- Articles - Title: Metal sensitivity in patients with orthopaedic implants: a prospective study
- Articles - Abstract:
Frigerio, E et al. (2011). Contact Dermatitis, 64: 273–279.
A total of 100 patients referred for total hip or total knee arthroplasty were assessed for metal allergy preoperatively and then at 1 year post-implantation by means of patch tests. In a pilot study, 20 patients also underwent both patch testing and a lymphocyte transformation test (LTT-MELISA®) for the same metals. Of 31/100 patients with an apparent history of nickel sensitivity determined during preoperative assessment of subjects, 12 tested negative on both tests, and 4 with a negative history of nickel sensitivity tested positive. One year post-implantation (72 patients), 5 patients who had initially tested negative for a metal allergy became positive for at least one or more metal constituents of the prosthesis on at least one or the other test. Given the discrepancies between the information obtained while taking patient histories and test results, preoperative history-taking alone appears to be insufficient for identifying patients with metal sensitivity. Moreover, the increase in the percentage of patients who tested positive for metal sensitivity 1 year postimplantation suggests the possibility of prosthesis-induced sensitization. Therefore, objective determination of metal sensitivity at preoperative assessment should be considered in planning arthroplasty intervention, as it would help the surgeon in selecting the most appropriate prosthesis for the patient and could benefit implant performance.
- Articles - Download: Metal_sensitivity_in_patients_with_orthopaedic_implants_a_prospective_study.pdf
- Articles - Title: The role of environmental factors in autoimmune thyroiditis
- Articles - Abstract:
Hybenova M, Hrda P, Procházková J, Stejskal V, Sterzl I. Neuro Endocrinol Lett. 2010;31(3):283-9.
Environmental factors can play an important role in the development of autoimmune thyroiditis (AT) and other autoimmune diseases. This article reviews the role of heavy metals and infectious agents in AT. It has been found that patients with AT and other autoimmune diseases, such as multiple sclerosis, psoriasis, systemic lupus erythematosus and atopic eczema, show increased lymphocyte reactivity in vitro to inorganic mercury, nickel and other metals compared to healthy controls. An important source of mercury is dental amalgam. Replacement of amalgam in mercury-allergic subjects resulted in improved health in about 70% of patients.
- Articles - Download: Environmental-factors-and-autoimmune-thyroiditis.pdf
- Articles - Title: A novel lymphocyte transformation test (LTT-MELISA®) for Lyme borreliosis
- Articles - Abstract:
Valentine-Thon E, Ilsemann K, Sandkamp M. Diagn Microbiol Infect Dis. 27;2006
In this study, we describe the development and clinical relevance of a novel LTT using a validated format (MELISA) together with well-defined recombinant Borrelia-specific antigens. From an initial screening of 244 patients with suspected Borrelia infection or disease, 4 informative recombinant antigens were selected: OspC (Borrelia afzelii), p41-1 (Borrelia garinii), p41-2 (B. afzelii), and p100 (B. afzelii). Thereafter, 30 seronegative healthy controls were tested in LTT-MELISA to determine specificity, 68 patients were tested in parallel to determine reproducibility, and 54 lymphocyte-reactive symptomatic patients were tested before and after antibiotic therapy to assess clinical relevance. Most (86.2%) of the 36.9% (90/244) LTT-MELISA positive patients were seropositive and showed symptoms of active LB. Specificity was 96.7% and reproducibility 92.6%. After therapy, most patients (90.7%) showed negative or markedly reduced lymphocyte reactivity correlating with clinical improvement. This novel LTT-MELISA assay appears to correlate with active LB and may have diagnostic relevance in confirming LB in clinically and serologically ambiguous cases.
- Articles - Download: A_novel_lymphocyte_transformation_test.pdf
- Articles - Title: Diagnosis and treatment of metal-induced side-effects
- Articles - Abstract:
Stejskal V, Hudecek R, Stejskal J, Sterzl I. Neuro Endocrinol Lett 2006; 27(Suppl 1): 7-16
Environmental factors are recognized as a cause of the increasing frequency of allergic and autoimmune diseases. In addition to external pollutants, metal ions released from dental restorations or from other body implants might trigger inflammation in susceptible subjects. In humans, genes governing metal-induced inflammation and autoimmunity are not yet known. In clinical praxis, metal-sensitive patients will present various symptoms ranging from oral mucosal changes and skin disease to excessive fatigue and autoimmune diseases. Since genetic markers of genetic susceptibility in man are not known, one has to rely on the phenototypic markers. Such biomarkers might be certain detoxification enzymes but also the presence of metal-specific memory cells in the blood. With the increasing use of metal implants in medicine and dentistry, it is important to have a proper tool for the diagnosis of metal allergy in susceptible subjects. In addition to patch test, an in vitro blood test, an optimized commercially available lymphocyte transformation test (MELISA®) is discussed. Both tests were used for the diagnosis of metal allergy in a selected group of 15 patients who suffered from clinical metal sensitivity in addition to other health problems. The concordance of the two tests was good but MELISA® detected more metal allergies than patch test. The removal of incompatible dental material (RID) resulted in long-term health improvement in the majority of patients. We postulate that in vivo, metal ions activate T-cells, initiating systemic inflammation, which, through cytokines, affects the brain and hypothalamus-pituitary-adrenal axis. The treatment and rehabilitation of metal sensitive patients is based on a firm understanding and recognition of individual susceptibility. RID has to be done with extreme caution and according to standard working protocol. If performed properly, this treatment can result in decreased systemic inflammation and improved health in sensitized patients.
- Articles - Download: diagnosis-and-treatment-of-metal-induced-side-effects.pdf
- Articles - Title: LTT-MELISA® is clinically relevant for detecting and monitoring metal sensitivity
- Articles - Abstract:
Valentine-Thon E, et al. Neuro Endocrinol Lett 2006; 27(Suppl 1): 17-24
Blood from 700 consecutive patients was tested against a total of 26 metals in the validated LTT-MELISA. For reproducibility testing, 391 single metal tests from 63 patients were performed in parallel. Finally, to assess clinical relevance, 14 patients with known metal exposure showing local (dry mouth, oral lichen planus, burning mouth Syndrome, eczema) and/or systemic (chronic infections, fatigue, autoimmune disorders, central nervous system disturbances, depression) effects were tested and their cases reported.
- Articles - Download: LTT-MELISA-is-clinically-relevant-for-detecting-and.pdf
More Articles …
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- Micro analysis of metals in dental restorations as part of a diagnostic approach in metal allergies
- Removal of dental amalgam decreases anti-TPO and anti-Tg autoantibodies in patients with autoimmune thyroiditis
- Sensitization to inorganic mercury could be a risk factor for infertility