title: Immunohistochemical characterization of the perivascular infiltrate cells in tissues adjacent to stainless steel implants compared with titanium implants.
abstract: Metallic orthopaedics implants are composed of elements that are known to be skin sensitizers in the general population. In this study, we analyzed the cells of perivascular infiltration in the tissue adjacent to titanium (n = 23) and steel (n = 8) implants after explantation of the metals by immunohistochemical methods. The following panel of monoclonal antibodies were used as parameters: CD 1a (Langerhans cells), CD 4 (T-helper cells), CD 8 (T-suppressor cells), CD 11c (monocytes and macrophages), CD 45 RO (memory cells), CD 45 RA (naive cells), eosinophil cationic proteins (ECP), neutrophil elastase, and HLA-DR. The number of perivascular total cells did not differ significantly. All cells were identified in both metal subgroups, but a statistical difference was not seen in the above-mentioned parameters. We conclude that sensitization to metals is possible in the tissue adjacent to steel and titanium implants, because all cells which play an important role in allergic delayed-type hypersensitivity (type IV) reactions are present. This phenomenon may be called a 'pre-sensitization' phase, because no sensitization or allergic reactions were seen in our cases. Second, in the present study, a statistical difference was not seen in the number of infiltrate cells in the tissue adjacent to steel compared with titanium implants.
authors.affiliation: Department of Dermatology and Allergy, Biederstein, Technical University Munich, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Thewes
authors.forename: R
authors.initials: R
authors.lastname: Kretschmer
authors.forename: M
authors.initials: M
authors.lastname: Gfesser
authors.forename: J
authors.initials: J
authors.lastname: Rakoski
authors.forename: M
authors.initials: M
authors.lastname: Nerlich
authors.forename: S
authors.initials: S
authors.lastname: Borelli
authors.forename: J
authors.initials: J
authors.lastname: Ring
mesh_terms: D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000032:analysis*; D001798:Blood Proteins / Q000032:analysis; D020878:Device Removal; D047091:Eosinophil Granule Proteins; D005260:Female; D005549:Foreign-Body Reaction / Q000276:immunology* / Q000473:pathology; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000276:immunology* / Q000473:pathology; D007595:Joint Prosthesis; D007958:Leukocyte Count; D019272:Leukocyte Elastase / Q000032:analysis; D007962:Leukocytes / Q000276:immunology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010328:Patch Tests; D012260:Ribonucleases; D013193:Stainless Steel; D014025:Titanium
chemical_list: D015703:Antigens, CD; D001798:Blood Proteins; D047091:Eosinophil Granule Proteins; D013193:Stainless Steel; D014025:Titanium; D012260:Ribonucleases; D019272:Leukocyte Elastase