Muris J, Kleverlaan C J, Feilzer A J, Valentine-Thon E
Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam, Louwesweg 1, Amsterdam 1066 EA, The Netherlands.
Allergy. 2009 Aug;64(8):1152-6. doi: 10.1111/j.1398-9995.2009.01963.x. Epub 2009 Feb 7.
For patch testing, replacement of the commonly used palladium dichloride (PdCl2) by sodium tetrachloropalladate (Na2[PdCl4]) was recently demonstrated to improve test accuracy and show a significant correlation with nickel (Ni), supporting the concept of cross-reactivity between Pd and Ni. A promising alternative to metal allergy patch testing is the in vitro lymphocyte proliferation test (LTT).
The aim of this study was to test whether Na2[PdCl4] is also more sensitive for diagnosing Pd allergy with a standardized LTT.
PATIENTS/METHODS: After determining optimal nontoxic and nonmitogenic concentrations for Na2[PdCl4], blood samples from 105 patients with clinical suspicion of metal allergy were tested with an LTT called memory lymphocyte immuno stimulation assay for Na2[PdCl4], PdCl2 and NiCl2. Reaction profiles were analysed for concordant positive reactions.
Using the conventional cut-off of stimulation index > or = 3, 74.3% showed a positive reaction to NiCl2, 15.2% to PdCl2 and 28.6% to Na2[PdCl4]. All positive results to PdCl2 were covered by Na2[PdCl4]. From the 30 positive reactions to Na2[PdCl4], 26 (87%) were concordant for NiCl2 reactivity.
In LTT, the use of Na2[PdCl4] results in more positive reactions in Pd allergy testing which are in concordance with positive reactions to PdCl2 and NiCl2.
在斑贴试验中，最近证实用四氯钯酸钠（Na₂[PdCl₄]）替代常用的二氯化钯（PdCl₂）可提高检测准确性，并显示出与镍（Ni）有显著相关性，这支持了钯和镍之间交叉反应的概念。体外淋巴细胞增殖试验（LTT）是金属过敏斑贴试验的一种有前景的替代方法。
本研究的目的是测试Na₂[PdCl₄]在标准化LTT中对诊断钯过敏是否也更敏感。
患者/方法：确定Na₂[PdCl₄]的最佳无毒和无促有丝分裂浓度后，对105例临床怀疑有金属过敏的患者的血样进行一种名为记忆淋巴细胞免疫刺激试验的LTT，检测Na₂[PdCl₄]、PdCl₂和NiCl₂。分析反应谱以确定一致的阳性反应。
使用刺激指数≥3的传统临界值，74.3%的患者对NiCl₂呈阳性反应，15.2%对PdCl₂呈阳性反应，28.6%对Na₂[PdCl₄]呈阳性反应。所有对PdCl₂的阳性结果都被Na₂[PdCl₄]涵盖。在对Na₂[PdCl₄]的30例阳性反应中，26例（87%）与对NiCl₂的反应性一致。
在LTT中，使用Na₂[PdCl₄]在钯过敏检测中产生更多阳性反应，这些反应与对PdCl₂和NiCl₂的阳性反应一致。
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