Nickel (Ni) allergic patients with complications to Ni containing joint replacement show preferential IL-17 type reactivity to Ni

• Published in: Contact dermatitis 2010-07, Vol.63 (1), p.15-22
• Main Authors: Summer, Burkhard, Paul, Carina, Mazoochian, Farhad, Rau, Christoph, Thomsen, Marc, Banke, Ingo, Gollwitzer, Hans, Dietrich, Karin-Almut, Mayer-Wagner, Susanne, Ruzicka, Thomas, Thomas, Peter
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; allergic contact dermatitis; Allergic diseases; arthroplasty; Arthroplasty, Replacement - adverse effects; Biological and medical sciences; Case-Control Studies; Chemical and industrial products toxicology. Toxic occupational diseases; Dermatitis, Allergic Contact - etiology; Dermatitis, Allergic Contact - immunology; Female; Humans; Immunopathology; Interferon-gamma - blood; Interferon-gamma - immunology; Interleukin-17 - blood; Interleukin-17 - immunology; Joint Prosthesis - adverse effects; Leukocytes, Mononuclear - immunology; Lymphocyte Activation - immunology; Male; Medical sciences; metals; Metals and various inorganic compounds; Middle Aged; Nickel - immunology; Reverse Transcriptase Polymerase Chain Reaction; Skin allergic diseases. Stinging insect allergies; Toxicology; Young Adult
• ISSN: 0105-1873; 1600-0536
• DOI: 10.1111/j.1600-0536.2010.01744.x

Background: Some nickel (Ni) allergic patients develop complications following Ni‐containing arthroplasty. In the peri‐implant tissue of such patients, we had observed lymphocyte dominated inflammation together with IFN‐γ and IL‐17 expression. Objectives: To determine whether Ni stimulation of peripheral blood mononuclear cells (PBMCs) of such patients would lead to a different cytokine pattern as compared to Ni‐allergic patients with symptom‐free arthroplasty. Patients and Methods: Based on history and patch testing in 15 Ni‐allergic patients (five without implant, five with symptom‐free arthroplasty, five with complicated arthroplasty) and five non‐allergic individuals, lymphocyte transformation test (LTT) was performed using PBMC. In parallel in vitro cytokine response to Ni was assessed by real‐time reverse transcriptase‐polymerase chain reaction (RT‐PCR). Results: All 15 Ni‐allergic individuals showed enhanced LTT reactivity to Ni (mean SI = 8.42 ± 1.8) compared to the non‐allergic control group. Predominant IFN‐γ expression to Ni was found both in the five allergic patients without arthroplasty and also in the five allergic, symptom‐free arthroplasty patients. In contrast, in the five Ni‐allergic patients with arthroplasty‐linked complications a predominant, significant IL‐17 expression to Ni was seen but not in patients with symptom‐free arthroplasty. Conclusions: The predominant IL‐17 type response to Ni may characterize a subgroup of Ni‐allergic patients prone to develop lymphocytic peri‐implant hyper‐reactivity.