- Articles - Title: Metal hypersensitivity in patients with failure of joint prosthesis treatment
- Articles - Abstract:
Bruna J, Prochazkova J, Podzimek S, Himmlova L, Janatova T, Vinsu A. J Immunol Res. 2025 Mar 10; 2025:4319686. doi: 10.1155/jimr/4319686.
The objective of this study is to measure lymphocyte responses to metal antigens using MELISA (memory lymphocyte immunostimulation assay) test–modified lymphocyte transformation test (mLTT) and to evaluate metal sensitization in patients with and without the need of prosthetic surgery. The patients in the study had known metal exposures, prior hypersensitivity reactions or implant-related complications. This study is a case-control retrospective survey. Authors retrospectively analyzed all patients from 2013 to 2018 who were referred to the Institute of Dental Medicine, General University Hospital in Prague, and First Faculty of Medicine, Charles University, Prague, either following joint prosthesis-related complications or as a preoperative evaluation concerning metal hypersensitivity. For the control group, authors selected healthy adults from their database. A group of 127 patients aged 25–81 years was chosen, 92 of which were female and 35 were male. The patients completed a special questionnaire aimed at information regarding their health status and history of metal exposure. After clinical examination, their peripheral blood samples were taken to perform mLTT. By comparison of the study group and control group mLTT results, it can be stated that patients of the study group showed a higher level of lymphocyte reactivity to most of the tested metal antigens. The study has revealed that the patients with the need of prosthetic surgery exhibited an elevated lymphocyte response to metal antigens. This result supports a metal-specific adaptive immune response and suggests involvement of metal exposure as a trigger for their health problems. Routine in vitro hypersensitivity testing before total joint replacement in patients with a history of health problems associated with metal exposure should be considered. Authors suggest performing mLTT testing preoperatively, during implant service, and before/after revision in case of complications.
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