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Paschaei N, Müller WD, Schmidt F, Hüsker K, von Baehr V, Pandis N, Jost-Brinkmann PG, Bartzela T. Unveiling the Role of Metal Ion Concentration versus Immune Sensitization in Orthodontic Patients-A Long-Term Prospective Evaluation. J Clin Med 2024; 13:4545. [PMID: 39124811 PMCID: PMC11312833 DOI: 10.3390/jcm13154545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 07/28/2024] [Accepted: 08/01/2024] [Indexed: 08/12/2024] Open
Abstract
Background: This longitudinal prospective study aimed to assess orthodontic patients' immune system response to metal ion release in saliva. Methods: Thirty adult patients (18-35 years) were equally divided into three groups: groups at the end (G1) and beginning (G2) of multibracket appliances (MBA) treatment and a non-treated control group (G3). Participants were evaluated at four timepoints within 21 days, with saliva samples being analyzed for metal ion concentrations and blood for the lymphocyte transformation test (LTT). Results: There were no significant differences between groups or timepoints for saliva. LTT analyses revealed hypersensitivity in one-third of all patients and 50% of G2 for nickel, with three developing sensitizations after MBA insertion. All nickel-sensitized patients exhibited varying elevated saliva nickel concentrations. The most nickel-sensitized patients had low ion saliva loads. In borderline nickel-sensitization cases, saliva ion concentrations were up to 20 times higher than the reference. Hypersensitivity to palladium, gold, and mercury was also observed. Conclusions: These findings indicate that increased MBA ion release was not inherently linked to the immune response (Type-IV sensitization), as reactions occurred even with ion levels below thresholds. This underlines the need for a comprehensive evaluation of the immune response to metal ion release in orthodontic patients.
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Affiliation(s)
- Nusha Paschaei
- Department of Orthodontics and Dentofacial Orthopedics, CharitéCenter for Oral Health Sciences CC 3, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4–6, 14197 Berlin, Germany
| | - Wolf-Dieter Müller
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, CharitéCenter for Oral Health Sciences CC 3, Dental Materials and Biomaterial Research, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4–6, 14197 Berlin, Germany; (W.-D.M.); (F.S.)
| | - Franziska Schmidt
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, CharitéCenter for Oral Health Sciences CC 3, Dental Materials and Biomaterial Research, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4–6, 14197 Berlin, Germany; (W.-D.M.); (F.S.)
| | - Katrin Hüsker
- Department of Immunology, IMD Institute of Medical Diagnostics Berlin-Potsdam GbR, 12247 Berlin, Germany; (K.H.); (V.v.B.)
| | - Volker von Baehr
- Department of Immunology, IMD Institute of Medical Diagnostics Berlin-Potsdam GbR, 12247 Berlin, Germany; (K.H.); (V.v.B.)
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, Dental School/Medical Faculty, University of Bern, Freiburgstraße 7, 3010 Bern, Switzerland;
| | - Paul-Georg Jost-Brinkmann
- Department of Orthodontics and Dentofacial Orthopedics, CharitéCenter for Oral Health Sciences CC 3, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4–6, 14197 Berlin, Germany
| | - Theodosia Bartzela
- Department of Orthodontics, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany
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2
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Bjørklund G, Đorđević AB, Hamdan H, Wallace DR, Peana M. Metal-induced autoimmunity in neurological disorders: A review of current understanding and future directions. Autoimmun Rev 2024; 23:103509. [PMID: 38159894 DOI: 10.1016/j.autrev.2023.103509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 12/21/2023] [Indexed: 01/03/2024]
Abstract
Autoimmunity is a multifaceted disorder influenced by both genetic and environmental factors, and metal exposure has been implicated as a potential catalyst, especially in autoimmune diseases affecting the central nervous system. Notably, metals like mercury, lead, and aluminum exhibit well-established neurotoxic effects, yet the precise mechanisms by which they elicit autoimmune responses in susceptible individuals remain unclear. Recent studies propose that metal-induced autoimmunity may arise from direct toxic effects on immune cells and tissues, coupled with indirect impacts on the gut microbiome and the blood-brain barrier. These effects can activate self-reactive T cells, prompting the production of autoantibodies, inflammatory responses, and tissue damage. Diagnosing metal-induced autoimmunity proves challenging due to nonspecific symptoms and a lack of reliable biomarkers. Treatment typically involves chelation therapy to eliminate excess metals and immunomodulatory agents to suppress autoimmune responses. Prevention strategies include lifestyle adjustments to reduce metal exposure and avoiding occupational and environmental risks. Prognosis is generally favorable with proper treatment; however, untreated cases may lead to autoimmune disorder progression and irreversible organ damage, particularly in the brain. Future research aims to identify genetic and environmental risk factors, enhance diagnostic precision, and explore novel treatment approaches for improved prevention and management of this intricate and debilitating disease.
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Affiliation(s)
- Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Mo i Rana, Norway.
| | | | - Halla Hamdan
- Department of Pharmacology, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - David R Wallace
- Department of Pharmacology, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Massimiliano Peana
- Department of Chemical, Physical, Mathematical and Natural Sciences, University of Sassari, Italy.
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3
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Kageyama Y, Aida K, Nishizaki Y, Ebisui T, Akiyama T, Nakamura T. Increased prevalence of zinc hypersensitivity in patients with primary Sjögren syndrome: A case-control study. Int J Rheum Dis 2024; 27:e14861. [PMID: 37574907 DOI: 10.1111/1756-185x.14861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 07/20/2023] [Accepted: 07/27/2023] [Indexed: 08/15/2023]
Affiliation(s)
- Yasunari Kageyama
- Takanawa Clinic, Minato-ku, Tokyo, Japan
- Tokai University Hospital, Isehara-shi, Japan
| | | | - Yasuhiro Nishizaki
- Tokai University Hospital, Isehara-shi, Japan
- Department of Clinical Health Science, Tokai University Tokyo Hospital, Tokai University School of Medicine, Shibuya-ku, Tokyo, Japan
| | | | - Tetsu Akiyama
- Laboratory of Molecular and Genetic Information, Institute for Quantitative Biosciences, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- The Social Cooperation Program of Cellular Dynamics, Institute for Quantitative Biosciences, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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4
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Hopkins K, Antelmi A, Dahlin J, Olsson K, Svedman C, Åstrand J, Bruze M. Increased Rates of Gold and Acrylate Allergy in Individuals with Fibromyalgia Tested with an Extended Dental Patch Test Series. Acta Derm Venereol 2023; 103:adv22336. [PMID: 38078690 PMCID: PMC10726376 DOI: 10.2340/actadv.v103.22336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 10/30/2023] [Indexed: 12/18/2023] Open
Abstract
Fibromyalgia is a common chronic pain condition. Rates of contact allergy in individuals with fibromyalgia have not been widely studied. Systemic contact allergy can present with muscle and joint pain and general malaise. The aim of this study is to investigate contact allergy rates in individuals with fibromyalgia to the sensitizers in an extended dental series and compare with control groups. Contact allergy to gold was significantly more common in the fibromyalgia group than the dermatitis control group. When corrected for patch test system, contact allergy to gold was significantly more common in the fibromyalgia group than the dental control group. Contact allergy to hydroxyethyl methacrylate and grouped acrylates and methacrylates was significantly more common in the fibromyalgia group than the dental control group. In conclusion, individuals with fibromyalgia may have a propensity to sensitization to gold, either via an increased exposure or an alteration in the oral environment. Gold is also implicated in systemic contact dermatitis and may be a factor in elicitation of symptoms in individuals with fibromyalgia. Acrylate allergy is also common in the fibromyalgia population and may be a consequence of occupational exposure or dental treatment.
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Affiliation(s)
- Katharine Hopkins
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden; Department of Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden.
| | - Annarita Antelmi
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Jakob Dahlin
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Karin Olsson
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Jacqueline Åstrand
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Magnus Bruze
- Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
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5
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Zhan W, Su Y, Chen X, Xiong H, Wei X, Huang X, Xiong Y. Aggregation-Induced Emission Luminogen-Encapsulated Fluorescent Hydrogels Enable Rapid and Sensitive Quantitative Detection of Mercury Ions. BIOSENSORS 2023; 13:bios13040421. [PMID: 37185496 PMCID: PMC10135736 DOI: 10.3390/bios13040421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 05/17/2023]
Abstract
Hg2+ contamination in sewage can accumulate in the human body through the food chains and cause health problems. Herein, a novel aggregation-induced emission luminogen (AIEgen)-encapsulated hydrogel probe for ultrasensitive detection of Hg2+ was developed by integrating hydrophobic AIEgens into hydrophilic hydrogels. The working mechanism of the multi-fluorophore AIEgens (TPE-RB) is based on the dark through-bond energy transfer strategy, by which the energy of the dark tetraphenylethene (TPE) derivative is completely transferred to the rhodamine-B derivative (RB), thus resulting in intense photoluminescent intensity. The spatial networks of the supporting hydrogels further provide fixing sites for the hydrophobic AIEgens to enlarge accessible reaction surface for hydrosoluble Hg2+, as well create a confined reaction space to facilitate the interaction between the AIEgens and the Hg2+. In addition, the abundant hydrogen bonds of hydrogels further promote the Hg2+ adsorption, which significantly improves the sensitivity. The integrated TPE-RB-encapsulated hydrogels (TR hydrogels) present excellent specificity, accuracy and precision in Hg2+ detection in real-world water samples, with a 4-fold higher sensitivity compared to that of pure AIEgen probes. The as-developed TR hydrogel-based chemosensor holds promising potential as a robust, fast and effective bifunctional platform for the sensitive detection of Hg2+.
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Affiliation(s)
- Wenchao Zhan
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, China
- School of Food Science and Technology, Nanchang University, Nanchang 330047, China
| | - Yu Su
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, China
- School of Food Science and Technology, Nanchang University, Nanchang 330047, China
| | - Xirui Chen
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, China
- School of Food Science and Technology, Nanchang University, Nanchang 330047, China
| | - Hanpeng Xiong
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, China
- School of Food Science and Technology, Nanchang University, Nanchang 330047, China
| | - Xiaxia Wei
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, China
- School of Food Science and Technology, Nanchang University, Nanchang 330047, China
| | - Xiaolin Huang
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, China
- School of Food Science and Technology, Nanchang University, Nanchang 330047, China
- Jiangxi-OAI Joint Research Institute, Nanchang University, Nanchang 330047, China
| | - Yonghua Xiong
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, China
- School of Food Science and Technology, Nanchang University, Nanchang 330047, China
- Jiangxi-OAI Joint Research Institute, Nanchang University, Nanchang 330047, China
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Cross-Reactivity of Intraoral Allergic Contact Mucositis in the Nickel-Sensitized Ear Model of Metal Allergy. Int J Mol Sci 2023; 24:ijms24043965. [PMID: 36835375 PMCID: PMC9965913 DOI: 10.3390/ijms24043965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/04/2023] [Accepted: 02/12/2023] [Indexed: 02/18/2023] Open
Abstract
Cross-reactivity of metal allergies can make metal allergy treatment complicated because the background of immune response in cross-reactions remains unknown. In clinical settings, cross-reactivity among several metals has been suspected. However, the precise mechanism of immune response in cross-reactivity is unclear. Two sensitizations with nickel, palladium, and chromium plus lipopolysaccharide solution into the postauricular skin were followed by a single nickel, palladium, and chromium challenge of the oral mucosa to generate the intraoral metal contact allergy mouse model. Results showed that the infiltrating T cells in nickel-sensitized, palladium- or chromium-challenged mice expressed CD8+ cells, cytotoxic granules, and inflammation-related cytokines. Thus, nickel ear sensitization can cause cross-reactive intraoral metal allergy.
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Tomášek A, Maňoušek J, Kuta J, Hlásenský J, Křen L, Šindler M, Zelený M, Kala P, Němec P. Metals and Trace Elements in Calcified Valves in Patients with Acquired Severe Aortic Valve Stenosis: Is There a Connection with the Degeneration Process? J Pers Med 2023; 13:jpm13020320. [PMID: 36836554 PMCID: PMC9967375 DOI: 10.3390/jpm13020320] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 01/30/2023] [Accepted: 02/07/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Acquired calcified aortic valve stenosis is the most common valve disease in adulthood. In the etiopathogenesis of this complex pathology, the importance of inflammation is mentioned, in which non-infectious influences represented by the biological effects of metal pollutants may participate. The main goal of the study was to determine the concentration of 21 metals and trace elements-aluminium (Al), barium (Ba), cadmium (Cd), calcium (Ca), chrome (Cr), cobalt (Co), copper (Cu), gold (Au), lead (Pb), magnesium (Mg), mercury (Hg), molybdenum (Mo), nickel (Ni), phosphorus (P), selenium (Se), strontium (Sr), sulfur (S), tin (Sn), titanium (Ti), vanadium (V) and zinc (Zn)-in the tissue of calcified aortic valves and to compare them with the concentrations of the same elements in the tissue of healthy aortic valves in the control group. MATERIAL AND METHODS The study group consisted of 49 patients (25 men, mean age: 74) with acquired, severe, calcified aortic valve stenosis with indicated heart surgery. The control group included 34 deceased (20 men, median age: 53) with no evidence of heart disease. Calcified valves were explanted during cardiac surgery and deep frozen. Similarly, the valves of the control group were removed. All valves were lyophilized and analyzed by inductively coupled plasma mass spectrometry. The concentrations of selected elements were compared by means of standard statistical methods. RESULTS Calcified aortic valves contained significantly higher (p < 0.05) concentrations of Ba, Ca, Co, Cr, Mg, P, Pb, Se, Sn, Sr and Zn and-in contrast-lower concentrations of Cd, Cu, Mo, S and V than valves of the control group. Significant positive correlations of concentrations between the pairs Ca-P, Cu-S and Se-S and strong negative correlations between the elements Mg-Se, P-S and Ca-S were found in the affected valves. CONCLUSION Aortic valve calcification is associated with increased tissue accumulation of the majority of the analyzed elements, including metal pollutants. Some exposure factors may increase their accumulation in the valve tissue. A relationship between exposure to environmental burden and the aortic valve calcification process cannot be ruled out. Advances in histochemical and imaging techniques allowing imaging of metal pollutants directly in valve tissue may represent an important future perspective.
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Affiliation(s)
- Aleš Tomášek
- Centre for Cardiovascular Surgery and Transplantation, Pekařská 53, 656 91 Brno, Czech Republic
| | - Jan Maňoušek
- Department of Internal Cardiology Medicine, University Hospital and Faculty of Medicine, Masaryk University, Jihlavská 20, 625 00 Brno, Czech Republic
| | - Jan Kuta
- Research Centre for Toxic Compounds in the Environment (RECETOX), Faculty of Science, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
| | - Jiří Hlásenský
- Department of Internal Cardiology Medicine, University Hospital and Faculty of Medicine, Masaryk University, Jihlavská 20, 625 00 Brno, Czech Republic
- Correspondence: ; Tel.: +420-532-232-454
| | - Leoš Křen
- Institute of Pathology, University Hospital and Faculty of Medicine, Masaryk University, Jihlavská 20, 625 00 Brno, Czech Republic
| | - Martin Šindler
- Institute of Forensic Medicine, St Anne’s University Hospital and Faculty of Medicine, Masaryk University, Tvrdého 2a, 662 99 Brno, Czech Republic
| | - Michal Zelený
- Institute of Forensic Medicine, St Anne’s University Hospital and Faculty of Medicine, Masaryk University, Tvrdého 2a, 662 99 Brno, Czech Republic
| | - Petr Kala
- Department of Internal Cardiology Medicine, University Hospital and Faculty of Medicine, Masaryk University, Jihlavská 20, 625 00 Brno, Czech Republic
| | - Petr Němec
- Centre for Cardiovascular Surgery and Transplantation, Pekařská 53, 656 91 Brno, Czech Republic
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Perng WT, Ma KSK, Hung HY, Tsai YC, Huang JY, Liao PL, Hung YM, Wei JCC. Dental caries and risk of newly-onset systemic lupus erythematosus: a nationwide population-based cohort study. Curr Med Res Opin 2023; 39:307-317. [PMID: 36533392 DOI: 10.1080/03007995.2022.2159146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE This study investigated whether patients with history of dental caries are associated with an increased risk of newly-onset systemic lupus erythematosus (SLE). METHODS A total of 501,461 carious patients and 258,918 controls without carious teeth were enrolled between 1997 and 2013 from the National Health Insurance Research Database. Subgroup analyses were conducted based on restorative materials including amalgam, composite resins, or both. The cumulative incidence and hazard ratios (HRs) of SLE development were derived after adjusting for age, sex, socioeconomic status, income, insured classification, comorbidities, and frequency of dental visit in a multivariable model. RESULTS The risk of SLE was significantly higher in carious patients (HR = 1.98, 95% confidence interval [CI] = 1.65-2.38) compared to controls. Dose-dependent relationship between caries and risk of SLE was identified. The risk of SLE was higher among those who had dental visits ≧11 (HR = 2.53, 95% CI = 1.86-3.43), followed by those with 3-10 dental visits (HR = 1.86, 95% CI = 1.36-2.54), when compared to those with 1-2 visits, and was higher among those who had carious teeth extractions ≧5 (HR = 1.88, 95% CI = 1.19-2.97), followed by those with 1-4 carious teeth extractions (HR = 1.36, 95% CI = 1.17-1.59) than those without extraction. The risk of SLE for dental caries management among different restorative materials, including amalgam, composite resins, or both, was not statistically different. CONCLUSIONS Patients with dental caries were associated with higher SLE risks. The relationship between dental caries and risk of SLE was dose-dependent, regardless of the material used for the restoration.
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Affiliation(s)
- Wuu-Tsun Perng
- Department of Recreational Sport & Health Promotion, National Pingtung University of Science and Technology, Pingtung, Taiwan
- Graduate Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Kevin Sheng-Kai Ma
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
| | - Hsin-Yu Hung
- Department of Education, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yi-Chieh Tsai
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Jing-Yang Huang
- Department of Medical Research, Chung Shan Medical University, Taichung, Taiwan
| | - Pei-Lun Liao
- Department of Medical Research, Chung Shan Medical University, Taichung, Taiwan
| | - Yao-Min Hung
- Division of Nephrology, Department of Internal Medicine, Taipei Veterans General Hospital Taitung Branch, Taitung, Taiwan
- College of Health and Nursing, Meijo University, Pingtung, Taiwan
- College of Science and Engineering, National Taitung University, Taitung, Taiwan
| | - James Cheng-Chung Wei
- Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
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Boutefnouchet T, Vallières F, Delisle J, Benderdour M, Fernandes JC. Lymphocyte transformation test reveals low prevalence of true metal hypersensitivity among pre-operative total knee arthroplasty patients. Knee Surg Sports Traumatol Arthrosc 2022; 30:4123-4133. [PMID: 35380240 DOI: 10.1007/s00167-022-06951-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/15/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE The aims of this study were to determine the prevalence of metal hypersensitivity, and identify pre-operative factors which could predict susceptibility to hypersensitivity reactions among patients scheduled for primary total knee arthroplasty (TKA). The present study used a testing method consistent with the recognised biological response to metals. METHODS A prospective cross-sectional analysis of 220 patients was conducted. All patients received a testing protocol using lymphocyte transformation test to evaluate reactivity to possible contents of orthopaedic implants. Test response is interpreted as stimulation index (SI) values. A comprehensive questionnaire was used to evaluate prior exposure. Patients were categorised according to SI values and the odds ratios (OR) were calculated as comparative effect measure for each predetermined prior exposure factor. RESULTS The prevalence of metal sensitivity response was 28% (n = 61) among patients with susceptibility to at least one agent (SI = 2 to 4.9), and 3.2% (n = 7) among patients with true hypersensitivity (SI ≥ 5). The population-weighted prevalence, adjusted for sampling weights of symptomatic knee osteoarthritis, was SI ≥ 5 = 4.7% (95% CI 0.4-11.8%) and SI ≥ 2 = 35.2% (95% CI 24.8-48.6%). Stimulation index levels of response to materials were markedly varied with the highest being aluminium. Female sex, smoking history, cutaneous reaction to jewellery, occupational exposure, and dental procedures were among factors shown to increase the odds of having higher reactivity response to tested metals. Nevertheless, patients with well-functioning prior contralateral TKA did not appear at greater risk of having either sensitivity or susceptibility with odds ratio (OR) = 0.2 (95% CI 0.01-3.2), p: NS and OR = 0.6 (95% CI 0.3-1.2), p: NS, respectively. Prior positive patch test was neither predictor of susceptibility to hypersensitivity OR = 1.2 (95% CI 0.6-2.6) p: NS nor predictor of true hypersensitivity OR = 0.7 (95% CI 0.08-6.1), p: NS. CONCLUSION Among patients scheduled for primary TKA with no prior clinical features of metal allergy the prevalence of true hypersensitivity to at least one metal is just over 3%. Patients are likely to encounter a material to which they have pre-existing susceptibility to hypersensitivity. With certain prior exposure factors, there was increased susceptibility to metal hypersensitivity reaction evoking an acquired condition. LEVEL OF EVIDENCE Level II, prospective cross-sectional study.
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Affiliation(s)
- Tarek Boutefnouchet
- CIUSSS Nord de L'Ile de Montréal, Hôpital du Sacré-Coeur de Montréal, Jean Talon and Fleury Hospitals, Montreal, QC, Canada.
- University Hospitals Birmingham NHS Trust, Mindelsohn Way, Edgbaston, Birmingham, B15 2GW, UK.
| | - Francis Vallières
- CIUSSS Nord de L'Ile de Montréal, Hôpital du Sacré-Coeur de Montréal, Jean Talon and Fleury Hospitals, Montreal, QC, Canada
| | - Josee Delisle
- CIUSSS Nord de L'Ile de Montréal, Hôpital du Sacré-Coeur de Montréal, Jean Talon and Fleury Hospitals, Montreal, QC, Canada
| | - Mohamed Benderdour
- CIUSSS Nord de L'Ile de Montréal, Hôpital du Sacré-Coeur de Montréal, Jean Talon and Fleury Hospitals, Montreal, QC, Canada
| | - Julio C Fernandes
- CIUSSS Nord de L'Ile de Montréal, Hôpital du Sacré-Coeur de Montréal, Jean Talon and Fleury Hospitals, Montreal, QC, Canada
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Arakelyan M, Spagnuolo G, Iaculli F, Dikopova N, Antoshin A, Timashev P, Turkina A. Minimization of Adverse Effects Associated with Dental Alloys. MATERIALS (BASEL, SWITZERLAND) 2022; 15:7476. [PMID: 36363067 PMCID: PMC9658402 DOI: 10.3390/ma15217476] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/17/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
Metal alloys are one of the most popular materials used in current dental practice. In the oral cavity, metal structures are exposed to various mechanical and chemical factors. Consequently, metal ions are released into the oral fluid, which may negatively affect the surrounding tissues and even internal organs. Adverse effects associated with metallic oral appliances may have various local and systemic manifestations, such as mouth burning, potentially malignant oral lesions, and local or systemic hypersensitivity. However, clear diagnostic criteria and treatment guidelines for adverse effects associated with dental alloys have not been developed yet. The present comprehensive literature review aims (1) to summarize the current information related to possible side effects of metallic oral appliances; (2) to analyze the risk factors aggravating the negative effects of dental alloys; and (3) to develop recommendations for diagnosis, management, and prevention of pathological conditions associated with metallic oral appliances.
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Affiliation(s)
- Marianna Arakelyan
- Therapeutic Dentistry Department, Institute for Dentistry, Sechenov University, 119991 Moscow, Russia
| | - Gianrico Spagnuolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80138 Napoli, Italy
| | - Flavia Iaculli
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80138 Napoli, Italy
| | - Natalya Dikopova
- Therapeutic Dentistry Department, Institute for Dentistry, Sechenov University, 119991 Moscow, Russia
| | - Artem Antoshin
- Institute for Regenerative Medicine, Sechenov University, 119991 Moscow, Russia
- World-Class Research Center “Digital Biodesign and Personalized Healthcare”, Sechenov University, 119991 Moscow, Russia
| | - Peter Timashev
- Institute for Regenerative Medicine, Sechenov University, 119991 Moscow, Russia
- World-Class Research Center “Digital Biodesign and Personalized Healthcare”, Sechenov University, 119991 Moscow, Russia
- Chemistry Department, Lomonosov Moscow State University, 119234 Moscow, Russia
| | - Anna Turkina
- Therapeutic Dentistry Department, Institute for Dentistry, Sechenov University, 119991 Moscow, Russia
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Roach K, Roberts J. A comprehensive summary of disease variants implicated in metal allergy. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2022; 25:279-341. [PMID: 35975293 PMCID: PMC9968405 DOI: 10.1080/10937404.2022.2104981] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Allergic disease represents one of the most prominent global public health crises of the 21st century. Although many different substances are known to produce hypersensitivity responses, metals constitute one of the major classes of allergens responsible for a disproportionately large segment of the total burden of disease associated with allergy. Some of the most prevalent forms of metal allergy - including allergic contact dermatitis - are well-recognized; however, to our knowledge, a comprehensive review of the many unique disease variants implicated in human cases of metal allergy is not available within the current scientific literature. Consequently, the main goal in composing this review was to (1) generate an up-to-date reference document containing this information to assist in the efforts of lab researchers, clinicians, regulatory toxicologists, industrial hygienists, and other scientists concerned with metal allergy and (2) identify knowledge gaps related to disease. Accordingly, an extensive review of the scientific literature was performed - from which, hundreds of publications describing cases of metal-specific allergic responses in human patients were identified, collected, and analyzed. The information obtained from these articles was then used to compile an exhaustive list of distinctive dermal/ocular, respiratory, gastrointestinal, and systemic hypersensitivity responses associated with metal allergy. Each of these disease variants is discussed briefly within this review, wherein specific metals implicated in each response type are identified, underlying immunological mechanisms are summarized, and major clinical presentations of each reaction are described.Abbreviations: ACD: allergic contact dermatitis, AHR: airway hyperreactivity, ASIA: autoimmune/ autoinflammatory syndrome induced by adjuvants, BAL: bronchoalveolar lavage, CBD: chronic beryllium disease, CTCL: cutaneous T-cell lymphoma, CTL: cytotoxic T-Lymphocyte, DRESS: drug reaction with eosinophilia and systemic symptoms, GERD: gastro-esophageal reflux disease, GI: gastrointestinal, GIP: giant cell interstitial pneumonia, GM-CSF: granulocyte macrophage-colony stimulating factor, HMLD: hard metal lung disease, HMW: high molecular weight, IBS: irritable bowel syndrome, Ig: immunoglobulin, IL: interleukin, LMW: low molecular weight, PAP: pulmonary alveolar proteinosis, PPE: personal protective equipment, PRR: pathogen recognition receptor, SLE: systemic lupus erythematosus, SNAS: systemic nickel allergy syndrome, Th: helper T-cell, UC: ulcerative colitis, UV: ultraviolet.
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Affiliation(s)
- Ka Roach
- Allergy and Clinical Immunology Branch (ACIB), National Institute of Occupational Safety and Health (NIOSH), Morgantown, WV, USA
| | - Jr Roberts
- Allergy and Clinical Immunology Branch (ACIB), National Institute of Occupational Safety and Health (NIOSH), Morgantown, WV, USA
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12
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Chen KH, Yu HC, Chang YC. Analysis of dental amalgam fillings on primary Sjögren's syndrome: A population-based case-control study in Taiwan. Medicine (Baltimore) 2021; 100:e28031. [PMID: 34964800 PMCID: PMC8615304 DOI: 10.1097/md.0000000000028031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 11/11/2021] [Indexed: 01/05/2023] Open
Abstract
Primary Sjören's syndrome (pSS) is an autoimmune disease characterized by the inflammatory infiltrate and progressive dysfunction of salivary glands. Dental amalgam with mercury has been raised the public concerns regarding its purported mercury toxicity from dental amalgam to possible systemic inflammatory and immune reactions.In this study, a nationwide population-based database was employed to investigate the association of amalgam filling (AMF) and the risk of pSS. A retrospective case-control study was sourced from the Taiwanese National Health Insurance Research Database (NHIRD) from 2000 to 2013. Case and control groups were matched by sex, age, urbanization level, monthly income, and comorbidities using the propensity score method with a 1:1 ratio. In this study, 5848 cases and 5848 controls were included.The results demonstrated no statistically significant differences between AMF and pSS (odds ratio [OR]: 0.974, 95% confidence interval [CI] = 0.904-1.049). In addition, pSS was also not associated with AMF for women (OR: 0.743, 95% CI = 0.552-1.000) and men (OR: 1.006, 95% CI = 0.670-1.509), respectively.Taken together, evidence demonstrated that the association of AMF and pSS was inconsistent from this robust register databank.
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Affiliation(s)
- Kun-Huang Chen
- The College of Management and Design, Ming Chi University of Technology, New Taipei, Taiwan
- Department of Artificial Intelligence, CTBC Business School, Tainan, Taiwan
| | - Hui-Chieh Yu
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
| | - Yu-Chao Chang
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
- Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
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13
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Tramontana M, Bianchi L, Hansel K, Agostinelli D, Stingeni L. Nickel Allergy: Epidemiology, Pathomechanism, Clinical Patterns, Treatment and Prevention Programs. Endocr Metab Immune Disord Drug Targets 2021; 20:992-1002. [PMID: 31994473 DOI: 10.2174/1871530320666200128141900] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 03/10/2019] [Accepted: 04/04/2019] [Indexed: 01/19/2023]
Abstract
Nickel is the most common cause of contact allergy in the general population and the most frequently detected allergen in patients patch tested for suspected allergic contact dermatitis (ACD). ACD from nickel is a typical type IV hypersensitivity. Nickel allergy is mostly caused by nonoccupational exposure, such as jewelry and clothing decorations, metal tools, medical devices (mainly orthopedic and orthodontic implants, cardiovascular prosthesis), eyeglasses, utensils, keys, pigment for paint, cosmetics, and food (mainly legumes, chocolate, salmon, peanuts). Occupational exposure can involve several workers (mechanics, metalworkers, platers, hairdressers, jewelers, workers in the constructions and electronic industries), classically involving hands and forearms. The classic clinical pattern of ACD caused by nickel is characterized by eczematous dermatitis involving the sites of direct contact with the metal. Non-eczematous-patterns are reported, including lichenoid dermatitis, granuloma annulare, vitiligo-like lesions, dyshidrosiform dermatitis, and vasculitis. In the case of systemic exposure to nickel, sensitized patients could develop systemic contact dermatitis. Patch testing represents the gold standard for the diagnosis of ACD from nickel. Treatment includes avoidance of contact with products containing nickel and the patient's education about the possible use of alternative products. A recent EU nickel directive, regulating the content and release of nickel from products, has caused a decrease of nickel contact allergy in some European countries. Nickel allergy is a relevant issue of public health with significant personal, social, and economic impact. This review summarizes epidemiology, pathomechanism, clinical patterns, treatment, and prevention programs.
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Affiliation(s)
- Marta Tramontana
- Dermatology Section, Department of Medicine, University of Perugia, Perugia, Italy
| | - Leonardo Bianchi
- Dermatology Section, Department of Medicine, University of Perugia, Perugia, Italy
| | - Katharina Hansel
- Dermatology Section, Department of Medicine, University of Perugia, Perugia, Italy
| | - Daniela Agostinelli
- Dermatology Section, Department of Medicine, University of Perugia, Perugia, Italy
| | - Luca Stingeni
- Dermatology Section, Department of Medicine, University of Perugia, Perugia, Italy
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14
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Titanium and Other Metal Hypersensitivity Diagnosed by MELISA® Test: Follow-Up Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5512091. [PMID: 34124241 PMCID: PMC8192180 DOI: 10.1155/2021/5512091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/07/2021] [Accepted: 05/20/2021] [Indexed: 11/22/2022]
Abstract
This study is aimed at proving the clinical benefit of the MELISA® test in the minimization or complete elimination of health problems in patients with confirmed hypersensitivity to metals used for tissue replacements. A group of 305 patients aged 20-75 years with previously proven metal hypersensitivity (initial MELISA® test), mainly to titanium and then to another fifteen metals, was chosen from the database at the Institute of Dental Medicine. From these patients, a final group of 42 patients agreed to participate in the study, 35 of which were female and 7 were male. The patients completed a special questionnaire aimed at information regarding change of health status from their last visit and determining whether the results of the initial MELISA® test and recommendations based on it were beneficial for patients or not. They were clinically examined, and peripheral blood samples were taken to perform follow-up MELISA® tests. Questionnaire data was processed, and the follow-up MELISA® test results were compared with the results of the initial MELISA® tests. For statistical analysis, the Fisher's exact test and paired T-test were used. Thirty-two patients reported that they followed the recommendations based on the results of the initial MELISA® tests, and of these, 30 patients (94%) confirmed significant health improvement. Six patients did not follow the recommendation, and from these, only one patient reported an improvement in his health problems. By comparison of the initial and follow-up MELISA® test results, it can be stated that the hypersensitivity to the given metal decreased or disappeared after the therapeutic interventions performed based on the initial MELISA® test results. The evaluation of the data obtained from patients in this study confirmed a significant clinical benefit of MELISA® test.
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15
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Geier DA, Geier MR. Dental Amalgams and the Incidence Rate of Arthritis among American Adults. CLINICAL MEDICINE INSIGHTS-ARTHRITIS AND MUSCULOSKELETAL DISORDERS 2021; 14:11795441211016261. [PMID: 34045912 PMCID: PMC8138300 DOI: 10.1177/11795441211016261] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 04/20/2021] [Indexed: 12/24/2022]
Abstract
This hypothesis-testing study evaluated the relationship between mercury
(Hg)-based dental amalgams and arthritis diagnoses among adults in the United
States (US). A total of 86 305 425 weighted-persons with ⩾1 dental amalgam
filling surface (DAFS) (exposed group) and 32 201 088 weighted-persons with ⩾1
other dental filling surface (ODFS) (no DAFS, unexposed group) were examined in
the 2015 to 2016 National Health and Nutritional Examination Survey (NHANES).
All persons were 20 to 80 years-old with known demographic characteristics and
arthritis status. Survey logistic regression and survey frequency modeling in
SAS were employed with and without adjustment of covariates. The arthritis rate
was significantly increased in the exposed group compared to the unexposed group
in the unadjusted (7.68-fold) and adjusted (4.89-fold) models. Arthritis (per
10 000 weighted-person-years) was 6.0-fold significantly increased in the
exposed group (6.2) compared to the unexposed group (1.06). A significant
bimodal dose-dependent relationship between DAFS and arthritis rate was
observed. The arthritis rate increased with increasing DAFS (peak among persons
with 4-7 DAFS) and, subsequently, decreased among those with >6 DAFS. A
significant decrease in arthritis rate among persons with >13 DAFS as
compared to those persons with 4 to 7 DAFS was observed. A significant
association between DAFS and arthritis risk and a dose-dependent DAFS associated
immune-stimulation/immune-suppression with arthritis risk were observed. An
estimated additional $96 835 814 US dollars (USD) are spent on annual medical
costs and $184 797 680 USD are lost in annual wages from reported new onset
arthritis attributably associated with DAFS (annual total cost = $281 633 494
USD).
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Affiliation(s)
- David A Geier
- Institute of Chronic Illnesses, Inc, Silver Spring, MD, USA.,CoMeD, Inc, Silver Spring, MD, USA
| | - Mark R Geier
- Institute of Chronic Illnesses, Inc, Silver Spring, MD, USA.,CoMeD, Inc, Silver Spring, MD, USA
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16
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Das DC, Jahan I, Uddin MG, Hossain MM, Chowdhury MAZ, Fardous Z, Rahman MM, Kabir AKMH, Deb SR, Siddique MAB, Das A. Serum CRP, MDA, Vitamin C, and Trace Elements in Bangladeshi Patients with Rheumatoid Arthritis. Biol Trace Elem Res 2021; 199:76-84. [PMID: 32306287 DOI: 10.1007/s12011-020-02142-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 04/02/2020] [Indexed: 02/06/2023]
Abstract
Rheumatoid arthritis (RA) is an autoimmune disorder that is a painful health crisis. This study aimed to assess the serum C-reactive protein (CRP), malondialdehyde (MDA), non-enzymatic antioxidant (vitamin C), and trace elements (Zn, Cu, Mn, and Fe) in RA patients, and thereby correlate these parameters with the association of RA. This study included 20 Bangladeshi RA patients and 20 normal healthy volunteers as control subjects. CRP level was determined using a laboratory-based latex agglutination-enhanced immunoassay. The lipid peroxidation level was determined by measurement of the serum level of MDA. Non-enzymatic antioxidant vitamin C was assessed by UV spectrophotometric method. Trace elements were determined by atomic absorption spectroscopy (AAS). Our study observed significantly higher concentrations of CRP (p < 0.001) and MDA (p < 0.001), and significantly lower concentrations of vitamin C (p < 0.001) in the RA patient. The mean values of Zn, Cu, Mn, and Fe were 6.62 ± 0.34, 1.42 ± 0.17, 7.51 ± 0.23, and 29.25 ± 0.41 ppm for the RA patients respectively and 13.57 ± 9.13, 1.15 ± 0.17, 1.59 ± 0.18, and 62.47 ± 5.25 ppm for the control subjects, consequently. There was a significant difference (p < 0.05) in the trace element levels between the RA patients and control subjects. Our study suggests that a higher concentration of CRP and MDA, lower levels of vitamin C, and altered trace elements may be linked to RA.
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Affiliation(s)
- Dalim Chandra Das
- Department of Pharmacy, Noakhali Science and Technology University, Noakhali, 3814, Bangladesh
| | - Israt Jahan
- Department of Pharmacy, Noakhali Science and Technology University, Noakhali, 3814, Bangladesh
| | - Md Giash Uddin
- Department of Pharmacy, University of Chittagong, Chittagong, 4331, Bangladesh
| | - Md Monir Hossain
- Department of Pharmacy, Mawlana Bhashani Science and Technology University, Santosh, Tangail, 1902, Bangladesh
| | - Muhammed Alamgir Zaman Chowdhury
- Agrochemical and Environmental Research Division, Institute of Food and Radiation Biology, Bangladesh Atomic Energy Research Establishment, Savar, Dhaka, 1349, Bangladesh
| | - Zeenath Fardous
- Agrochemical and Environmental Research Division, Institute of Food and Radiation Biology, Bangladesh Atomic Energy Research Establishment, Savar, Dhaka, 1349, Bangladesh
| | - Md Mujibur Rahman
- Department of Medicine, Dhaka Medical College and Hospital, Dhaka, 1000, Bangladesh
| | - A K M Humayun Kabir
- Department of Medicine, Dhaka Medical College and Hospital, Dhaka, 1000, Bangladesh
| | - Sudip Ranjan Deb
- Department of Medicine, Dhaka Medical College and Hospital, Dhaka, 1000, Bangladesh
| | | | - Abhijit Das
- Department of Pharmacy, Noakhali Science and Technology University, Noakhali, 3814, Bangladesh.
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17
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Kageyama Y, Shimokawa Y, Kawauchi K, Morimoto M, Aida K, Akiyama T, Nakamura T. Evaluation of the SNP rs2367563 genotyping test as an adjunctive detection tool for dental metal hypersensitivity. AIMS ALLERGY AND IMMUNOLOGY 2021. [DOI: 10.3934/allergy.2021008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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18
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Bjørklund G, Dadar M, Chirumbolo S, Aaseth J, Peana M. Metals, autoimmunity, and neuroendocrinology: Is there a connection? ENVIRONMENTAL RESEARCH 2020; 187:109541. [PMID: 32445945 DOI: 10.1016/j.envres.2020.109541] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 04/04/2020] [Accepted: 04/14/2020] [Indexed: 06/11/2023]
Abstract
It has been demonstrated that metals can induce autoimmunity. However, few studies have attempted to assess and elucidate the underlying mechanisms of action. Recent research has tried to evaluate the possible interactions of the immune system with metal ions, particularly with heavy metals. Research indicates that metals have the potential to induce or promote the development of autoimmunity in humans. Metal-induced inflammation may dysregulate the hypothalamic-pituitary-adrenal (HPA) axis and thus contribute to fatigue and other non-specific symptoms characterizing disorders related to autoimmune diseases. The toxic effects of several metals are also mediated through free radical formation, cell membrane disturbance, or enzyme inhibition. There are worldwide increases in environmental metal pollution. It is therefore critical that studies on the role of metals in autoimmunity, and neuroendocrine disorders, including effects on the developing immune system and brain and the genetic susceptibility are performed. These studies can lead to efficient preventive strategies and improved therapeutic approaches. In this review, we have retrieved and commented on studies that evaluated the effects of metal toxicity on immune and endocrine-related pathways. This review aims to increase awareness of metals as factors in the onset and progression of autoimmune and neuroendocrine disorders.
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Affiliation(s)
- Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Mo i Rana, Norway.
| | - Maryam Dadar
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | - Salvatore Chirumbolo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy; CONEM Scientific Secretary, Verona, Italy
| | - Jan Aaseth
- Research Department, Innlandet Hospital Trust, Brumunddal, Norway; IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Massimiliano Peana
- Department of Chemistry and Pharmacy, University of Sassari, Sassari, Italy
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19
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Zhang Y, Anderson KM, Freed BM, Dai S, Pacheco KA. HLA-DR53 (DRB4∗01) associates with nickel sensitization. Ann Allergy Asthma Immunol 2020; 125:614-616. [PMID: 32693207 DOI: 10.1016/j.anai.2020.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Yan Zhang
- Department of Pharmaceutical Sciences, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, Colorado; Department of Immunology and Microbiology, University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Kirsten M Anderson
- Department of Pharmaceutical Sciences, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, Colorado; Department of Immunology and Microbiology, University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Brian M Freed
- ClinImmune Labs and Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Shaodong Dai
- Department of Pharmaceutical Sciences, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, Colorado; Department of Immunology and Microbiology, University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
| | - Karin A Pacheco
- Department of Medicine, National Jewish Health, Denver, Colorado; Division of Environmental & Occupational Health, Colorado School of Public Health University of Colorado Anschutz Medical Campus, Aurora, Colorado.
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20
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Manousek J, Felsoci M, Miklik R, Parenica J, Krejci J, Bjørklund G, Klanova J, Mlejnek D, Miklikova M, Lokaj P, Chirumbolo S, Spinar J. Delayed-type Hypersensitivity to Metals in Newly Diagnosed Patients with Nonischemic Dilated Cardiomyopathy. Cardiovasc Toxicol 2020; 20:571-580. [PMID: 32557318 DOI: 10.1007/s12012-020-09582-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The causes of nonischemic dilated cardiomyopathy are classified as genetic or nongenetic, but environmental factors such as metal pollutants may interact with genetic susceptibility. The presence of metal particles has been detected in the myocardium, including in those patients with dilated cardiomyopathy. It is also known that hypersensitivity reactions can induce inflammation in tissue. The present study aimed to verify if metal-induced delayed-type hypersensitivity is present in patients with nonischemic dilated cardiomyopathy. The patient group consisted of 30 patients with newly diagnosed dilated cardiomyopathy; the control group comprised 41 healthy subjects. All patients and control subjects provided blood samples for lymphocyte transformation testing (MELISA®) to assess possible hypersensitivity to seven common metals. Specific exposure to metals was based on interview data. Results showed that exposure to cadmium and lead (p = 0.0002), aluminum (p = 0.0006), nickel (p = 0.0012), and chromium (p = 0.0065) was more often reported by patients than controls. The patients also had significantly more frequent hypersensitivity reactions to mercury (26.7% vs. 7.3%, p = 0.014624), nickel (40% vs. 12.2%, p = 0.02341), and silver (20% vs. 4.8%, p = 0.025468) than the control group. Patients with dilated cardiomyopathy had greater exposure to certain metals compared with healthy controls. Hypersensitivity to metals was more frequent in patients with dilated cardiomyopathy, suggesting a possible association that warrants further investigation.
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Affiliation(s)
- Jan Manousek
- Department of Internal Medicine and Cardiology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Marian Felsoci
- Department of Internal Medicine and Cardiology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Roman Miklik
- Department of Cardiology, University Hospital and Faculty of Medicine Pilsen, Charles University, Prague, Czech Republic.
| | - Jiri Parenica
- Department of Internal Medicine and Cardiology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jan Krejci
- Department of Cardiovascular Diseases, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine (CONEM), Toften 24, 8610, Mo i Rana, Norway.
| | - Jana Klanova
- Research Centre for Toxic Compounds in the Environment (RECETOX), Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Dalibor Mlejnek
- Department of Cardiovascular Diseases, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Marie Miklikova
- Department of Internal Medicine and Cardiology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Petr Lokaj
- Department of Internal Medicine and Cardiology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Salvatore Chirumbolo
- Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.,CONEM Scientific Secretary, Verona, Italy
| | - Jindrich Spinar
- Department of Internal Medicine and Cardiology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
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21
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Bjørklund G, Peana M, Dadar M, Chirumbolo S, Aaseth J, Martins N. Mercury-induced autoimmunity: Drifting from micro to macro concerns on autoimmune disorders. Clin Immunol 2020; 213:108352. [PMID: 32032765 DOI: 10.1016/j.clim.2020.108352] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 02/02/2020] [Accepted: 02/03/2020] [Indexed: 12/20/2022]
Abstract
Mercury (Hg) is widely recognized as a neurotoxic metal, besides it can also act as a proinflammatory agent and immunostimulant, depending on individual exposure and susceptibility. Mercury exposure may arise from internal body pathways, such as via dental amalgams, preservatives in drugs and vaccines, and seafood consumption, or even from external pathways, i.e., occupational exposure, environmental pollution, and handling of metallic items and cosmetics containing Hg. In susceptible individuals, chronic low Hg exposure may trigger local and systemic inflammation, even exacerbating the already existing autoimmune response in patients with autoimmunity. Mercury exposure can trigger dysfunction of the autoimmune responses and aggravate immunotoxic effects associated with elevated serum autoantibodies titers. The purpose of the present review is to provide a critical overview of the many issues associated with Hg exposure and autoimmunity. In addition, the paper focuses on individual susceptibility and other health effects of Hg.
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Affiliation(s)
- Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Mo i Rana, Norway.
| | - Massimiliano Peana
- Department of Chemistry and Pharmacy, University of Sassari, Sassari, Italy
| | - Maryam Dadar
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | - Salvatore Chirumbolo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy; CONEM Scientific Secretary, Verona, Italy
| | - Jan Aaseth
- Research Department, Innlandet Hospital Trust, Brumunddal, Norway
| | - Natália Martins
- Faculty of Medicine, University of Porto, Porto, Portugal; Institute for Research and Innovation in Health (I3S), University of Porto, Porto, Portugal
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22
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Pamphlett R, Kum Jew S. Mercury Is Taken Up Selectively by Cells Involved in Joint, Bone, and Connective Tissue Disorders. Front Med (Lausanne) 2019; 6:168. [PMID: 31380381 PMCID: PMC6659129 DOI: 10.3389/fmed.2019.00168] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 07/08/2019] [Indexed: 12/15/2022] Open
Abstract
Background: The causes of most arthropathies, osteoarthritis, and connective tissue disorders remain unknown, but exposure to toxic metals could play a part in their pathogenesis. Human exposure to mercury is common, so to determine whether mercury could be affecting joints, bones, and connective tissues we used a histochemical method to determine the cellular uptake of mercury in mice. Whole neonatal mice were examined since this allowed histological assessment of mercury in joint, bone, and connective tissue cells. Materials and Methods: Pregnant mice were exposed to a non-toxic dose of 0.5 mg/m3 of mercury vapor for 4 h a day on gestational days 14-18. Neonates were sacrificed at postnatal day 1, fixed in formalin, and transverse blocks of the body were processed for paraffin embedding. Seven micrometer sections were stained for inorganic mercury using silver nitrate autometallography, either alone or combined with CD44 immunostaining to detect progenitor cells. Control neonates were not exposed to mercury during gestation. Results: Uptake of mercury was marked in synovial cells, articular chondrocytes, and periosteal and tracheal cartilage cells. Mercury was seen in fibroblasts in the dermis, aorta, esophagus and striated muscle, some of which were CD44-positive progenitor cells, and in the endothelial cells of small blood vessels. Mercury was also present in renal tubules and liver periportal cells. Conclusions: Mercury is taken up selectively by cells that are predominantly affected in rheumatoid arthritis and osteoarthritis. In addition, fibroblasts in several organs often involved in multisystem connective tissue disorders take up mercury. Mercury provokes the autoimmune, inflammatory, genetic, and epigenetic changes that have been described in a range of arthropathies and bone and connective tissue disorders. These findings support the hypothesis that mercury exposure could trigger some of these disorders, particularly in people with a genetic susceptibility to autoimmunity.
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Affiliation(s)
- Roger Pamphlett
- Discipline of Pathology, Brain and Mind Centre, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
- Department of Neuropathology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Stephen Kum Jew
- Discipline of Pathology, Brain and Mind Centre, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
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23
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Shibuya S, Watanabe K, Tsuji G, Ichihashi M, Shimizu T. Platinum and palladium nanoparticle-containing mixture, PAPLAL, does not induce palladium allergy. Exp Dermatol 2019; 28:1025-1028. [PMID: 31260134 DOI: 10.1111/exd.13996] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 06/04/2019] [Accepted: 06/21/2019] [Indexed: 12/23/2022]
Abstract
Palladium (Pd) is a common metal found in jewellery and dental appliances, but it has been shown to be likely to cause metal allergy. We previously reported that platinum (nPt) and palladium (nPd) nanoparticle-containing mixture (PAPLAL) has both superoxide dismutase and catalase activities and that the topical application of PAPLAL improved skin atrophy induced by chronic oxidative damage in an ageing mouse model. However, the safety of PAPLAL for preventing Pd allergy remains unclear. In the present study, we investigated whether or not PAPLAL induces Pd allergy. We found that PAPLAL treatment caused no skin inflammation, while nPd administration caused only slight skin inflammation compared to the palladium chloride-induced severe reaction in an experimental metal allergy model. A gene expression analysis revealed that PAPLAL treatment significantly suppressed the expression of Inf-γ, Il-1β and Tnfα genes. Even in human clinical trials using patches containing metal nanoparticles, nPd and PAPLAL failed to induce significant skin inflammation. These results suggest that mixing with nPt in PAPLAL suppresses the inflammation response of nPd. PAPLAL can be expected to be applied to various skin treatments as a safe topical substance.
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Affiliation(s)
- Shuichi Shibuya
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan.,Aging Stress Response Project Team, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kenji Watanabe
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan.,Aging Stress Response Project Team, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Gaku Tsuji
- Research and Clinical Center for Yusho and Dioxin, Kyushu University Hospital, Fukuoka, Japan.,Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masamitsu Ichihashi
- Anti-Aging Medical Research Center, Graduate School of Life and Medical Sciences, Doshisha University, Kyoto, Japan.,Faculty of Pharmaceutical Science, Kobe Gakuin University, Kobe, Japan.,Arts Ginza Clinic, Tokyo, Japan
| | - Takahiko Shimizu
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan.,Aging Stress Response Project Team, National Center for Geriatrics and Gerontology, Obu, Japan
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Poziomkowska-Gęsicka I, Summer B, Sokołowska M, Thomas P, Kurek M. Allergic contact dermatitis caused by hypersensitivity to gold - description of a clinical case. Contact Dermatitis 2018; 78:363-365. [PMID: 29611263 DOI: 10.1111/cod.12949] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 11/21/2017] [Accepted: 11/26/2017] [Indexed: 11/28/2022]
Affiliation(s)
| | - Burkhard Summer
- Clinic of Dermatology and Allergology, University of Munich, 80337 Munich, Germany
| | | | - Peter Thomas
- Clinic of Dermatology and Allergology, University of Munich, 80337 Munich, Germany
| | - Michał Kurek
- Department of Clinical Allergology, PMU, Szczecin 70-111, Poland
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25
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Bjørklund G, Skalny AV, Rahman MM, Dadar M, Yassa HA, Aaseth J, Chirumbolo S, Skalnaya MG, Tinkov AA. Toxic metal(loid)-based pollutants and their possible role in autism spectrum disorder. ENVIRONMENTAL RESEARCH 2018; 166:234-250. [PMID: 29902778 DOI: 10.1016/j.envres.2018.05.020] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 05/18/2018] [Accepted: 05/18/2018] [Indexed: 06/08/2023]
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social interaction, verbal and non-verbal communication, and stereotypic behaviors. Many studies support a significant relationship between many different environmental factors in ASD etiology. These factors include increased daily exposure to various toxic metal-based environmental pollutants, which represent a cause for concern in public health. This article reviews the most relevant toxic metals, commonly found, environmental pollutants, i.e., lead (Pb), mercury (Hg), aluminum (Al), and the metalloid arsenic (As). Additionally, it discusses how pollutants can be a possible pathogenetic cause of ASD through various mechanisms including neuroinflammation in different regions of the brain, fundamentally occurring through elevation of the proinflammatory profile of cytokines and aberrant expression of nuclear factor kappa B (NF-κB). Due to the worldwide increase in toxic environmental pollution, studies on the role of pollutants in neurodevelopmental disorders, including direct effects on the developing brain and the subjects' genetic susceptibility and polymorphism, are of utmost importance to achieve the best therapeutic approach and preventive strategies.
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Affiliation(s)
- Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Mo i Rana, Norway.
| | - Anatoly V Skalny
- Peoples' Friendship University of Russia (RUDN University), Moscow, Russia; Yaroslavl State University, Yaroslavl, Russia; All-Russian Research Institute of Medicinal and Aromatic Plants, Moscow, Russia
| | - Md Mostafizur Rahman
- Department of Environmental Sciences, Jahangirnagar University, Dhaka, Bangladesh; Graduate School of Environmental Science, Hokkaido University, Japan
| | - Maryam Dadar
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | - Heba A Yassa
- Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Jan Aaseth
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Elverum, Norway; Department of Research, Innlandet Hospital Trust, Brumunddal, Norway
| | - Salvatore Chirumbolo
- Department of Neurological and Movement Sciences, University of Verona, Verona, Italy
| | | | - Alexey A Tinkov
- Peoples' Friendship University of Russia (RUDN University), Moscow, Russia; Yaroslavl State University, Yaroslavl, Russia
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26
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Bjørklund G, Dadar M, Aaseth J. Delayed-type hypersensitivity to metals in connective tissue diseases and fibromyalgia. ENVIRONMENTAL RESEARCH 2018; 161:573-579. [PMID: 29245125 DOI: 10.1016/j.envres.2017.12.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 11/28/2017] [Accepted: 12/03/2017] [Indexed: 06/07/2023]
Abstract
Rheumatic diseases include a group of autoimmune disorders with environmental and genetic etiology that are characterized as a subgroup of connective tissue diseases (CTD). Rheumatoid arthritis (RA) often involves the small joints of the hands in a symmetrical fashion that can lead to loss of joint function, and RA, as well as Sjögren's syndrome (SS) and other rheumatic diseases, are often accompanied by sensitivity to metals. Numerous investigations on metal sensitivity were evaluated in this review. A detailed metal exposure history was collected by different evaluation of studies. In all subjects, the main source of metal exposure was nickel, mercury, gold, palladium, titanium, and chromium. All of SLE (systemic lupus erythematosus), RA and SS patients appeared to have an increased frequency of metal delayed-type hypersensitivity (DTH) (Type IV allergy). As dental restorative materials release minor amounts of their metals (including mercury, gold, and nickel), many adults are commonly exposed to these metal ions by vapor or corrosion into saliva. Metal-related DTH in these patients will induce an inflammatory response. Such inflammations are important factors in CTD progress. It is hypothesized that metal-specific T cell reactivity can act as an etiological agent in the propagation and chronification of rheumatic inflammation. The key responses of metal delayed-type hypersensitivity in autoimmunity are precipitating as an appealing challenge for further investigations.
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Affiliation(s)
- Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Toften 24, 8610 Mo i Rana, Norway.
| | - Maryam Dadar
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | - Jan Aaseth
- Faculty of Public Health, Inland Norway University of Applied Sciences, Elverum, Norway; Department of Research, Innlandet Hospital Trust, Brumunddal, Norway
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27
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Bjørklund G, Dadar M, Mutter J, Aaseth J. The toxicology of mercury: Current research and emerging trends. ENVIRONMENTAL RESEARCH 2017; 159:545-554. [PMID: 28889024 DOI: 10.1016/j.envres.2017.08.051] [Citation(s) in RCA: 246] [Impact Index Per Article: 35.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 08/27/2017] [Accepted: 08/30/2017] [Indexed: 05/16/2023]
Abstract
Mercury (Hg) is a persistent bio-accumulative toxic metal with unique physicochemical properties of public health concern since their natural and anthropogenic diffusions still induce high risk to human and environmental health. The goal of this review was to analyze scientific literature evaluating the role of global concerns over Hg exposure due to human exposure to ingestion of contaminated seafood (methyl-Hg) as well as elemental Hg levels of dental amalgam fillings (metallic Hg), vaccines (ethyl-Hg) and contaminated water and air (Hg chloride). Mercury has been recognized as a neurotoxicant as well as immunotoxic and designated by the World Health Organization as one of the ten most dangerous chemicals to public health. It has been shown that the half-life of inorganic Hg in human brains is several years to several decades. Mercury occurs in the environment under different chemical forms as elemental Hg (metallic), inorganic and organic Hg. Despite the raising understanding of the Hg toxicokinetics, there is still fully justified to further explore the emerging theories about its bioavailability and adverse effects in humans. In this review, we describe current research and emerging trends in Hg toxicity with the purpose of providing up-to-date information for a better understanding of the kinetics of this metal, presenting comprehensive knowledge on published data analyzing its metabolism, interaction with other metals, distribution, internal doses and targets, and reservoir organs.
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Affiliation(s)
- Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Toften 24, 8610 Mo i Rana, Norway.
| | - Maryam Dadar
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | | | - Jan Aaseth
- Innlandet Hospital Trust and Inland Norway University of Applied Sciences, Elverum, Norway
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28
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Updyke KM, Urso B, Beg S, Solomon J. Developing a Continuous Quality Improvement Assessment Using a Patient-Centered Approach in Optimizing Systemic Lupus Erythematosus Disease Control. Cureus 2017; 9:e1762. [PMID: 29226052 PMCID: PMC5722635 DOI: 10.7759/cureus.1762] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Systemic lupus erythematosus (SLE) is a multi-organ, autoimmune disease in which patients lose self-tolerance and develop immune complexes which deposit systemically causing multi-organ damage and inflammation. Patients often experience unpredictable flares of symptoms with poorly identified triggers. Literature suggests exogenous exposures may contribute to flares in symptoms. An online pilot survey was marketed globally through social media to self-reported SLE patients with the goal to identify specific subpopulations who are susceptible to disease state changes based on analyzed exogenous factors. The pilot survey was promoted for two weeks, 80 respondents fully completed the survey and were included in statistical analysis. Descriptive statistical analysis was performed on de-identified patient surveys and compared to previous literature studies reporting known or theorized triggers in the SLE disease state. The pilot survey identified similar exogenous triggers compared to previous literature, including antibiotics, increasing beef intake, and metal implants. The goal of the pilot survey is to utilize similar questions to develop a detailed internet-based patient interactive form that can be edited and time stamped as a method to promote continuous quality improvement assessments. The ultimate objective of the platform is to interact with SLE patients from across the globe longitudinally to optimize disease control and improve quality of care by allowing them to avoid harmful triggers.
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Affiliation(s)
| | - Brittany Urso
- Medical Student, University of Central Florida College of Medicine
| | - Shazia Beg
- Rheumatology, University of Central Florida College of Medicine
| | - James Solomon
- Dermatology, University of Central Florida College of Medicine
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29
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Environmental triggers in systemic lupus erythematosus. Semin Arthritis Rheum 2017; 47:710-717. [PMID: 29169635 DOI: 10.1016/j.semarthrit.2017.10.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 09/20/2017] [Accepted: 10/02/2017] [Indexed: 12/25/2022]
Abstract
Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect almost any organ in the human body. Despite significant advancements in our understanding of SLE over the recent years, its exact mode of onset and disease progression remains elusive. Low concordance rates among monozygotic twins with SLE (as low as 24%), clustering of disease prevalence around polluted regions and an urban-rural difference in prevalence all highlight the importance of environmental influences in SLE. Experimental data strongly suggests a complex interaction between the exposome (or environmental influences) and genome (genetic material) to produce epigenetic changes (epigenome) that can alter the expression of genetic material and lead to development of disease in the susceptible individual. In this review, we focus on the available literature to explore the role of environmental factors in SLE disease onset and progression and to better understand the role of exposome-epigenome-genome interactions in this dreaded disease.
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30
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The Putative Role of Environmental Mercury in the Pathogenesis and Pathophysiology of Autism Spectrum Disorders and Subtypes. Mol Neurobiol 2017; 55:4834-4856. [DOI: 10.1007/s12035-017-0692-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 07/13/2017] [Indexed: 01/28/2023]
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31
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Undifferentiated connective tissue disease, fibromyalgia and the environmental factors. Curr Opin Rheumatol 2017; 29:355-360. [DOI: 10.1097/bor.0000000000000392] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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32
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Matsubara R, Kumagai K, Shigematsu H, Kitaura K, Nakasone Y, Suzuki S, Hamada Y, Suzuki R. Fexofenadine Suppresses Delayed-Type Hypersensitivity in the Murine Model of Palladium Allergy. Int J Mol Sci 2017; 18:ijms18071357. [PMID: 28672829 PMCID: PMC5535850 DOI: 10.3390/ijms18071357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 06/16/2017] [Accepted: 06/20/2017] [Indexed: 02/07/2023] Open
Abstract
Palladium is frequently used in dental materials, and sometimes causes metal allergy. It has been suggested that the immune response by palladium-specific T cells may be responsible for the pathogenesis of delayed-type hypersensitivity in study of palladium allergic model mice. In the clinical setting, glucocorticoids and antihistamine drugs are commonly used for treatment of contact dermatitis. However, the precise mechanism of immune suppression in palladium allergy remains unknown. We investigated inhibition of the immune response in palladium allergic mice by administration of prednisolone as a glucocorticoid and fexofenadine hydrochloride as an antihistamine. Compared with glucocorticoids, fexofenadine hydrochloride significantly suppressed the number of T cells by interfering with the development of antigen-presenting cells from the sensitization phase. Our results suggest that antihistamine has a beneficial effect on the treatment of palladium allergy compared to glucocorticoids.
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Affiliation(s)
- Ryota Matsubara
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, 2-3-1 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Japan.
- Department of Rheumatology and Clinical Immunology, Clinical Research Center for Rheumatology and Allergy, Sagamihara National Hospital, National Hospital Organization, 18-1 Sakuradai, Minami-ku, Sagamihara 252-0392, Japan.
| | - Kenichi Kumagai
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, 2-3-1 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Japan.
- Department of Rheumatology and Clinical Immunology, Clinical Research Center for Rheumatology and Allergy, Sagamihara National Hospital, National Hospital Organization, 18-1 Sakuradai, Minami-ku, Sagamihara 252-0392, Japan.
| | - Hiroaki Shigematsu
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, 2-3-1 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Japan.
- Department of Rheumatology and Clinical Immunology, Clinical Research Center for Rheumatology and Allergy, Sagamihara National Hospital, National Hospital Organization, 18-1 Sakuradai, Minami-ku, Sagamihara 252-0392, Japan.
| | - Kazutaka Kitaura
- Department of Rheumatology and Clinical Immunology, Clinical Research Center for Rheumatology and Allergy, Sagamihara National Hospital, National Hospital Organization, 18-1 Sakuradai, Minami-ku, Sagamihara 252-0392, Japan.
| | - Yasunari Nakasone
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, 2-3-1 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Japan.
- Department of Rheumatology and Clinical Immunology, Clinical Research Center for Rheumatology and Allergy, Sagamihara National Hospital, National Hospital Organization, 18-1 Sakuradai, Minami-ku, Sagamihara 252-0392, Japan.
| | - Satsuki Suzuki
- Section of Biological Science, Research Center for Odontology, The Nippon Dental University School of Life Dentistry at Tokyo, 1-9-20 Fujimi, Chiyoda-ku, Tokyo 102-8159, Japan.
| | - Yoshiki Hamada
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, 2-3-1 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Japan.
| | - Ryuji Suzuki
- Department of Rheumatology and Clinical Immunology, Clinical Research Center for Rheumatology and Allergy, Sagamihara National Hospital, National Hospital Organization, 18-1 Sakuradai, Minami-ku, Sagamihara 252-0392, Japan.
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33
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Kilduff CLS, Casswell EJ, Imonikhe R, Marjanovic B. Type IV Hypersensitivity to Gold Weight Upper-Eyelid Implant: Case Report and Review of the Literature. Ocul Immunol Inflamm 2017; 26:910-914. [DOI: 10.1080/09273948.2017.1311922] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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34
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Piscaglia AC, Laterza L, Cesario V, Gerardi V, Landi R, Lopetuso LR, Calò G, Fabbretti G, Brisigotti M, Stefanelli ML, Gasbarrini A. Nodular lymphoid hyperplasia: A marker of low-grade inflammation in irritable bowel syndrome? World J Gastroenterol 2016; 22:10198-10209. [PMID: 28028368 PMCID: PMC5155179 DOI: 10.3748/wjg.v22.i46.10198] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Revised: 10/25/2016] [Accepted: 11/16/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the prevalence of nodular lymphoid hyperplasia (NLH) in adult patients undergoing colonoscopy and its association with known diseases.
METHODS We selected all cases showing NLH at colonoscopy in a three-year timeframe, and stratified them into symptomatic patients with irritable bowel syndrome (IBS)-type symptoms or suspected inflammatory bowel disease (IBD), and asymptomatic individuals undergoing endoscopy for colorectal cancer screening. Data collection included medical history and final diagnosis. As controls, we considered all colonoscopies performed for the aforementioned indications during the same period.
RESULTS One thousand and one hundred fifty colonoscopies were selected. NLH was rare in asymptomatic individuals (only 3%), while it was significantly more prevalent in symptomatic cases (32%). Among organic conditions associated with NLH, the most frequent was IBD, followed by infections and diverticular disease. Interestingly, 31% of IBS patients presented diffuse colonic NLH. NLH cases shared some distinctive clinical features among IBS patients: they were younger, more often female, and had a higher frequency of abdominal pain, bloating, diarrhoea, unspecific inflammation, self-reported lactose intolerance and metal contact dermatitis.
CONCLUSION About 1/3 of patients with IBS-type symptoms or suspected IBD presented diffuse colonic NLH, which could be a marker of low-grade inflammation in a conspicuous subset of IBS patients.
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Delayed-Type Hypersensitivity to Metals of Environmental Burden in Patients with Takotsubo Syndrome - Is There a Clinical Relevance? PLoS One 2016; 11:e0164786. [PMID: 27824862 PMCID: PMC5100929 DOI: 10.1371/journal.pone.0164786] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Accepted: 10/01/2016] [Indexed: 12/27/2022] Open
Abstract
Objective Takotsubo syndrome (TS) is a heart condition characterised by a sudden transient left ventricular dysfunction; its pathophysiology is probably associated with elevated levels of catecholamines but the exact mechanism is not known as yet. Literature and clinical experience suggest that TS affects persons with various comorbidities. This pilot work aims to evaluate the frequency of comorbidities with potential pathological immune reactivity, and to evaluate the potential association between TS and hypersensitivity to metals assessed by LTT-MELISA®. Methodology, Results A total of 24 patients (23 women, 1 man) with a history of TS attack and 27 healthy controls were evaluated. Hypersensitivity was evaluated by a lymphocyte transformation test (LTT-MELISA®); a questionnaire of environmental burden was used to select evaluated metals. A total of 19 patients (79%) had at least one condition that might potentially be associated with pathological immune reactivity (autoimmune thyroid disease, drug allergy, bronchial asthma, cancer, contact dermatitis, rheumatoid arthritis). Hypersensitivity to metals was identified significantly more frequently in TS patients than in healthy controls (positive reaction to at least one metal was identified in 95.8% of TS patients and in 59.3% of controls; p = 0.003); the difference was statistically significant for mercury (45.8% and 14.8%, respectively; p = 0.029). Conclusion Our work shows that conditions with pathological immune reactivity occur frequently in TS patients, and our data suggest a possible association between TS and hypersensitivity to metals (mercury in particular) evaluated by LTT-MELISA®. We also suggest that apart from the triggering stress factor, potential existence of other serious conditions should be considered when taking medical history of TS patients.
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Sahebari M, Ayati R, Mirzaei H, Sahebkar A, Hejazi S, Saghafi M, Saadati N, Ferns GA, Ghayour-Mobarhan M. Serum Trace Element Concentrations in Rheumatoid Arthritis. Biol Trace Elem Res 2016; 171:237-245. [PMID: 26450515 DOI: 10.1007/s12011-015-0501-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Accepted: 08/31/2015] [Indexed: 01/08/2023]
Abstract
Rheumatoid arthritis (RA) is a condition that is associated with oxidative stress. Serum trace elements and their related transport proteins, e.g., albumin and ceruloplasmin, play an important role in the antioxidant defense. Trace element status may therefore be involved in the pathogenesis of RA or be affected by the disease activity of this chronic inflammatory condition. The study participants were 110 patients with RA and 100 sex- and age-matched healthy volunteers. Serum concentrations of albumin, ceruloplasmin, selenium, zinc, copper, and zinc/copper ratio were measured in all subjects. The relationship between these parameters and disease activity score was also assessed. Lower concentrations of serum Alb, Zn, and Se were independently related to disease activity index. High concentrations of serum copper were associated with the presence of RA. Serum Cu concentrations were positively related to disease activity as assessed by the disease activity score. Low serum concentrations of Zn and Se, and high serum Cu concentrations may be associated with the presence of RA or be a consequence of this condition. Of the trace elements that were investigated in the present study, only serum Cu was positively correlated with disease activity.
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Affiliation(s)
- Maryam Sahebari
- Rheumatic Diseases Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Razie Ayati
- Rheumatic Diseases Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamed Mirzaei
- Department of Medical Biotechnology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sepideh Hejazi
- Rheumatic Diseases Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Massoud Saghafi
- Rheumatic Diseases Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nayyereh Saadati
- Rheumatic Diseases Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Division of Medical Education, Brighton and Sussex Medical School, Falmer, Brighton, Sussex, BN1 9PH, UK
| | - Majid Ghayour-Mobarhan
- Biochemistry of Nutrition Research Center, Cardiovascular Research Centre, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, 99199-91766.
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Interplay of innate and adaptive immunity in metal-induced hypersensitivity. Curr Opin Immunol 2016; 42:25-30. [PMID: 27228132 DOI: 10.1016/j.coi.2016.05.001] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 05/02/2016] [Accepted: 05/03/2016] [Indexed: 12/16/2022]
Abstract
Metal-induced hypersensitivity is driven by T cell sensitization to metal ions. Recent advances in our understanding of the complex interactions between innate and adaptive immunity have expanded our knowledge of the pathogenesis of these diseases. Metals activate the innate immune system through direct binding to pathogen recognition receptors, activation of the inflammasome, or the induction of cellular death and release of alarmins. Certain metals can serve as adjuvants, promoting dendritic cell activation and migration as well as antigen presentation to metal-specific T cells. These T cells can recognize metals as haptens or as altered MHC-peptide complexes. The ability of metals to create these neoantigens emphasizes the similarity between metal-induced hypersensitivity and autoimmunity.
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Vasconcelos DM, Santos SG, Lamghari M, Barbosa MA. The two faces of metal ions: From implants rejection to tissue repair/regeneration. Biomaterials 2016; 84:262-275. [DOI: 10.1016/j.biomaterials.2016.01.046] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 01/20/2016] [Accepted: 01/21/2016] [Indexed: 12/20/2022]
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39
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Molecular Mechanisms of Nickel Allergy. Int J Mol Sci 2016; 17:ijms17020202. [PMID: 26848658 PMCID: PMC4783936 DOI: 10.3390/ijms17020202] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 01/29/2016] [Accepted: 01/29/2016] [Indexed: 12/28/2022] Open
Abstract
Allergic contact hypersensitivity to metals is a delayed-type allergy. Although various metals are known to produce an allergic reaction, nickel is the most frequent cause of metal allergy. Researchers have attempted to elucidate the mechanisms of metal allergy using animal models and human patients. Here, the immunological and molecular mechanisms of metal allergy are described based on the findings of previous studies, including those that were recently published. In addition, the adsorption and excretion of various metals, in particular nickel, is discussed to further understand the pathogenesis of metal allergy.
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