Cross‐reactivity between nickel and palladium demonstrated by systemic administration of nickel

Abstract

Concomitant patch test reactions to nickel and palladium have frequently been reported in patients undergoing investigation because of suspected allergic contact dermatitis. Theoretically, these reactions can be explained by multiple, concomitant, simultaneous sensitization as well as cross-sensitization. We studied whether concomitant reactions to nickel and palladium could represent cross-sensitization in females hypersensitive to combinations of nickel, palladium and cobalt. Females were patch tested with serial dilutions of nickel sulfate, cobalt chloride and palladium chloride on the upper back. 1 month later, when the patch test reactions were gone, the patients were randomized into 2 groups that were challenged orally with either nickel or placebo. 1 day later, the areas of previous positive patch test reactions were read in a blind way looking for flare-up reactions. Nickel provocation but not placebo yielded flare-up reactions on sites previously tested with nickel (P = 0.012) and palladium (P = 0.006), but were also observed on sites previously tested with cobalt, even though this was not statistically significant. Flare-up reactions of previous patch test reactions to nickel and palladium after oral challenge with nickel speak in favour of a cross-reactivity mechanism.

Nickel, palladium and rhodium induced IFN-gamma and IL-10 production as assessed by in vitro ELISpot-analysis in contact dermatitis patients

“…In Ni sensitized subjects a simultaneous patch test reactivity to Pd has been frequently reported [19,20] and a double sensitization can be hypothesised especially in individuals wearing dental prosthesis. Nevertheless, a cutaneous cross-reactivity cannot be excluded for the chemical and structural similarities of Ni and Pd [21].…”

Allergy to Metals as a Cause of Orthopedic Implant Failure

“…This frequency is evidently higher than in the general population, especially because it concerns older people. The positive patch test with palladium and cooper occurred only in people sensitized to nickel, which could result from cross-reactivity between these metals [14,15]. It is important to note that in all sensitized patients, recurring inflammations of tissues around implants and periodical skin lesions appeared approximately one year after operation.…”

A Perspective on the Challenges and Issues in Developing Biomarkers for Human Allergic Risk Assessments

“…This can occur through a single exposure or through multiple exposures. The first exposure might not cause any noticeable effects and some metal sensitizations can be triggered in humans by another metal, such as palladium cross reacting with nickel [5]. Once an allergen interacts with the individual, the immune system undergoes antigen processing to form a subject and allergen-specific hapten that can be processed and presented by antigen presenting cells.…”

“…Once positive to an allergen such as nickel, the positivity will remain for a very long time and possibly for the individual's entire life, which does not reflect the clinical situation when the implant was removed and the symptoms no longer exist, but the test continues to remain positive [26]. Furthermore, these tests cannot differentiate between palladium cross-reacting as nickel, because palladium has 90% cross reactivity with nickel [5].…”