dermatitis 1980;6(5):309–315. [DOI] [PubMed] [Google Scholar]
  • 63.Api AM Belsito D Botelho D, et al. RIFM fragrance ingredient safety assessment, 1-(3-methyl-2-benzofuranyl)ethanone, CAS Registry Number 23911-56-0. Food Chem Toxicol 2021;153 Suppl 1:112300. [DOI] [PubMed] [Google Scholar]
  • 64.RIFM . Cutaneous Test-Patch Test. Unpublished work. RIFM report number 52954. 1997.
  • 65.Api AM Belsito D Biserta S, et al. RIFM fragrance ingredient safety assessment, 2-methyldecanenitrile, CAS Registry Number 69300-15-8. Food Chem Toxicol 2021;153 Suppl 1:112296. [DOI] [PubMed] [Google Scholar]
  • 66.RIFM . Delayed Dermal Sensitization Study in Guinea Pig. Unpublished work. RIFM report number 31689. 1989.
  • 67.Api AM Belsito D Bhatia S, et al. RIFM fragrance ingredient safety assessment, Linalool, CAS registry number 78-70-6. Food Chem Toxicol 2015;82(suppl):S29–S38. [DOI] [PubMed] [Google Scholar]
  • 68.Skold M Borje A Matura M, et al. Studies on the autoxidation and sensitizing capacity of the fragrance chemical linalool, identifying a linalool hydroperoxide. Contact Dermatitis 2002;46(5):267–272. [DOI] [PubMed] [Google Scholar]
  • 69.Skold M Borje A Harambasic E, et al. Contact allergens formed on air exposure of linalool. Identification and quantification of primary and secondary oxidation products and the effect on skin sensitization. Chem Res Toxicol 2004;17(12):1697–1705. [DOI] [PubMed] [Google Scholar]
  • 70.Karlberg AT, Boman A, Melin B. Animal experiments on the allergenicity of d-limonene—the citrus solvent. Ann Occup Hyg 1991;35(4):419–426. [DOI] [PubMed] [Google Scholar]
  • 71.Uter W Geier J Frosch P, et al. Contact allergy to fragrances: current patch test results (2005–2008) from the Information Network of Departments of Dermatology. Contact Dermatitis 2010;63(5):254–261. [DOI] [PubMed] [Google Scholar]
  • 72.Basketter D Beken S Bender H, et al. Building confidence in skin sensitisation potency assessment using new approach methodologies: report of the 3rd EPAA Partners Forum, Brussels, 28th October 2019. Regul Toxicol Pharmacol 2020;117:104767. [DOI] [PubMed] [Google Scholar]
  • 73.OECD . Guidance Document on the Reporting of Defined Approaches and Individual Information Sources to be Used within Integrated Approaches to Testing and Assessment (IATA) for Skin Sensitisation. OECD Series on Testing and Assessment, No 256. Paris, France: OECD Publishing; 2017.
  • 74.Gilmour N Kern PS Alepee N, et al. Development of a next generation risk assessment framework for the evaluation of skin sensitisation of cosmetic ingredients. Regul Toxicol Pharmacol 2020;116:104721. [DOI] [PubMed] [Google Scholar]
  • 75.Kleinstreuer NC Hoffmann S Alepee N, et al. Non-animal methods to predict skin sensitization (II): an assessment of defined approaches (*). Crit Rev Toxicol 2018;48(5):359–374. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 76.Natsch A Emter R Haupt T, et al. Deriving a no expected sensitization induction level for fragrance ingredients without animal testing: an integrated approach applied to specific case studies. Toxicol Sci 2018;165(1):170–185. [DOI] [PubMed] [Google Scholar]
  • 77.Cottrez F Boitel E Auriault C, et al. Genes specifically modulated in sensitized skins allow the detection of sensitizers in a reconstructed human skin model. Development of the SENS-IS assay. Toxicol In Vitro 2015;29(4):787–802. [DOI] [PubMed] [Google Scholar]
  • 78.Cottrez F Boitel E Ourlin JC, et al. SENS-IS, a 3D reconstituted epidermis based model for quantifying chemical sensitization potency: reproducibility and predictivity results from an inter-laboratory study. Toxicol In Vitro 2016;32:248–260. [DOI] [PubMed] [Google Scholar]
  • 79.Zeller KS Forreryd A Lindberg T, et al. The GARD platform for potency assessment of skin sensitizing chemicals. ALTEX 2017;34(4):539–559. [DOI] [PubMed] [Google Scholar]
  • 80.Wareing B Urbisch D Kolle SN, et al. Prediction of skin sensitization potency sub-categories using peptide reactivity data. Toxicol In Vitro 2017;45(Pt 1):134–145. [DOI] [PubMed] [Google Scholar]
  • 81.Natsch A Haupt T Wareing B, et al. Predictivity of the kinetic direct peptide reactivity assay (kDPRA) for sensitizer potency assessment and GHS subclassification. ALTEX 2020;37(4):652–664. [DOI] [PubMed] [Google Scholar]
  • 82.Natsch A Emter R Gfeller H, et al. Predicting skin sensitizer potency based on in vitro data from KeratinoSens and kinetic peptide binding: global versus domain-based assessment. Toxicol Sci 2015;143(2):319–332. [DOI] [PubMed] [Google Scholar]
  • 83.Hirota M Fukui S Okamoto K, et al. Evaluation of combinations of in vitro sensitization test descriptors for the artificial neural network-based risk assessment model of skin sensitization. J Appl Toxicol 2015;35(11):1333–1347. [DOI] [PubMed] [Google Scholar]
  • 84.Hirota M, Ashikaga T, Kouzuki H. Development of an artificial neural network model for risk assessment of skin sensitization using human cell line activation test, direct peptide reactivity assay, KeratinoSens™ and in silico structure alert parameter. J Appl Toxicol 2018;38(4):514–526. [DOI] [PubMed] [Google Scholar]
  • 85.Jaworska JS Natsch A Ryan C, et al. Bayesian integrated testing strategy (ITS) for skin sensitization potency assessment: a decision support system for quantitative weight of evidence and adaptive testing strategy. Arch Toxicol 2015;89(12):2355–2383. [DOI] [PubMed] [Google Scholar]
  • 86.Kolle SN, Landsiedel R, Natsch A. Replacing the refinement for skin sensitization testing: considerations to the implementation of adverse outcome pathway (AOP)-based defined approaches (DA) in OECD guidelines. Regul Toxicol Pharmacol 2020;115:104713. [DOI] [PubMed] [Google Scholar]

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