title: Interferon-gamma secreted from peripheral blood mononuclear cells as a possible diagnostic marker for allergic contact dermatitis to gold.
abstract: 10% of patch-tested patients have a positive reaction to gold. Most lack clinical symptoms, but allergic contact dermatitis (ACD) to gold is increasing. In this study, 77 dermatological outpatients were divided into 3 groups depending on epicutaneous patch test outcomes: a group positive to gold (EPI+), a group negative to gold (EPI-), and a group with irritant reactions to gold (EPI-IR). Lymphocytes were stimulated in vitro with gold sodium thiosulfate. Proliferation was assessed using the lymphocyte transformation test (LTT), and cytokine secretion was assessed using a multibead array (Luminex; Linco Research Inc., St. Charles, MO, USA), in order to evaluate whether an in vitro method with high diagnostic accuracy could be devised. The EPI+ group showed a significantly increased secretion of interferon (IFN)-gamma, interleukin (IL)-2, and IL-13 and also showed a significantly higher stimulation indexes for LTT, compared to the other 2 subject groups. Sensitivity and specificity were calculated for all methods individually and combined, but IFN-gamma assessment alone was the most accurate method for identifying ACD to gold, with sensitivity and specificity of 81.8% and 82.1%, respectively. This method also identified 87.5% of the EPI-IR subjects as non-allergic. Therefore, assessment of secretion of IFN-gamma should be a valuable complement to patch test for diagnosing gold allergy.
authors.affiliation: Molecular and Immunological Pathology, IMK, Linköping University, 581 85 Linköping, and Department of Dermatology, University Hospital, Orebro, Sweden.
authors.forename: Jenny
authors.initials: J
authors.lastname: Christiansen
authors.forename: Gunilla
authors.initials: G
authors.lastname: Färm
authors.forename: Ruth
authors.initials: R
authors.lastname: Eid-Forest
authors.forename: Chris
authors.initials: C
authors.lastname: Anderson
authors.forename: Karin
authors.initials: K
authors.lastname: Cederbrant
authors.forename: Per
authors.initials: P
authors.lastname: Hultman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D017449:Dermatitis, Allergic Contact / Q000097:blood / Q000175:diagnosis*; D005260:Female; D006052:Gold Sodium Thiomalate / Q000009:adverse effects / Q000276:immunology*; D006801:Humans; D007371:Interferon-gamma / Q000096:biosynthesis*; D007378:Interleukins / Q000096:biosynthesis; D007963:Leukocytes, Mononuclear / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D018501:Antirheumatic Agents; D015415:Biomarkers; D007378:Interleukins; D006052:Gold Sodium Thiomalate; D007371:Interferon-gamma