Yang J, Merritt K
Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio 44106-7207.
J Biomed Mater Res. 1994 Nov;28(11):1249-58. doi: 10.1002/jbm.820281102.
Sensitivity to nickel, cobalt, and chromium is common among the general population. The identification of these sensitivities is generally by the detection of cell-mediated immunity. Detection of humoral immunity to these metals has rarely been undertaken because suitable assays are not available. To further our knowledge about the systemic humoral immune system response to weak hapten-syngeneic or allogeneic protein conjugates (corrosion and wear products of metallic orthopedic devices), a sensitive enzyme-linked immunosorbent assay (ELISA) method for testing for antibody (humoral immunity) to metals was developed. Microtiter plates were coated with human serum albumin (HSA) or glutathione (GSH) and then conjugated with metal ions. Plates coated with HSA or GSH and without metal ions served as background controls. An indirect ELISA method was used to detect antibody binding. Patients bearing cobalt-chromium alloy devices were considered to be the most likely candidates as sources of antibody to metal and were used to document the usefulness of the test. Specificity of the test was documented by inhibition studies with these metal ions in the ELISA assay. The serum samples of 10 patients were screened for the presence of Cr-, Co-, or Ni-specific antibody at various periods up to 5.5 years after implantation of F-75 cobalt alloy total joint replacements. All patients had implants that were functioning well. The pre- and postimplantation humoral immune profiles of patients were determined and compared with each preimplantation control and with a pooled normal serum sample. This study presents evidence that metal-protein complex-specific antibodies can be detected. The clinical implications remain to be determined.
对镍、钴和铬过敏在普通人群中很常见。这些过敏反应的识别通常通过检测细胞介导的免疫来进行。由于缺乏合适的检测方法，很少进行针对这些金属的体液免疫检测。为了进一步了解全身体液免疫系统对弱半抗原 - 同基因或异基因蛋白质结合物（金属骨科器械的腐蚀和磨损产物）的反应，开发了一种用于检测金属抗体（体液免疫）的灵敏酶联免疫吸附测定（ELISA）方法。微量滴定板先用人类血清白蛋白（HSA）或谷胱甘肽（GSH）包被，然后与金属离子结合。用HSA或GSH包被但不含金属离子的板作为背景对照。采用间接ELISA方法检测抗体结合。植入钴铬合金器械的患者被认为是最有可能产生金属抗体的来源，并用于证明该检测方法的有效性。通过在ELISA测定中用这些金属离子进行抑制研究来证明该检测方法的特异性。在植入F - 75钴合金全关节置换物后的5.5年期间，对10名患者的血清样本在不同时间段进行了铬、钴或镍特异性抗体的筛查。所有患者的植入物功能良好。测定并比较了患者植入前和植入后的体液免疫谱，以及每个植入前对照和一份混合正常血清样本。本研究提供了可检测到金属 - 蛋白质复合物特异性抗体的证据。其临床意义仍有待确定。
