Memory T helper cells identify patients with nickel, cobalt, and chromium metal allergy.

Abstract

BACKGROUND:

Patch testing is the gold standard for identifying culprit allergens in allergic contact dermatitis; however, it is laborious and positive reactions are difficult to quantitate. Development of complementary in vitro tests is, therefore, of great importance.

OBJECTIVES:

This study aimed to improve the in vitro lymphocyte proliferation test (LPT) to detect allergic responses to nickel (Ni), cobalt (Co), and chromium (Cr).

METHODS:

Twenty-one metal allergic patients with a positive patch test to Ni (n=16), Co (n=8), and Cr (n=3) and 13 controls were included. All were tested by a flow cytometric LPT.

RESULTS:

Metal-reactive cells were identified as T helper (Th) cells with high expression of the memory marker CD45RO. Skin-homing (cutaneous lymphocyte-associated antigen positive [CLA+]) Ni-reactive memory Th (Thmem hi ) cells identified individuals with a positive patch test for Ni with 100% sensitivity (95% confidence interval [CI] 81%-100%) and 92% specificity (95% CI 67%-100%). Moreover, Co-specific Thmem hi cells expressing CCR6 identified patients with a positive patch test for Co with 63% sensitivity (95% CI 31%-86%) and 100% specificity (95% CI 77%-100%). In Cr allergic individuals, Cr-reactive Thmem hi cells tended to increased CLA and CCR6 expression.

CONCLUSION:

Metal-reactive Th cells with high expression of CD45RO and coexpression of CLA and CCR6 improved the LPT, making it an attractive supplement to the patch test.

• Authors: Lars H Blom, Sali A Elrefaii, Claus Zachariae, Jacob P Thyssen, Lars K Poulsen, Jeanne D Johansen
• Journal: Contact dermatitis (Contact Dermatitis) Vol. 85 Issue 1 Pg. 7-16 (Jul 2021) ISSN: 1600-0536 [Electronic] England
• PMID: 33576045 (Publication Type: Journal Article)
• Copyright: © 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chemical References

• Chromium
• Cobalt
• Nickel

Topics

• Adult
• Chromium (immunology)
• Cobalt (immunology)
• Dermatitis, Allergic Contact (diagnosis, immunology)
• Female
• Flow Cytometry
• Humans
• Immunologic Memory
• Male
• Middle Aged
• Nickel (immunology)
• Patch Tests
• T-Lymphocyte Subsets (immunology)