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Given the increasing use of nanomaterials in industry and medicine, understanding how cobalt speciation affects skin immune activation is of growing clinical relevance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Fourteen cobalt\u2010allergic individuals underwent standardized patch testing with cobalt chloride (CoCl\n                      <jats:sub>2<\/jats:sub>\n                      ) and CoNPs at equivalent nominal doses. Skin biopsies from positive reactions were analyzed by RNA sequencing to characterize immune and barrier\u2010related pathways. Cobalt penetration and localization were further examined in reconstructed and ex\u00a0vivo human skin models using inductively coupled plasma mass spectrometry (ICP\u2010MS) and laser ablation ICP\u2010TOFMS imaging.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Both\n                      <jats:styled-content style=\"fixed-case\">\n                        CoCl\n                        <jats:sub>2<\/jats:sub>\n                      <\/jats:styled-content>\n                      and\n                      <jats:styled-content style=\"fixed-case\">CoNPs<\/jats:styled-content>\n                      elicited positive patch test reactions, although\n                      <jats:styled-content style=\"fixed-case\">CoNP<\/jats:styled-content>\n                      responses were delayed and milder.\n                      <jats:styled-content style=\"fixed-case\">\n                        CoCl\n                        <jats:sub>2<\/jats:sub>\n                      <\/jats:styled-content>\n                      also demonstrated a clearer dose\u2010dependent increase in clinical reactivity, whereas\n                      <jats:styled-content style=\"fixed-case\">CoNP<\/jats:styled-content>\n                      responses were comparatively stable across concentrations. Transcriptomic profiling revealed substantial overlap between exposures, with reaction strength emerging as the main determinant of gene expression changes. Increasing severity was associated with enrichment of interferon signaling, inflammatory response, apoptosis, cell cycle\u2010related programs, and glycolysis in both exposures. Lipid metabolic pathways were significantly associated with reaction strength in\n                      <jats:styled-content style=\"fixed-case\">\n                        CoCl\n                        <jats:sub>2<\/jats:sub>\n                      <\/jats:styled-content>\n                      \u2010exposed skin but not in\n                      <jats:styled-content style=\"fixed-case\">CoNP<\/jats:styled-content>\n                      \u2010exposed samples. Direct comparison using a paired\n                      <jats:styled-content style=\"fixed-case\">DESeq2<\/jats:styled-content>\n                      design identified 281 differentially expressed genes between\n                      <jats:styled-content style=\"fixed-case\">\n                        CoCl\n                        <jats:sub>2<\/jats:sub>\n                      <\/jats:styled-content>\n                      and\n                      <jats:styled-content style=\"fixed-case\">CoNP<\/jats:styled-content>\n                      . Functional enrichment of these genes revealed distinct biological signatures between exposures, including upregulated interferon and antiviral pathways and downregulated epithelial differentiation programs in\n                      <jats:styled-content style=\"fixed-case\">\n                        CoCl\n                        <jats:sub>2<\/jats:sub>\n                      <\/jats:styled-content>\n                      compared to\n                      <jats:styled-content style=\"fixed-case\">CoNP<\/jats:styled-content>\n                      . In complementary skin models,\n                      <jats:styled-content style=\"fixed-case\">\n                        CoCl\n                        <jats:sub>2<\/jats:sub>\n                      <\/jats:styled-content>\n                      exhibited deeper penetration, higher trans\u2010epidermal flux, and broader intracellular accumulation across epidermal and dermal cell populations, whereas\n                      <jats:styled-content style=\"fixed-case\">CoNPs<\/jats:styled-content>\n                      remained largely confined to the stratum corneum and adnexal structures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Cobalt\u2010induced ACD is shaped by both reaction strength and cobalt speciation. While CoCl\n                      <jats:sub>2<\/jats:sub>\n                      and CoNPs share a core interferon\u2010driven inflammatory program that scales with clinical severity, ionic cobalt penetrates more deeply and preferentially engages interferon and antiviral pathways in dermal compartments, whereas CoNPs are retained more superficially and are associated with epithelial differentiation programs. These findings underscore the importance of chemical form, tissue penetration, bioavailability, and retention in determining immune responses and dermal hazard of cobalt and other metal nanomaterials.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/all.70422","type":"journal-article","created":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T03:00:42Z","timestamp":1782010842000},"page":"3568-3583","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Distinct Skin Penetration and Immune Responses to Ionic and Nanoparticulate Cobalt in Allergic Contact Dermatitis"],"prefix":"10.1111","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8112-0252","authenticated-orcid":false,"given":"Paulina","family":"Werner","sequence":"first","affiliation":[{"name":"Institute of Environmental Medicine Karolinska Institutet  Solna 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