Metal Allergy pp 125-133 | Cite as

Assessment for Metal Allergy: In Vitro Assays

  • Thomas Rustemeyer


Cutaneous exposure to metal salts may result in sensitization to metals and lead to allergic contact dermatitis. To date, patch testing is the method of choice for diagnosing metal allergy in a clinical setting. However, this method has its limitations, such as boosting of existing sensitization, activating sensitization by testing, or interobserver variability. Therefore, a reliable alternative method for routine diagnosis would be of significant use. Possible alternatives to patch testing are in vitro proliferation assays, such as the lymphocyte transformation test (LTT). LTT is used to establish in vitro whether a patient has developed a T-cell response against a certain metal and is mainly used in an experimental setting. This chapter aims to determine the validity of LTT for routine metal allergy diagnosis based on available peer-reviewed medical literature. Due to the limited number of published articles concerning sensitivity, specificity, and reproducibility of LTT for the diagnosis of metal allergies, it is impossible to draw firm conclusions regarding the validity of in vitro tests. Nevertheless, this chapter will provide an overview on the available scientific data and, by pin-pointing the current needs, suggest new approaches.


Metal allergy Allergic contact dermatitis Lymphocyte transformation test LTT Lymphocyte proliferation test LPT Lymphocyte activation test Memory lymphocyte immune-stimulation assay 


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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Dermatology and AllergologyVU University Medical Center AmsterdamHV AmsterdamThe Netherlands

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