title: Metal-specific lymphocyte reactivity is downregulated after dental metal replacement.
abstract: OBJECTIVE
  This study was done to evaluate the results and clinical relevance of an optimized lymphocyte proliferation test, MELISA, for metal-induced inflammation in patients with CFS-like symptoms. The treatment of patients consisted of the replacement of incompatible dental materials (RID) together with supportive anti-oxidant therapy.
  
  
  METHODS
  513 patients were tested by MELISA at the beginning of the study. Out of this group, 248 patients were available for follow-up MELISA after RID.
  
  
  METHODS
  In MELISA, lymphocytes are isolated from the blood and cultivated with different metal salts in tissue culture medium containing 10% inactivated human AB+ serum or autologous serum. After 5 days, the presence of metal-reactive lymphocytes are measured by isotope labelling of newly formed DNA in growing lymphoblasts and evaluated by calculating the Stimulation Index.
  
  
  RESULTS
  Nickel was the most common sensitizer, followed by inorganic mercury, thimerosal, lead, cadmium, palladium and gold. After RID treatment, a decrease of metal-specific lymphocyte responses in patients who reacted to metals at the beginning of the study could be observed. The cultivation of lymphocytes in autologous and homologous serum did not significantly affect the results. Simultaneous, the health status of patients improved as well.
  
  
  CONCLUSIONS
  Replacement of incompatible dental materials resulted in down-regulation of metal-induced lymphocyte sensitivity in vitro, as well as in the improvement of health status of majority of patients with unspecific CFS-like symptoms.
authors.affiliation: Foundation for Metal Biology, Uppsala, Sweden. yaqobamer@hotmail.com
authors.forename: Amer
authors.initials: A
authors.lastname: Yaqob
authors.forename: Antero
authors.initials: A
authors.lastname: Danersund
authors.forename: Vera Dm
authors.initials: VD
authors.lastname: Stejskal
authors.forename: Anders
authors.initials: A
authors.lastname: Lindvall
authors.forename: Romuald
authors.initials: R
authors.lastname: Hudecek
authors.forename: Ulf
authors.initials: U
authors.lastname: Lindh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000975:Antioxidants / Q000627:therapeutic use; D001672:Biocompatible Materials / Q000009:adverse effects; D002469:Cell Separation; D002908:Chronic Disease; D003764:Dental Materials / Q000378:metabolism*; D015536:Down-Regulation; D004797:Enzyme-Linked Immunosorbent Assay; D015673:Fatigue Syndrome, Chronic / Q000209:etiology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000276:immunology; D008214:Lymphocytes / Q000737:chemistry / Q000187:drug effects*; D008297:Male; D008670:Metals / Q000009:adverse effects* / Q000276:immunology*; D008875:Middle Aged
chemical_list: D000975:Antioxidants; D001672:Biocompatible Materials; D003764:Dental Materials; D008670:Metals