Serum and urine nickel in nickel‐sensitized women: effects of oral challenge with the metal

Andreassi, Marco; Gioacchino, Mario Di; Sabbioni, E.; Pietra, R.; Masci, S; Amerio, Pierluigi; Bavazzano, P; Boscolo, P

doi:10.1111/j.1600-0536.1998.tb05629.x

Cited by 21 publications

(13 citation statements)

References 17 publications

(31 reference statements)

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“…Similar data are also reported after higher (lO mg) nickel doses (26,27,31). Likely, these symptoms are related to the generic state of discomfort rather than specifically to ingested nickel; therefore, only cutaneous and gastrointestinal symptoms clinically characterize SNAS.…”

Section: Discussionsupporting

confidence: 69%

“…However, the majority of patients report symptoms following repeated ingestion ofnickel-rich foods and not after a single nickel-rich meal. Therefore, there is the need to carefully study nickel metabolism not only after a single challenge (31), but also in real life to observe the possible accumulation of the metal in the body in SNAS patients compared to healthy subjects and ACD patients. In any case, patients who are positive to a nickel oral challenge report that restriction of dietary nickel is associated to a significant amelioration (frequently disappearance) ofSNAS symptoms.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Systemic Nickel Allergy Syndrome: Nosologic Framework and Usefulness of Diet Regimen for Diagnosis

Braga

Quecchia

Perotta

et al. 2013

Int J Immunopathol Pharmacol

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Systemic (gastrointestinal and skin) reactions to ingestion of nickel rich foods in patients with nickel allergic contact dermatitis characterize Systemic Nickel Allergy Syndrome (SNAS). The objective of the study was to describe the nosologic framework of the syndrome and to compare sensibility and specificity for SNAS diagnosis between two different low nickel diets -BraMa-Ni and the usually prescribed list of forbidden foods -along with patient adherence to diet. One hundred forty-five patients with suspected SNAS (by history and benefit from nickel dietary restrictions) were selected and orally challenged with nickel for a definite diagnosis. Specificity and sensibility of the diets were calculated in relation to the results of nickel challenges. The nosologic framework of SNAS was deduced from the clinical pictures of 98 patients with positive nickel challenge and characterized essentially by skin and gastrointestinal symptoms, whereas all other symptoms (dizziness, headache etc.) were never elicited by the oral nickel challenge. The specificity and sensibility of BraMa-Ni in detecting SNAS were significantly higher than the forbidden food list diet, with an excellent patient adherence. Therefore, BraMa-Ni diet can be prescribed for the treatment of the syndrome other than for the diagnosis, the gold standard of which remains the oral nickel challenge. Nickel (Ni) is an ubiquitous highly sensitizing metal which can trigger allergic contact dermatitis (ACD) in about 10-20% ofthe worldwide population (1). Twenty percent of these ACD patients also experience urticaria and angioedema, flares, itching, cough, headache and gastrointestinal symptoms due to the ingestion of nickel-rich foods (2-4). This condition, firstly known as systemic contact dermatitis, has been named systemic nickel allergy syndrome (SNAS) which better describes both the involvement of organs other than the skin and the implied immunologic mechanism that not only involves ACD typical Th1 but also Th2 cytokines (5).Few works have addressed the clinical nosology of this syndrome, being symptomatology described in case reports (6-8), in some therapeutic trials (4, 10), as a result of oral nickel challenges (9).In patients with suspected SNAS, a low nickel diet reduces symptoms and is applicable as a

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Systemic Nickel Allergy Syndrome: Nosologic Framework and Usefulness of Diet Regimen for Diagnosis

Braga

Quecchia

Perotta

et al. 2013

Int J Immunopathol Pharmacol

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“…Blood values reflect metal concentration in the circulating blood stream and define the actual body burden, dependent on the half-life of the metal under study. In humans, Ni increases in serum 4 h after Ni ingestion and decreases after 24 h (32). Similarly, during an intravenous infusion of Al 3+ for 1 h, the plasma level of Al increased rapidly and decreased immediately following cessation of infusion (33).…”

Section: Lorenzenplatementioning

confidence: 96%

Immunological Impact of Metals in Harbor Seals (Phoca vitulina) of the North Sea

Kakuschke¹,

Valentine-Thon²,

Griesel³

et al. 2005

Environ. Sci. Technol.

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Environmental pollutants may affect the immune system of marine mammals in many areas of the industrialized world. This study provides the first evidence for metal-induced hypersensitivity in harbor seals and demonstrates a relationship between this immunopathy and the level of metals in blood. The concentrations of 20 essential and nonessential elements were analyzed in the blood of 13 harbor seals from the North Sea. In addition, their T-lymphocyte response to metals in terms of hypersensitivity was investigated using a lymphocyte transformation test (LTT) according to the MELISA (memory lymphocyte immuno-stimulation assay) modification. The results showed metal hypersensitivities in 7 of 11 seals investigated in MELISA (data from two seals could not be assessed), reflecting a positive or possible positive reaction in 13 of 154 total single tests. Four animals responded to one metal and three animals to multiple metals. The sensitizing metals were molybdenum (Mo), titanium (Ti), nickel (Ni), chromium (Cr), aluminum (Al), lead (Pb), and tin (Sn). Furthermore, the seals with a Ni-, Al-,.and Cr-sensibilization showed the highest concentrations of these metals in blood. In 8 of the 13 positive cases, elevated blood metal concentrations correlated with the hypersensitivity reaction. Summarizing, we demonstrate in this first pilot study the potential immunological impact of metals in seals, a topic rarely investigated previously. Our results show the value of a combined biological and effect-monitoring tool to investigate pollution-induced immunopathies in live animals.

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“…Interestingly, serum and urine NiSO4 levels following nickel challenge are the same in both sensitized and normal females (190), suggesting that altered nickel metabolism does not determine development of disease. A comparison of cytokine responses to a 5% NiSO4 patch test among five patients with atopic dermatitis and seven nonatopic patients, both with nickel contact allergy, showed similar increased expression of y-interferon, IL-2, and IL-4.…”

Section: Metal Fume Fevermentioning

confidence: 98%

Inorganic dust pneumonias: the metal-related parenchymal disorders.

Kelleher

Pacheco

Newman

2000

Environ Health Perspect

150

117

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In recent years the greatest progress in our understanding of pneumoconioses, other than those produced by asbestos, silica, and coal, has been in the arena of metal-induced parenchymal lung disorders. Inhalation of metal dusts and fumes can induce a wide range of lung pathology, including airways disorders, cancer, and parenchymal diseases. The emphasis of this update is on parenchymal diseases caused by metal inhalation, including granulomatous disease, giant cell interstitial pneumonitis, chemical pneumonitis, and interstitial fibrosis, among others. The clinical characteristics, epidemiology, and pathogenesis of disorders arising from exposure to aluminum, beryllium, cadmium, cobalt, copper, iron, mercury, and nickel are presented in detail. Metal fume fever, an inhalation fever syndrome attributed to exposure to a number of metals, is also discussed. Advances in our knowledge of antigen-specific immunologic reactions in the lung are particularly evident in disorders secondary to beryllium and nickel exposure, where immunologic mechanisms have been well characterized. For example, current evidence suggests that beryllium acts as an antigen, or hapten, and is presented by antigen-presenting cells to CD4+ T cells, which possess specific surface antigen receptors. Other metals such as cadmium and mercury induce nonspecific damage, probably by initiating production of reactive oxygen species. Additionally, genetic susceptibility markers associated with increased risk have been identified in some metal-related diseases such as chronic beryllium disease and hard metal disease. Future research needs include development of biologic markers of metal-induced immunologic disease, detailed characterization of human exposure, examination of gene alleles that might confer risk, and association of exposure data with that of genetic susceptibility. Key words: aluminum, beryllium, cadmium, cobalt, copper, hard metal disease, iron, mercury, metal fume fever, nickel, pneumoconiosis. The term pneumoconiosis, first introduced in the 19th century, refers to diseases and pathologic consequences from inhalation of particulate dusts. In recent years the greatest progress in our understanding of pneumoconioses, other than those produced by asbestos, silica, and coal, has been in the arena of metalinduced parenchymal lung disorders. As presented in Table 1 (1). A major theme that emerges in reviewing recent developments in metal-related lung toxicity is the extent to which various metals are capable of inducing both antigen-specific immunologic reactions in the lung and nonspecific "innate" immune system responses characterized by inflammation frequently triggered by oxidant injury. With the recognition of these immune and inflammatory effects comes a growing awareness of the potential hazards to the lung at low levels of exposure. There is also increasing research being conducted on the interaction between metal exposure and the human genome. In the cases of beryllium and cobalt, for example, there is emerging recognition of the spec...

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Serum and urine nickel in nickel‐sensitized women: effects of oral challenge with the metal

Cited by 21 publications

References 17 publications

Systemic Nickel Allergy Syndrome: Nosologic Framework and Usefulness of Diet Regimen for Diagnosis

Systemic Nickel Allergy Syndrome: Nosologic Framework and Usefulness of Diet Regimen for Diagnosis

Immunological Impact of Metals in Harbor Seals (Phoca vitulina) of the North Sea

Inorganic dust pneumonias: the metal-related parenchymal disorders.

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