Comparison of Personal History with Patch Test Results in Metal Allergy

Böhm, Ingrid; Brody, Marlene; Bauer, R.

doi:10.1111/j.1346-8138.1997.tb02831.x

Cited by 10 publications

(7 citation statements)

References 29 publications

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“…Twenty‐three per cent of the patients of Frigerio et al had a positive patch test reaction; that is, approximately three quarters of his patients underwent the complete test process, resulting in unnecessary costs. As in previous studies, this suggests that a negative history of contact allergy and negative patch test results have good concordance . Therefore, with the much higher proportion of positive results and the low prevalence of relevant PO positive patch test reactions in our study, we suggest that only patients with a clear history of contact allergy to metals should be patch tested.…”

Section: Discussionsupporting

confidence: 80%

Metal hypersensitivity in patients with orthopaedic implant complications—A retrospective clinical study

et al. 2018

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Background Hypersensitivity to metals as a cause of implant‐related complications has been a subject of controversy. Projections indicate an increase in the frequency of joint replacements of between 300% and 600% by the year 2030; therefore, this issue is of considerable interest. Objective To evaluate sensitization to implant materials in patients with implant‐related complications, to identify allergens, and to clarify whether hypersensitivity is a relevant cause. Methods Patients with implant‐related complications or a positive history of contact allergy and planned total joint replacements referred for allergological investigation between 2004 and 2017 were retrospectively analysed. Results In total, 311 patients were included. A positive patch test reaction to a metal was seen in 64.4% of preoperative patients and in 54.6% of patients with implant‐related complications. Common alloy metals such as cobalt, chromium and titanium gave positive reactions in up to 2.9% of patients with implant‐related complications. None of the patients with skin changes had a positive patch test reaction to an implant metal. Conclusion Other factors, such as the type of replaced joint and mechanical stress, seem to be more relevant for implant‐related complications. Sensitization to metals or other materials seems to rarely play a role, and is overestimated.

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Section: Discussionsupporting

confidence: 80%

Metal hypersensitivity in patients with orthopaedic implant complications—A retrospective clinical study

et al. 2018

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“…N ickel (Ni) is one of the most common contact sensitizers causing delayed-type hypersensitivity in humans (1)(2)(3)(4). Accordingly, the cellular immune response to Ni 2ϩ ions has become a model system for studying hapten-induced hypersensitivity (5-6).…”

Section: Preferential Usage Of Tcr-v␤17 By Peripheral and Cutaneous Tmentioning

confidence: 99%

Preferential Usage of TCR-Vβ17 by Peripheral and Cutaneous T Cells in Nickel-Induced Contact Dermatitis

Büdinger

Neuser²,

Totzke

et al. 2001

The Journal of Immunology

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Nickel (Ni) is one of the most common contact sensitizers in man, and Ni-induced contact dermatitis is considered as a model of hapten-induced delayed type hypersensitivity. Previous studies indicated that Ni-reactive T cells derived from Ni-allergic individuals preferentially express distinct TCR-Vβ chains. However, data on the TCR-Vβ repertoire of Ni-responsive T cells are not consistent. Therefore, the aim of this study was to identify the TCR-Vβ receptors of Ni-responsive peripheral and cutaneous T cells in a cohort of 17 donors with Ni-induced contact dermatitis in comparison with those of 6 healthy controls. Peripheral NiSO4-responsive T lymphocytes showed a significant overexpression of TCR-Vβ17 and the frequency of TCR-Vβ17+ T cells correlated significantly with the in vitro reactivity of PBMC to NiSO4. In addition, the cutaneous infiltrate of Ni-induced patch test reactions consisted primarily of Vβ17+ T cells. The majority of patch test-derived NiSO4-responsive T cells of three allergic donors were TCR-Vβ17+, whereas patch test-derived NiSO4 unresponsive T cells of four additional donors did not express TCR-Vβ17. Skin-derived Ni-responsive T cell lines from three donors uniformly secreted the Th2 cytokine, IL-5, but no IFN-γ or IL-10. These in vitro and in vivo findings strongly suggest that T cells with a restricted TCR-Vβ repertoire, i.e., Vβ17, predominate in NiSO4-induced contact dermatitis and may be crucial in the effector phase of Ni hypersensitivity.

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“…A 1+, 2+, or 3+ reading was interpreted as a positive response. An irritant response, a doubtful, or a negative reading was interpreted as a negative response [22]. …”

Section: Methodsmentioning

confidence: 99%

Prospective analysis of human leukocyte functional tests reveals metal sensitivity in patients with hip implant

et al. 2013

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BackgroundThe aim of the study was to examine the reactivity of peripheral human leukocytes to various metal ions prior and following hip replacement in order to investigate implant-induced metal sensitivity.MethodsThree patient groups were set up: (1) individuals without implants and no history of metal allergy (7 cases), (2) individuals without implants and known history of metal allergy (7 cases), and (3) patients undergoing cementless hip replacement (40 cases). Blood samples were taken in groups 1 and 2 at three different occasions; in group 3, prior and 3, 6, 12, 24, and 36 months after surgery. Peripheral leukocytes were separated and left either untreated or challenged with Ti, NiCl2, CoCl2, CrCl3, and phytohemagglutinin. Cell proliferation, cytokine release, and leukocyte migration inhibition assays were performed. Metal-induced reactivity was considered when all three assays showed significant change. Skin patch tests were also carried out.ResultsBoth skin patch tests and leukocyte functional tests were negative in group 1, and both were positive in group 2. In group 3, after 6 months, 12% of the patients showed reactivity to the tested metals except for NiCl2. Following the 36-month period, 18% of group three became sensitive to metals (including all the earlier 12%). In contrast, patch tests were negative at each time point in group 3.ConclusionsOrthopedic implant material may induce metal reactivity after implantation in a manner where susceptibility is yet to be elucidated. Leukocyte triple assay technique might be a useful tool to test implant material-related sensitivity.

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Comparison of Personal History with Patch Test Results in Metal Allergy

Cited by 10 publications

References 29 publications

Metal hypersensitivity in patients with orthopaedic implant complications—A retrospective clinical study

Metal hypersensitivity in patients with orthopaedic implant complications—A retrospective clinical study

Preferential Usage of TCR-Vβ17 by Peripheral and Cutaneous T Cells in Nickel-Induced Contact Dermatitis

Prospective analysis of human leukocyte functional tests reveals metal sensitivity in patients with hip implant

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