Nickel (Ni) allergic patients with complications to Ni containing joint replacement show preferential IL-17 type reactivity to Ni.
BACKGROUND
Some nickel (Ni) allergic patients develop complications following Ni-containing arthroplasty. In the peri-implant tissue of such patients, we had observed lymphocyte dominated inflammation together with IFN-gamma and IL-17 expression.


OBJECTIVE
To determine whether Ni stimulation of peripheral blood mononuclear cells (PBMCs) of such patients would lead to a different cytokine pattern as compared to Ni-allergic patients with symptom-free arthroplasty.


METHODS
Based on history and patch testing in 15 Ni-allergic patients (five without implant, five with symptom-free arthroplasty, five with complicated arthroplasty) and five non-allergic individuals, lymphocyte transformation test (LTT) was performed using PBMC. In parallel in vitro cytokine response to Ni was assessed by real-time reverse transcriptase-polymerase chain reaction (RT-PCR).


RESULTS
All 15 Ni-allergic individuals showed enhanced LTT reactivity to Ni (mean SI = 8.42 +/- 1.8) compared to the non-allergic control group. Predominant IFN-gamma expression to Ni was found both in the five allergic patients without arthroplasty and also in the five allergic, symptom-free arthroplasty patients. In contrast, in the five Ni-allergic patients with arthroplasty-linked complications a predominant, significant IL-17 expression to Ni was seen but not in patients with symptom-free arthroplasty.


CONCLUSIONS
The predominant IL-17 type response to Ni may characterize a subgroup of Ni-allergic patients prone to develop lymphocytic peri-implant hyper-reactivity.
Summer
Burkhard
B
Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität, München, Germany. Burkhard.Summer@med.uni-muenchen.de
Paul
Carina
C
Mazoochian
Farhad
F
Rau
Christoph
C
Thomsen
Marc
M
Banke
Ingo
I
Gollwitzer
Hans
H
Dietrich
Karin-Almut
KA
Mayer-Wagner
Susanne
S
Ruzicka
Thomas
T
Thomas
Peter
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000009:adverse effects*; D016022:Case-Control Studies; D017449:Dermatitis, Allergic Contact / Q000209:etiology / Q000276:immunology*; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000097:blood / Q000276:immunology; D020381:Interleukin-17 / Q000097:blood / Q000276:immunology*; D007595:Joint Prosthesis / Q000009:adverse effects*; D007963:Leukocytes, Mononuclear / Q000276:immunology; D008213:Lymphocyte Activation / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009532:Nickel / Q000276:immunology*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D055815:Young Adult
D020381:Interleukin-17; D009532:Nickel; D007371:Interferon-gamma