Relation Between Atopy and Metal Hypersensitivity

The relation between atopy, a condition with inherited predisposition to develop IgE-mediated hyper-sensitivity to small quantities of inhaled or ingested environmental agents, and metal immunotoxicology was discussed at the workshop of Immunotoxicity of Metals and Immunotoxicology in 1989 (Cattaneo, 1990). Although case reports of type I hypersensitiv-ity caused by sensitization to chromium (Section 5.2), cobalt (Section 5.3), nickel (Section 5.6), and platinum (Section 5.7) have been published, only platinum allergy is sufficiently frequent to be assessed for the influence of atopy. A recent review found no association between atopy and type I allergy to platinum salts (Merget et al., 2003). With regard to metal-induced type IV allergy, allergic contact dermatitis, no increased predisposition was reported as a result of atopy at the workshop in 1989 (Cattaneo, 1990). No conclusive new information has been published since then. For example, with regard to the most frequent clinical relevant sensitizing metal in the population, nickel, a few studies have indicated an increased incidence of allergic contact dermatitis in atopics (Dotterud and Falk, 1994), whereas other studies have not (McDonagh et al., 1992). Recent studies have tried to discern different immune responses to nickel in atopic and non-atopic patients using in vitro techniques; in one study there were no differences (Szepietowski et al., 1997), but another study reported an impaired immune response to nickel in atopics (Buchvald and Lundeberg, 2004).

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