The role of lymphocyte proliferation tests in assessing occupational sensitization and disease.
OBJECTIVE
Lymphocyte proliferation testing (LPT) is used in diagnosing occupationally acquired delayed-type hypersensitivity. It has been used in beryllium-health effects, and its role is expanding in metal allergy. It may find application in diagnosis of other sensitizers.


RESULTS
Use of the beryllium LPT (BeLPT) in medical surveillance identifies beryllium sensitization at low exposure with chronic beryllium disease (CBD) that leads to physiologic impairment and need for immunosuppressive medications. New studies indicate that both beryllium exposure and genetic variation are associated with increased risk of CBD. Borderline positive BeLPTs warrant inclusion into diagnostic algorithms. Furthermore, use of LPTs to diagnose metal allergy is being proposed in diagnosis of chromium allergy and hypersensitivity to surgical implants. New occupational sensitizers continue to be identified including metalworking fluids, the sterilizing agent ortho-phthalaldehyde and the solvent para-chlorobenzotrifluoride. Use of LPT in occupational surveillance to these agents and other known sensitizers may play expanding roles.


CONCLUSIONS
Lymphocyte proliferation testing serves a valuable role in diagnosing occupational sensitization, as demonstrated with beryllium-health effects, as cases continue to be found at low exposure levels. The use of LPTs in diagnosing contact allergy is expanding, and new applications may be identified in human and animal studies.
Occupational Health Program, Division of General Internal Medicine, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA. shines@medicine.umaryland.edu
Stella E
SE
Hines
Karin
K
Pacheco
Lisa A
LA
Maier
D000485:Allergens / Q000009:adverse effects; D000818:Animals; D001607:Berylliosis / Q000175:diagnosis / Q000276:immunology; D001608:Beryllium / Q000633:toxicity; D002908:Chronic Disease; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis* / Q000276:immunology; D008213:Lymphocyte Activation; D008297:Male; D051379:Mice; D009784:Occupational Diseases / Q000175:diagnosis* / Q000276:immunology; D016273:Occupational Exposure; D009764:o-Phthalaldehyde / Q000009:adverse effects
D000485:Allergens; D009764:o-Phthalaldehyde; D001608:Beryllium