title: Association of CD69 up-regulation on CD4+ Cla+ T cells versus patch test, strip patch test and clinical history in nickel sensitization.
abstract: OBJECTIVE
  The patch test (PT) with its modification - the strip patch test (SPT) - is the standard in vivo procedure to diagnose an allergic contact dermatitis (ACD). To date, none of the in vitro tests for the diagnosis of ACD fulfils the requirements of an easy, valid and reliable test. To investigate the prediction ability of a flow cytometric assay of CD69 up-regulation on CD4+ CLA+ T cells in nickel-sensitive and non-nickel-sensitive patients.
  
  
  METHODS
  In a prospective, investigator-blinded, clinical study a total of 85 nickel-sensitive (n = 44; 51.8%) and non-nickel-sensitive patients (n = 41; 48.2%) were enrolled. The association between CD69 up-regulation on CD4+ CLA+ T cells on the one hand and PT, SPT, and clinical history on the other hand was measured. Association is expressed with c statistic values (receiver operating characteristic analysis) and corresponding 95% CIs.
  
  
  RESULTS
  The associations were c = 0.57 (95% CI: 0.42-0.72) between CD69 up-regulation and PT, c = 0.49 (95% CI: 0.36-0.62) between CD69 up-regulation and SPT, and c = 0.51 (95% CI: 0.37-0.64) between CD69 up-regulation and clinical history.
  
  
  CONCLUSIONS
  CD69 up-regulation on CD4+ CLA+ T cells in vitro could not predict neither a positive PT or SPT result nor a positive clinical history to nickel sulfate. The combination of clinical history and patch testing still remains the basis for diagnosing ACD.
authors.affiliation: Department of Dermatology and Allergology, Ruhr University Bochum, St. Josef-Hospital, Gudrunstrasse 56, 44791 Bochum, NRW, Germany. h.dickel@klinikum-bochum.de
authors.forename: Heinrich
authors.initials: H
authors.lastname: Dickel
authors.forename: O
authors.initials: O
authors.lastname: Kuss
authors.forename: J
authors.initials: J
authors.lastname: Kamphowe
authors.forename: P
authors.initials: P
authors.lastname: Altmeyer
authors.forename: S
authors.initials: S
authors.lastname: Höxtermann
mesh_terms: D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000378:metabolism*; D000945:Antigens, Differentiation, T-Lymphocyte / Q000378:metabolism*; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis; D004342:Drug Hypersensitivity / Q000175:diagnosis*; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D037181:Lectins, C-Type / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009532:Nickel / Q000276:immunology*; D010328:Patch Tests; D015854:Up-Regulation; D000099192:CD69 Antigens
chemical_list: D015703:Antigens, CD; D000945:Antigens, Differentiation, T-Lymphocyte; D037181:Lectins, C-Type; D009532:Nickel; D000099192:CD69 Antigens