Gold – a controversial sensitizer

Bruze, M.; Andersen, Klaus Ejner

doi:10.1111/j.1600-0536.1999.tb06079.x

Cited by 59 publications

(21 citation statements)

References 57 publications

(86 reference statements)

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“…A frequency of about 10% of gold allergy in consecutively patch tested dermatitis patients has been reported (18). Gold allergy has, though, been regarded as a controversial subject (18).…”

Section: Discussionmentioning

confidence: 99%

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Contact allergy to gold in patients with gold‐plated intracoronary stents

Svedman¹,

Tillman²,

Gustavsson

et al. 2005

Contact Dermatitis

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An increasingly common and effective method for the treatment of atherosclerotic disease in the coronary arteries is percutaneous transluminal coronary angioplasty (PTCA) and stenting. The stents are made of different metals. An increased rate of restenosis when using gold-plated stents has been shown. Contact allergy to gold is common in many countries. Recently, a study has shown an increased rate of contact allergy to nickel among patients with restenosis and a nickel-containing stent. The aims of our study were to investigate whether there was an increased rate of contact allergy to gold among patients with gold-plated stents and if this increased the risk of restenosis. 22 patients who had received a gold-plated stent were patch tested. An age- and sex-matched population of 88 patients, previously patch tested because of a suspected contact dermatitis, served as controls. In the stent group, 10/22 (45.5%) had a contact allergy to gold, in the control group 18/88 (20.5%); the difference is statistically significant (P = 0.04). There was no significant difference regarding frequency of restenosis. Our study indicates that there is a risk of sensitizing the patient when implanting a gold-plated stent. Further studies are needed to confirm these results and to evaluate whether there is an increased risk of restenosis.

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“…A frequency of about 10% of gold allergy in consecutively patch tested dermatitis patients has been reported (18). Gold allergy has, though, been regarded as a controversial subject (18).…”

Section: Discussionmentioning

confidence: 99%

“…Gold allergy has, though, been regarded as a controversial subject (18). Today, the existence of gold allergy is accepted while there are still doubts about the clinical relevance of gold allergy.…”

Section: Discussionmentioning

confidence: 99%

Contact allergy to gold in patients with gold‐plated intracoronary stents

Svedman¹,

Tillman²,

Gustavsson

et al. 2005

Contact Dermatitis

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“…Gold salts are known contact sensitizers, but the high contact allergy rates recently reported among dermatitis patients routinely tested are surprising. As long as our knowledge of the clinical relevance is insufficient, gold salts should not be included in standard series at departments where there is no intention of participating in the scientific exploration of the clinical relevance of this contact allergy (33).…”

Section: Clinical Relevancementioning

confidence: 99%

Thoughts on sensitizers in a standard patch test series

et al. 1999

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On behalf of the European Society of Contact DermatitisPatch testing is the predominant method of establishing contact allergy. The present patch test technique is the result of a continuous process of development and improvement since its first application in the late 19th century. The perfect patch test should give no false-positive and no false-negative reactions. The ideal patch test should also cause as few adverse reactions as possible, particularly no patch test sensitization. Even though the history and examination of a patient with suspected allergic contact dermatitis will give clues to possible sensitizers, it is not sufficient to patch test only with initially suspected sensitizers; unsuspected sensitizers used for patch testing frequently turn out to be the real cause of the dermatitis. Fortunately, a small number of substances are considered to account for the majority of delayed hypersensitivity reactions. Therefore, generally 20-25 test preparations consisting of chemically defined compounds, mixes of allergens, and natural and synthetic compounds, are grouped into a standard test series. The requirements to be fulfilled by a sensitizer in a standard patch test series are discussed in this article. A procedure of investigations is proposed before a sensitizer is included in a standard series.

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“…Until recently, Au allergy was considered rare in the absence of its medical use. During the 1990s, increasing numbers of reports of Au sensitivity have appeared [87,88]. Case reports of contact allergy to Au have been reported from jewelry, dental fixtures, orbital implants, electroplating solutions, etc.…”

Section: Goldmentioning

confidence: 99%

“…Most of those testing positive do not have clinical symptoms. Bruze and Andersen have highlighted this controversy and pointed out the need to demonstrate exposure and causation or aggravation of dermatitis in addition to showing allergy [87]. They point out the need for further research into the role of jewelry and dental work in sensitization, and investigation of the release of Au from various alloys into sweat and saliva.…”

Section: Goldmentioning

confidence: 99%

Mechanisms of immunosensitization to metals (IUPAC Technical Report)

Templeton¹

2004

Pure and Applied Chemistry

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A project is underway within IUPAC to evaluate and harmonize the use of various biomarkers for immunosensitization to metals. This present review summarizes our knowledge of the mechanisms by which certain trace elements evoke allergenicity. Some physiological electrolytes (e.g., Na+, K+) and macronutrients (e.g., Ca2+, Fe3+) are immunologically inactive. However, some trace elements essential for cell function (e.g., Co2+, Cu2+, Cr3+), as well as nonessential elements generally considered toxic (e.g., Hg species) or in use as therapeutic agents (e.g., some species of Pt and Au), can give rise to adverse immune reactions. Specific immunological responses to Ni, Co, Cr, Hg, Be, Cu, Pt, Pd, Ir, In, and Au are discussed. In general, these elements can activate T or B cells by specific receptor interactions, resulting in clonal expansion of a metal-specific lymphocyte and an immune response (typically dermatitis) upon re-exposure. Compelling evidence points to the primary role of the T cell in responding to the metal. T-cell activation occurs when a protein of the major histocompatibility complex (MHC) binds to a T-cell receptor in the presence of an MHC binding peptide. Many antigenic substances result in presentation of MHC bound antigenic peptides to the T-cell receptor; metal ions appear to act as haptens that directly or indirectly cause structural changes in MHC molecule-peptide complexes that result in recognition of these complexes by specific T-cell subsets. Nickel and gold are particularly instructive in understanding mechanisms, and are used to discuss models in which the metal may bind to the antigenic peptide (i) before or (ii) after its association with the MHC/T-cell receptor complex, (iii) may bind to the MHC/receptor complex prior to recruitment of the antigenic peptide, or (iv) may bind to the formed peptide/MHC/receptor complex through ligands contributed by one or more of the components.

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Gold – a controversial sensitizer

Cited by 59 publications

References 57 publications

Contact allergy to gold in patients with gold‐plated intracoronary stents

Contact allergy to gold in patients with gold‐plated intracoronary stents

Thoughts on sensitizers in a standard patch test series

Mechanisms of immunosensitization to metals (IUPAC Technical Report)

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