What is a metal allergy?
Many every day metals can cause a Type IV allergic reaction in genetically predisposed individuals. This allergy is mediated by T-lymphocytes (white blood cells) that have had prior contact to a given allergen (memory lymphocytes). When they are exposed to the sensitizing allergen, these memory lymphocytes respond by enlarging (lymphoblast transformation) and dividing (proliferation). The newly formed cells (effector cells) together with their secreted cytokines mediate the resulting allergic reaction (see test principle).
What symptoms may be indicative of a metal allergy?
The classical symptom is contact eczema. In addition, chronic exposure to metals may cause a wide range of symptoms and has been implicated in the etiology of allergy, chronic fatigue syndrome (CFS), multiple sclerosis (MS), fibromyalgia, and possibly multiple chemical sensitivity (MCS).
Which metals can induce an allergy?
The most frequent metal allergens are nickel, gold, palladium, different types of mercury compounds, cobalt and chromium. Occasionally, other metals can induce positive responses in MELISA®, such as beryllium, titanium, tin, platinum and copper.
In which every day items or medical products can sensitizing metals be found?
Jewelry, dental restorations and implants, cosmetics, metal joint prostheses, vascular stents, coins, etc.
Do certain occupations pose a special risk for inducing a metal allergy?
Construction workers (masons, concrete workers): chromium, cobalt; miners: chromium, cobalt; electricians, photographers: chromium; aircraft constructors: beryllium; hair dressers, beauticians: nickel, titanium; galvanizers: nickel, chromium, cobalt, mercury; rubber industry: chromium, cobalt; maids: nickel; wood and paper industry: chromium; shoemakers: chromium; painters: chromium, cobalt; metal workers: chromium, nickel, cobalt; textile industry, dentists, dental technicians: nickel, mercury.
In which fields of medicine does a metal allergy play an important role?
General medicine, dentistry, allergology, occupational medicine, orthopedics, surgery, dermatology, internal medicine, pediatrics, homeopathic medicine, and environmental medicine.
How can a metal allergy be diagnosed?
With a skin test or, more reliably, with the MELISA® test (memory lymphocyte immuno stimulation assay).
Is the MELISA® test medically validated, i.e., were MELISA® test results correlated with other parameters of a metal allergy (skin tests, etc.)?
Yes, during development of the test by Prof. Stejskal as well as in follow-up studies (see Literature).
How does the MELISA® test work?
White blood cells (lymphocytes) from whole blood are isolated and tested against allergens chosen accordingly to the patients anamnesis, dental and occupational history. The blood is incubated for five days and the lymphocyte reaction is measured by two separate technologies: one based on the uptake of radioisotope by dividing lymphocytes; the other by evaluation by microscopy. The level of reactivity is measured as a Stimulation Index (SI). A value over 3 indicates a positive reaction to a given allergen.
What material is required for the MELISA® test?
MELISA® laboratories need 20-40 ml of blood depending on the number of metals tested. The blood has to be drawn into special tubes containing sodium citrate (anti-coagulant). The patient should not be taking any immuno suppressive medication as this may affect the test results. Examples of such medication are steroids, allergy medicine, anti-inflammatory medicine, painkillers etc.
Can the blood samples be sent to a laboratory?
Yes, with a courier such as FedEx or DHL. The blood must be stored at room temperature and arrive in the laboratory within 24 hours (maximally 48 hours) of drawing. Write on package: "warm transport, do not chill". Designate samples "clinical specimens, non-infectious, non-hazardous"
How long does the MELISA® test take?
Approx. 1 week.
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