The flare-up reactions after systemic provocation in contact allergy to nickel and gold.
In a controlled double-blind experimental study, patients with contact allergy to nickel or gold were exposed systemically to their contact allergen. Nickel sulfate was given orally, gold sodium thiomalate intramuscularly, and placebo by both routes. Clinical reactions including body temperature were followed and 7 plasma cytokines and acute phase reactants were assayed before and 24 h after provocation. Clinical flare-up, with reactivation of healing patch tests and/or toxicoderma-like reactions, was observed in patients receiving their specific allergen. A transient fever was noted in patients allergic to gold when exposed to gold, not in others. There was a significant increase in plasma tumour necrosis factor-alpha, soluble tumour necrosis factor receptor 1, interleukin-1 receptor antagonist, and neutrophil gelatinase associated lipocalin in patients allergic to gold when exposed to gold allergen. Furthermore, in patients allergic to nickel exposed to nickel allergen there was a highly significant increase in plasma soluble tumour necrosis factor receptor 1. Interferon-gamma, interleukin-4, and C-reactive protein did not increase in any of the patient groups. Clinical reactions during flare-up in contact allergy are accompanied by release in the blood of several cytokines. This release is not a consequence of a toxic effect or bound to a particular allergen. Instead, the cytokine release should be considered a general phenomenon characteristic of the flare-up in contact allergy.
Möller
H
H
Department of Dermatology, Malmö University Hospital, Lund University, Sweden.
Ohlsson
K
K
Linder
C
C
Björkner
B
B
Bruze
M
M
D000209:Acute-Phase Proteins; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000485:Allergens / Q000008:administration & dosage / Q000009:adverse effects; D015703:Antigens, CD / Q000097:blood / Q000187:drug effects; D001831:Body Temperature / Q000187:drug effects; D002097:C-Reactive Protein / Q000187:drug effects / Q000378:metabolism; D002352:Carrier Proteins / Q000097:blood / Q000187:drug effects; D017449:Dermatitis, Allergic Contact / Q000097:blood / Q000209:etiology*; D004311:Double-Blind Method; D005260:Female; D006052:Gold Sodium Thiomalate / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007273:Injections, Intramuscular; D053590:Interleukin 1 Receptor Antagonist Protein; D000071068:Lipocalin-2; D054834:Lipocalins; D008297:Male; D008875:Middle Aged; D009532:Nickel / Q000008:administration & dosage / Q000009:adverse effects*; D015513:Oncogene Proteins; D010328:Patch Tests; D011518:Proto-Oncogene Proteins; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood / Q000187:drug effects; D047888:Receptors, Tumor Necrosis Factor, Type I; D012795:Sialoglycoproteins / Q000097:blood / Q000187:drug effects; D012867:Skin / Q000187:drug effects / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000187:drug effects / Q000378:metabolism
D000209:Acute-Phase Proteins; D000485:Allergens; D015703:Antigens, CD; D002352:Carrier Proteins; C507763:IL1RN protein, human; D053590:Interleukin 1 Receptor Antagonist Protein; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D015513:Oncogene Proteins; D011518:Proto-Oncogene Proteins; D018124:Receptors, Tumor Necrosis Factor; D047888:Receptors, Tumor Necrosis Factor, Type I; D012795:Sialoglycoproteins; D014409:Tumor Necrosis Factor-alpha; D006052:Gold Sodium Thiomalate; C029938:nickel sulfate; D009532:Nickel; D002097:C-Reactive Protein