Please click the relevant allergen for more information
A wide variety of metals can be tested, either by selecting panels or by selecting individual metals according to the patient's exposure. Although each laboratory will have its own testing panels, typical panels are HERE.
Each laboratory will offer slightly different testing panels. Typically, the panels will be based on the patient’s current exposure. Ideally, patients should contact their health care provider to find out the exact composition of their fillings, crowns, wires, pin and/or implants. The clinic/laboratory testing panels have been devised to include the most commonly found allergy causing metals in various metal alloys used in dentistry and surgery.
A detailed overview of metals found in frequently used dental and orthopaedic restorations as well as an overview of metals present in our environment could be found HERE.
The metals in the middle of the periodic table are called transition metals. Most of the metals used in dental restorations such as titanium, chromium, nickel, gold and mercury are transition metals. As the name suggests, they are unstable and their ions may bind to enzymes and cell proteins in the body. Most people will not react the new metal bound to protein structure. However, in genetically susceptible people, the new structure will activate an immune response and might lead to allergy and autoimmunity.
Theoretically, all metals can provoke allergy reactions, but certain metals are more frequently allergy-inducing than others. Also, we are more frequently exposed to certain metals, mainly nickel, from food and jewellery, cobalt and chromium from orthopaedic implants, titanium from implants and cosmetics and mercury, from amalgam fillings and polluted fish.
If you have been occupationally exposed to a metal which is not tested routinely, please contact us and we will try to arrange or possibly develop testing for you.
- Borrelia (Lyme disease)
Lyme disease is a bacterial infection caused by a spirochete, a type of bacteria, called Borrelia burgdorferi, which is passed to a person by a tick bite. Lyme disease has many symptoms, but skin problems, arthritis and various neurological symptoms are usually present. Examples include a skin rash, headaches, neck pain, chronic fatigue, fibromyalgia, joint pain, emotional instability and mental confusion.
Unfortunately, standard laboratory testing is often unable to give clear results of whether a patient is infected or not. The standard serological test ELISA has the broadest detection rate but low specificity. Specificity can be improved with the Western Blot. The test with the highest specificity but with a fairly low detection rate is the PCR test.
Lyme disease is often misdiagnosed as chronic fatigue syndrome, multiple sclerosis, fibromyalgia, rheumatoid arthritis or a number of other autoimmune and neurological diseases, which can lead to the true infection remaining untreated, allowing it to further disseminate the bacteria. If the neurological form of borreliosis is left untreated for years, it can lead to severe debility.
The MELISA test assay can now be applied to diagnose active Lyme disease, especially in serologically and clinically unclear cases. A positive reaction in the MELISA test demonstrates current active infection with Borrelia burgdorferi sensu lato. In addition to the standard four recombinant antigens derived from B.afzelii and B.garinii, the test includes three additional antigens derived from B.burgdorferi sensu stricto (a recombinant outer surface protein OspC, a recombinant p41-internal fragment, and a full antigen lysate). Read more on our Lyme page.
- Gluten / Gliadin
Cereals are among the most common foods to induce an immune reaction. There are four types of proteins present in cereals defined as albumins, globulins, prolamins and glutelins. 30-60% of the protein content consists of prolamin. The name prolamin refers to its high content of proline and glutamine. 50% of the protein in oat, barley and wheat consists of these amino acids.
Food allergies may be immediate, type I allergies sometimes causing anaphylaxis caused by IgE-mediated mast cell degranulation and histamine release. Or food allergies may be type IV cell mediated reactions with food-specific T cells as key players. For instance coeliac disease is sometimes described as type IV hypersensitivity to gluten, the protein found in wheat, barley and rye.
In a Swedish study (unpublished) 20 patients with irritable colon, eczema and premenstrual syndrome, often combined with psychological problems, were studied before and after elimination of cereals from their diet. Almost all of the patients noticed a positive effect following the elimination of gluten-containing meals, the majority immediately or within a week. Seven of the patients were tested for tissue transglutaminase but none had positive results. Thus, in these patients, serum tests seemed to have limited diagnostic value. In cooperation with the Swiss allergologist Dr Paul Corthay, and the MELISA laboratory in Geneva, we have conducted a study on the use of MELISA for the diagnosis of gluten allergy in patients attending allergy clinics near Geneva. Most of the patients suffered from various allergies but psychological and gastrointestinal problems often complicated the clinical picture. In addition to detailed anamnesis and testing with MELISA, prick test with food extracts and serum transglutaminase IgG and IgA were also determined.
In preliminary experiments, gluten extract did not induce significant lymphocyte proliferation in non-allergic healthy subjects.
In a 2006 study, 136 patients were tested to gluten and dental metals by the MELISA test. Forty-four patients were found gluten-positive (32%) while serum tests were only rarely positive. Gluten-positive patients responded significantly more often to dental metals as compared to gluten-negative patients (P< 0,001 for Hg, Sn, Ti, Al, and P< 0,05 for Pb, MeHg, Ni, Thimerosal). Skin prick tests depended on the individual variability (the quality of the skin) and varied largely. MELISA testing for gliadin/gluten may be useful to detect non-coeliac gluten sensitivity.
Gluten-specific MELISA seems to be clinically relevant as shown is some case reports. After strict avoidance of gluten-containing foods, gluten-positive lymphocyte reactivity returned to normal and the patients' health improved. Therefore it is important that subjects are still eating gluten containing foods prior to MELISA testing.
In conclusion, gluten reactivity seems to be common in patients with allergic diseases and the simultaneous testing of gluten together with metal testing seems to be beneficial to the patient.
Casein is a protein commonly found in milk from mammals. As a food source, casein is found in virtually all milk-based dairy products, including butter, cheese and ice cream. It's also found as an ingredient in some foods claimed as "non-dairy," margarine and soy cheese products included. The symptoms associated with a casein allergy can be immediate and include wheezing, difficulty breathing, vomiting and hives, swelling of the lips, mouth and tongue and face. The reaction for a casein intolerance takes a bit more time to appear. Gastrointestinal problems, such as diarrhea, bloating and abdominal cramps, are common symptoms but joint pain, fatigue and behavioral changes can also occur.
Candida albicans is a form of yeast. Found in approximately 80% of the human population, it usually doesn’t cause any harm but overgrowth can result in candidiasis. Candidiasis is often observed in immuno-compromised individuals. While symptoms vary, they can include bloating, abdominal distension, and food intolerances but also profound tiredness, depression and anxiety. A positive MELISA result indicates that a patient is likely to have Candida overgrowth and should consider treatment.
- Bone cement
Allergy to bone cement is an under-researched field but some researchers have identified allergies to certain constituents including methyl methacrylate (MMA) and in particular benzoyl peroxide. These substances can be tested at some European laboratories offering MELISA testing. This article adds: "On a practical note, it may be emphasized that one of the most common allergens in bone-cement, benzoyl peroxide, is challenging to test since it may elicit irritant patch test reactions."
The materials used will vary by manufacturer but more information can be found HERE.
- Pharmaceutical drugs
MELISA was originally developed for the testing of drug allergy in occupational settings. Though today the test is mostly used to screen for allergy to metals, the following substances can be tested on request. Please contact the laboratory before you send the blood.
Laboratoire MGD SA, Switzerland
Formaldehyde, Camphoroquinone, Benzoylperoxyde
InVitaLab Medizindiagnostik, Germany
Formaldehyde, Diclophenac, Erythromicin, Penicillum, Cefuroxime, Benzylpenicillin