Memory T helper cells identify patients with nickel, cobalt, and chromium metal allergy

Lars H. Blom*, Sali A. Elrefaii, Claus Zachariae, Jacob P. Thyssen, Lars K. Poulsen, Jeanne D. Johansen

*Corresponding author af dette arbejde
8 Citationer (Scopus)

Abstract

Background: Patch testing is the gold standard for identifying culprit allergens in allergic contact dermatitis; however, it is laborious and positive reactions are difficult to quantitate. Development of complementary in vitro tests is, therefore, of great importance. Objectives: This study aimed to improve the in vitro lymphocyte proliferation test (LPT) to detect allergic responses to nickel (Ni), cobalt (Co), and chromium (Cr). Methods: Twenty-one metal allergic patients with a positive patch test to Ni (n=16), Co (n=8), and Cr (n=3) and 13 controls were included. All were tested by a flow cytometric LPT. Results: Metal-reactive cells were identified as T helper (Th) cells with high expression of the memory marker CD45RO. Skin-homing (cutaneous lymphocyte-associated antigen positive [CLA+]) Ni-reactive memory Th (Thmemhi) cells identified individuals with a positive patch test for Ni with 100% sensitivity (95% confidence interval [CI] 81%-100%) and 92% specificity (95% CI 67%-100%). Moreover, Co-specific Thmemhi cells expressing CCR6 identified patients with a positive patch test for Co with 63% sensitivity (95% CI 31%-86%) and 100% specificity (95% CI 77%-100%). In Cr allergic individuals, Cr-reactive Thmemhi cells tended to increased CLA and CCR6 expression. Conclusion: Metal-reactive Th cells with high expression of CD45RO and coexpression of CLA and CCR6 improved the LPT, making it an attractive supplement to the patch test.

OriginalsprogEngelsk
TidsskriftContact Dermatitis
Vol/bind85
Udgave nummer1
Sider (fra-til)7-16
Antal sider10
ISSN0105-1873
DOI
StatusUdgivet - jul. 2021

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