ISNVD Abstract Book

Does metal-induced hypersensitivity, a risk factor for
venous stenosis and restenosis, contribute to brain and
venous abnormalities in multiple sclerosis sufferers?
Stejskal V PhD 1 , Tsamopoulos N MD 2 , Manginas N MD 3
1
Dept of Immunology, University of Stockholm. 2 Dept of Interventional Neuroradiology, Mediterraneo Hospital, Athens, Greece. 3 Dept of Interventional Cardiology, Mediterraneo Hospital, Athens, Greece
PURPOSE
RESULTS
We asked why restenosis occurred in the majority of multiple sclerosis patients treated by percutaneous transluminal angioplasty (PTA) for
subsequent
restenosis after PTA.
34 patients with central nervous (CNS) and systemic symptoms suspected to have been caused by dental amalgam. Similar changes were not
®
patients with CNS symptoms and MRI changes were found against inorganic mercury, phenyl mercury, gold and lead.
INTRODUCTION
observed reduced signal density on T2 weighted magnetic resonance images (MRI) of the basal ganglia in the brain of MS patients and
areas of low density in T2 weighted imaging and the location of iron deposits as well as the correlation between the extent of gray matter T-2
An important factor for restenosis, sometimes observed after cardiovascular stenting, is immune reactivity to metals in the stents. Thus, cellular
hypersensitivity (Type 4, delayed type allergy) to stent materials increases the risk for restenosis in patients who are patch test positive to nickel
Thus, patients suffering from gold allergy developed restenosis more frequently than similarly treated non-allergic patients, or patients with gold
allergy but implanted with nickel or titanium-coated stents (Fig 1). The frequency of gold sensitization increases with the number of dental gold
restorations. Further, in addition to cadmium and lead, which induce arrhythmias and high blood pressure, many studies indicate the role of
In addition to patch testing, metal allergy may be diagnosed by determining the presence of memory T lymphocytes in peripheral blood.
This so-called Lymphocyte Transformation Test (LTT) has been used for many years and has been standardized and validated in the form of
MELISA ® ® detects abnormal cellular reactivity in patients suffering from
is shown in Fig 2 and described in more detail below. The clinical relevance of MELISA ®
reactivity following the replacement of sensitizing metals with non-metallic dental materials. In mercury-allergic patients suffering from multiple
MATERIALS AND METHODS
FIG 1
FIG 2
MELISA ® - MEmory Lymphocyte Immuno Stimulation A
present in the environment and in dental restorations, as well as from other sources (Figs 3 and 4).
FIG 3
FIG 4
Interestingly, titanium dioxide (TiO 2 ), previously thought to be “bio-inert”, stimulated the MS patients’ lymphocytes. Exposure to TiO 2 is very
common, since it is added to pharmaceutical drugs as well as to foods, cosmetics and supplements. Titanium activates vein endothelial cells in
vitro
Further, TiO 2
and abnormal deposition of iron in the brain and veins of MS patients.
Accumulation of iron around the vein endings in the gray matter and the presence of lymphocytes and macrophages around demyelinating
plaques could be due to dissemination of metal ions released from dying blood macrophages entering the brain through a damaged blood brain
barrier.
Local brain macrophages (oligodendrocytes) might further ingest the metal debris and become damaged in the process. Since
CONCLUSION
deposits in the basal ganglia.
FIG 11
FIG 12
TABLE 1
(SI). A value over 3 indicated a positive reaction to the given allergen.
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