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

我们对211例金属过敏患者和108名正常健康志愿者进行了LTT和CAST，并比较了两种斑贴试验的结果。在LTT稀释度系列中，分别配制50、250、6250、31250和156520X的斑贴试验液，分别于培养3d和6d后测定各稀释度的S.I.(%)。在铸型背景下，测定金属含量，建立斑贴试验溶液的最佳稀释系列，并与食物过敏试验一样，测定每种溶液的S.I.(%)。在Pd、Au、Co的LTT中，最大S.I.培养3天被认为是评估金属过敏的最佳条件，但敏感性不是很高，更长时间培养的意义仍有待确定。最大SI值为200μg/ml8ug/mlNiSO，培养3d为代表镍过敏的最佳值。我们需要更多的斑贴试验阳性患者来确定6天培养的有效性。在LTT中，铬和汞的S.I.值与斑贴试验结果无相关性。LTT似乎不能用于诊断铬或汞过敏。在管型中，除低浓度的Pd溶液外，未观察到非特异性阳性反应。然而，没有那么多金属过敏患者表现出阳性反应。在少数患者中，最高浓度的AUS.I.为阳性。在其他金属中，灵敏度很低。我们需要调查更多的患者来证实这些结果。结论：镍、钯、金、钴的LTT可作为金属过敏的一种诊断方法，但敏感性较低。

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.