Immunological characterization of the allergic contact mucositis related to the ingestion of nickel-rich foods.
BACKGROUND
The ingestion of nickel (Ni)-rich foods may result in allergic contact mucositis (ACM), a not yet well defined condition identifiable by oral mucosa patch test (omPT). Our aim was to characterize immunologically the ACM taking advantage from the allergen exposure that occurs during the omPT for Ni.


METHODS
Thirty-seven symptomatic patients underwent to omPT for Ni. Before and after omPT, serum and urine Ni concentrations were determined by mass spectrometry, the white blood cells were counted by hemochromocytometric assay, the peripheral lymphocyte typing was carried out by flow cytometry, total IgE and cytokine serum concentrations were measured by immunoenzymatic assays. The local lymphocyte typing was performed by immunohistochemistry only after omPT.


RESULTS
According to the omPT outcomes, 25 patients were defined as Ni-sensitive and the remaining 12 as controls. After omPT, serum and urine Ni concentrations increased significantly in all patients, while a significant increment of circulating lymphocytes and neutrophils was highlighted, respectively, in Ni-sensitive and control patients. Consistently, the Th and Tc circulating lymphocytes, as well as the Th/Tc ratio increased significantly in Ni-sensitive patients after omPT. No noteworthy increment in serum concentrations of total IgE and selected cytokines was observed in any patient after omPT. The presence of CD3+, CD4+, and CD8+ cells was highlighted on the oral mucosa biopsy samples taken from Ni-sensitive patients after omPT.


CONCLUSIONS
In patients with ACM, a local adaptive response with increased lymphocyte trafficking appears to be the most likely mechanism of reaction to Ni administered with the omPT.
Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy. Electronic address: marco.ditola@uniroma1.it.
Marco
M
Di Tola
Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy.
Mariacatia
M
Marino
UOC Laboratory Diagnostics, S. Andrea Hospital, Rome, Italy.
Rachele
R
Amodeo
UOC Laboratory Diagnostics, S. Andrea Hospital, Rome, Italy.
Fabio
F
Tabacco
Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy.
Rossella
R
Casale
UOC Laboratory Diagnostics, S. Andrea Hospital, Rome, Italy.
Luciano
L
Portaro
Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy.
Raffaele
R
Borghini
Department of Allergology, S. Gallicano Dermatology Institute, Rome, Italy.
Antonio
A
Cristaudo
Department of Chemistry and Pharmaceutical Technologies, Sapienza University, Rome, Italy.
Fedele
F
Manna
Department of Dermatology and Plastic Surgery, Sapienza University, Rome, Italy.
Alfredo
A
Rossi
Laboratory of Immunology and Allergology, IRCCS Istituto Dermopatico dell'Immacolata, Rome, Italy.
Ornella
O
De Pità
UOC Laboratory Diagnostics, S. Andrea Hospital, Rome, Italy; Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy.
Patrizia
P
Cardelli
Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy.
Antonio
A
Picarelli
D056704:Adaptive Immunity / Q000276:immunology; D000328:Adult; D017252:CD3 Complex / Q000276:immunology / Q000378:metabolism; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology / Q000378:metabolism; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology / Q000378:metabolism; D016207:Cytokines / Q000097:blood / Q000276:immunology; D017449:Dermatitis, Allergic Contact / Q000276:immunology*; D005260:Female; D005434:Flow Cytometry; D005512:Food Hypersensitivity / Q000276:immunology*; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D007958:Leukocyte Count; D008214:Lymphocytes / Q000276:immunology / Q000378:metabolism; D008297:Male; D013058:Mass Spectrometry; D008875:Middle Aged; D009061:Mouth Mucosa / Q000276:immunology / Q000473:pathology; D052016:Mucositis / Q000276:immunology*; D009532:Nickel / Q000097:blood / Q000276:immunology* / Q000652:urine; D010328:Patch Tests / Q000379:methods; D051193:Toll-Like Receptors / Q000276:immunology / Q000378:metabolism; D055815:Young Adult
D017252:CD3 Complex; D016207:Cytokines; D051193:Toll-Like Receptors; D007073:Immunoglobulin E; D009532:Nickel
Allergic contact mucositis; Local adaptive response; Nickel; Oral mucosa patch test; Toll-like receptors