RESUMO
BACKGROUND: Allergic contact dermatitis is a frequent, often disabling disease caused by countless substances. Patch testing remains the gold standard test to identify the causative agent; however, it is subjective, time-consuming and not completely safe. Alternative methods were tried, but significant success has only been achieved with nickel. OBJECTIVE: Develop an alternative or complementary allergic contact dermatitis diagnostic test. METHODS: We compared the lymphocyte proliferative rate and cytokine production (IFN-γ, IL-2, IL-4, IL-5, IL-10, IL-12, IL-13, IL-17 and RANTES) between 18 chromium allergic patients and 19 controls. RESULTS: The lymphocyte proliferation test and some of the cytokines tested (IFN-γ, IL-2, IL-5, IL-12 and IL-13) were able to discriminate allergic patients. However, striking results were only achieved using IL-13, leading to an accuracy of about 90%. CONCLUSIONS: If further studies confirm the data found, IL-13 could be used as an alternative or complementary test to detect chromium contact allergy whereas lymphocyte proliferation test, IFN-γ, IL-2, IL-5 and IL-12 detections may serve as additional diagnostic tests.
Assuntos
Biomarcadores/sangue , Cromo/efeitos adversos , Dermatite de Contato/diagnóstico , Interleucina-13/sangue , Adulto , Idoso , Estudos de Casos e Controles , Proliferação de Células , Dermatite de Contato/sangue , Feminino , Humanos , Linfócitos/patologia , Masculino , Pessoa de Meia-Idade , Testes do EmplastroRESUMO
BACKGROUND: Lymphocyte proliferation testing (LPT) has some advantages over patch testing to diagnose allergic contact dermatitis. It is harmless, objective and can be used in clinical situations where patch testing is not recommended. Unfortunately, significant success has only been achieved with nickel. There are few studies on chromium LPT and they were performed with different methods, leading to inconsistent results. METHODS: To determine the best parameters for chromium LPT, we tested 20 patients with allergic contact dermatitis to the metal and 20 controls, using various protocols. RESULTS: The best sensitivity and specificity ratios were achieved with 6-day cultures stimulated with a range from 7.5 x 10(-4) to 5 x 10(-3) mol/L of nonfiltered chromium chloride solutions. The sensitivity, specificity and accuracy values found within this range were 65%, 95% and 80%, respectively. CONCLUSION: Further investigation is necessary to achieve better sensitivity values.