The usefulness of LTT and CAST in the diagnosis of metal allergy

我们对211名金属过敏患者和108名正常健康志愿者采用市售的金属系列贴片试验溶液进行了LTT和CAST，并比较了每次贴片试验的结果。在LTT稀释系列中，配制贴片试验溶液（50、250、6250、31250和156520X），与药物LTT和si浓度相同，分别在培养3天或6天后测定每种稀释液的si（%）。在CAST背景下，通过测定金属含量，建立斑贴试验溶液的最佳稀释系列，并测定每一种溶液的S.I.(%)，与食物过敏试验情况相同。在Pd， Au， Co的LTT中，最大S.I.为3天培养被认为是评估金属过敏的最佳条件，尽管敏感性不是很高，更长的培养的意义仍有待确定。在Ni的LTT中，在最大si浓度下观察到非特异性淋巴细胞的增殖，在200μg/ml的8ug/ml的NiSO中，培养3天的最大si值是代表Ni过敏的最佳值。我们需要更多的阳性斑贴试验患者来确定6天培养的有效性。在LTT中，Cr和Hg的S.I.值与斑贴试验结果无关。LTT似乎对诊断Cr或Hg过敏没有帮助。在CAST中，除较低浓度的Pd溶液外，未观察到非特异性阳性反应。然而，金属过敏患者的阳性反应并不多。在Au中，sii的最高浓度在几例患者中呈阳性。对其他金属的敏感性很低。我们需要调查更多的患者来证实这些结果。结论Ni， Pd, Au， Co的LTT可作为金属过敏的诊断方法，但敏感性相对较低。

We performed LTT and CAST with commercially available metal series patch test solutions in 211 patients with metal allergy and 108 normal healthy volunteers and compared the result of each patch test. In LTT dilution series of patch test solution (50, 250, 6250, 31250 and 156520X) was propared as in the case of drug LTT and S.I.(%) of each dilution was measured after cultured 3 days or 6 days. In CAST background by metals was measured to establish optimal dilution series of patch test solution, and S.I. (%) of each solution was measured as in the case of food allergy test. In LTT of Pd, Au, Co, maximum S.I. For 3days culture was thought to be the optimal condition to assess metal allergy, although sensitivity is not very high and significance of longer culture was still to be determined. In LTT of Ni non-specific lymphocyte proliferation was observed at the concentration of maximum S.I. The maximum S.I. Of 200μg/ml 8ug/ml NiSO, for 3days culture was the most optimal value to represent Ni allergy. We need more positive patch test patients to determine the usefulness of 6 days culture. In LTT of Cr and Hg S.I. Value did not correlate to the results of patch test. LTT seems not to be useful to diagnose Cr or Hg allergy. In CAST non-specific positive reactions were not observed excopt in the lower concentration of Pd solution. However, not so many patients with metal allergy showed positive reactions. In Au S.I. Of the highest concentration was positive in several patients. In other metals sensitivity was very low. We need to investigate more patients to confirm these results. IN conclusion LTT of Ni, Pd, Au, Co can be used as a diagnostic method to assess metal allergy, although sensitivity is relatively low.