Continuing the quest for autoimmunity due to oral metal exposure.
OBJECTIVE
The role of metal exposure in the development of autoimmune disease (AID) is still controversial. Here, we studied the relationship between oral metal exposure, metal allergy and autoimmunity.


METHODS
A mixed population (n = 78) of non-allergic volunteers, metal-allergic patients and patients with oral problems putatively due to metal alloys was evaluated for oral Ni, Pd, Au and Hg exposure and skin hypersensitivity. Clinical autoimmune parameters were based on medical histories; additionally, serum levels of the four most common autoantibodies were measured.


RESULTS
Skin hypersensitivity, as seen mainly for Ni and/or Pd, was not positively associated with autoimmune parameters. In contrast, metal hypersensitive individuals showed an extremely low frequency of thyroid autoantibodies (3% vs 20% in non-hypersensitive controls). Next, the relation between metal exposure and autoimmunity was evaluated in individuals >35 years (n = 58), since from that age on metal exposure had plateaued and was not correlated with age. In this subgroup, oral Ni exposure was associated (p < 0.01) with self-reported AID, irrespective of autoantibody levels. These unexpected findings warrant further confirmation in a larger test group. Of note, oral Pd, Au or Hg contacts were not associated with any of the clinical or serological autoimmune phenomena tested.


CONCLUSIONS
The results of this study support the view that development of metal contact allergies may prevent autoimmune activation, and, second, that oral exposure to Pd, Au or Hg does not facilitate the development of AID.
a Laboratory of Medical Immunology, Department of Pathology , VU University Medical Centre , Amsterdam , The Netherlands .|b Department of Biomedical Science and Department of Prosthodontic, Faculty of Dentistry , Jember University , Jember , Indonesia .
Dessy
D
Rachmawati
c Department of Dental Materials Science , Academic Centre for Dentistry Amsterdam (ACTA), VU University Amsterdam and University of Amsterdam , Amsterdam , The Netherlands , and.
Joris
J
Muris
a Laboratory of Medical Immunology, Department of Pathology , VU University Medical Centre , Amsterdam , The Netherlands .
Rik J
RJ
Scheper
d Department of Dermatology , VU University Medical Centre , Amsterdam , The Netherlands.
Thomas
T
Rustemeyer
c Department of Dental Materials Science , Academic Centre for Dentistry Amsterdam (ACTA), VU University Amsterdam and University of Amsterdam , Amsterdam , The Netherlands , and.
Cornelis J
CJ
Kleverlaan
c Department of Dental Materials Science , Academic Centre for Dentistry Amsterdam (ACTA), VU University Amsterdam and University of Amsterdam , Amsterdam , The Netherlands , and.
Albert J
AJ
Feilzer
a Laboratory of Medical Immunology, Department of Pathology , VU University Medical Centre , Amsterdam , The Netherlands .
B Mary E
BM
von Blomberg
a Laboratory of Medical Immunology, Department of Pathology , VU University Medical Centre , Amsterdam , The Netherlands .
Ingrid M W
IM
van Hoogstraten
D000328:Adult; D001323:Autoantibodies / Q000096:biosynthesis*; D015551:Autoimmunity / Q000187:drug effects*; D016022:Case-Control Studies; D003722:Dental Alloys / Q000009:adverse effects*; D005260:Female; D006046:Gold / Q000494:pharmacology; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D008297:Male; D008628:Mercury / Q000494:pharmacology; D008875:Middle Aged; D009055:Mouth / Q000187:drug effects* / Q000276:immunology / Q000473:pathology; D009532:Nickel / Q000009:adverse effects*; D010165:Palladium / Q000494:pharmacology; D012867:Skin / Q000187:drug effects / Q000276:immunology / Q000473:pathology; D012882:Skin Tests
D001323:Autoantibodies; D003722:Dental Alloys; D010165:Palladium; D006046:Gold; D009532:Nickel; D008628:Mercury
Amalgam; allergy; autoimmunity; gold; nickel; oral metal exposure; palladium