Interleukin 1, a multifunctional cytokine, plays a central role in inflammatory processes and induction of the immune response. Target cells possess 200 -5000 (or more) interleukin 1 receptors per cell, but they exhibit a full biological response when only 1 -2% of these receptors are occupied by interleukin la or I . Methotrexate has been reported to be beneficial in several inflammatory and autoimmune diseases. On the other hand, many of these diseases are known to share an overproduction of interleukin 1. It has been demonstrated that methotrexate has no influence on the interleukin 1 synthesis, so we focused our attention on the ability of methotrexate to interfere with the binding of interleukin 1 β to the interleukin 1 receptor. The experiments were performed on monocytes, lymphocytes and granulocytes using a recombinant human cytokine probe. Methotrexate led to an astonishing decrease in the binding of interleukin 1 β to the interleukin 1 receptor of peripheral blood cells, whereas methylprednisolone and indomethacin were not inhibitory. The inhibitory effect of methotrexate was dose dependent. An excess of interleukin I abolished the inhibition of cytokine binding by methotrexate. We also demonstrated that methotrexate does not affect the integrity of the interleukin 1 receptor or of the target cells. Our results demonstrate that methotrexate blocks the interleukin l -interleukin 1 receptor pathway. Methotrexate is therefore another interleukin 1 inhibitor and a clinically efficient anticytokine. but exert a full biological effect when only 1 -2% of Interleukin 1 is represented by two distinct cytokines, these receptors are occupied by interleukin 1 (2). interleukin la and interleukin I polypeptides, which ^ ,11·,.,

In order to compare the validity of patient personal history of contact sensitivity to metal alloys with patch test results, 160 patients with hand eczema were patch tested with a standard series according to the ICDRG after a special questionnaire. In 65%, history and patch test results were identical. Seventy-eight (48.8%) patients thought they would be allergic to metal ions, whereas the patch test revealed a positive result in only 21.3% cases. Positive history but negative test was more frequent in women; in the male group, negative history and positive patch test was the most common finding. Although 82 patients had a negative history, the patch test was positive for contact sensitivity to metal allergens in 12 of them. Both false positive patch tests and false negative histories are possible. Since many factors influence a positive patch test, not only the patient's history but also a synopsis of the anamnesis and patch testing will help to achieve the correct diagnosis of metal contact hypersensitivity.