In Vitro Metal-Reactivity Is Associated With In Vivo Metal-Specific Antibodies (IgG) In Individuals with Metal Implants

摘要

Hypersensitivity to metallic implants occurs as a result of individually specific humoral and adaptive immune responses. Although adaptive cellular immunity has been correlated with metal sensitivity, other studies have suggested that metal-protein antibodies (humoral immunity) can be detected in subjects with total joint arthroplasty (TJA)(1). However, a possible correlation between metal hypersensitivity in TJA subjects with the presence of metal-protein complex specific antibodies in serum remains un-investigated, i.e. can increased metal sensitivity in TJA subjects be attributed to an enhanced specific antibody capability to recognize metal-protein conjugates? To address this question we hypothesized that implant soluble metals, in conjunction with peri-implant structural proteins (collagen I), will exhibit preferential antibody binding in metal-reactive TJA subjects when compared to non-reactive subjects in a concentration-dependent manner. We tested this hypothesis by measuring systemic serum IgG recognition (binding) of three implant metal-protein complexes at three concentrations in metal-reactive and non-reactive TJA groups.