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Frontiers in Immunology 2019Arthroplasty ranks among the greatest achievements of surgical medicine, with total hip replacement termed "the operation of the century." Despite its wide success,... (Review)
Review
Arthroplasty ranks among the greatest achievements of surgical medicine, with total hip replacement termed "the operation of the century." Despite its wide success, arthroplasty bears risks, such as local reactions to implant derived wear and corrosion products. Prevalence of allergies across Western society increases and along the number of reported hypersensitivity reactions to orthopedic implant materials. In this context the main focus is on delayed hypersensitivity (DTH). This mechanism is mainly attributed to T cells and an overreaction of the adaptive immune system. Arthroplasty implant materials are in direct contact with bone marrow (BM), which is discussed as a secondary lymphoid organ. However, the mechanisms of sensitization toward implant wear remain elusive. Nickel and cobalt ions can form haptens with native peptides to activate immune cell receptors and are therefore common T helper allergens in cutaneous DTH. The rising prevalence of metal-related allergy in the general population and evidence for the immune-modulating function of BM allow for the assumption hypersensitivity reactions could occur in peri-implant BM. There is evidence that pro-inflammatory factors released during DTH reactions enhance osteoclast activity and inhibit osteoblast function, an imbalance characteristic for osteolysis. Even though some mechanisms are understood, hypersensitivity has remained a diagnosis of exclusion. This review aims to summarize current views on the pathomechanism of DTH in arthroplasty with emphasis on BM and discusses recent advances and future directions for basic research and clinical diagnostics.
Topics: Animals; Arthroplasty; Bone Marrow; Humans; Hypersensitivity, Delayed; Metals; Prostheses and Implants
PubMed: 31620137
DOI: 10.3389/fimmu.2019.02232 -
The American Journal of Pathology Jan 1978
Review
Topics: Anaphylaxis; Animals; Antigen-Antibody Reactions; Autoimmune Diseases; Complement System Proteins; Female; Graft Rejection; Graft vs Host Reaction; Granuloma; Humans; Hypersensitivity; Hypersensitivity, Delayed; Immune System Diseases; Male; Pregnancy
PubMed: 23009
DOI: No ID Found -
Journal of Investigational Allergology... Dec 2022
Topics: Humans; Salts; Drug Hypersensitivity; Desensitization, Immunologic; Hypersensitivity, Delayed; Iron
PubMed: 35118939
DOI: 10.18176/jiaci.0789 -
Ugeskrift For Laeger Sep 2018Local anaesthetics (LA) are frequently used, but allergy to LA is very rare. It can only be verified in about 1% of the patients referred with suspected allergy.... (Review)
Review
Local anaesthetics (LA) are frequently used, but allergy to LA is very rare. It can only be verified in about 1% of the patients referred with suspected allergy. Reactions may be due to vasovagal or toxic reactions, allergies to additives or other products used during administration. Suspicion of allergy should be investigated to rule out or confirm allergy. In case of allergy to LA, search of a safe alternative ensures the patients future ability to receive LA treatment. The investigation method depends on, whether a type I- or type IV reaction is suspected.
Topics: Algorithms; Anesthetics, Local; Drug Hypersensitivity; Humans; Hypersensitivity, Delayed; Hypersensitivity, Immediate
PubMed: 30274575
DOI: No ID Found -
Basic & Clinical Pharmacology &... Feb 2017In this MiniReview, we summarize the body of knowledge on the delayed-type hypersensitivity arthritis (DTHA) model, a recently developed arthritis model with 100%... (Review)
Review
In this MiniReview, we summarize the body of knowledge on the delayed-type hypersensitivity arthritis (DTHA) model, a recently developed arthritis model with 100% incidence, low variation and synchronized onset in C57BL/6 (B6) mice, and compare it to other murine arthritis models. It is desirable to have robust arthritis models in B6 mice, as many transgene strains are bred on this background. However, several of the most widely used mouse model of arthritis cannot be induced in B6 mice without the drawback of lower incidence, reduced severity and higher variation, if at all. DTHA is induced by modifying a classical methylated bovine serum albumin (mBSA)-induced DTH response by administering a cocktail of anti-type II collagen antibodies (anti-CII) between immunization and challenge. Arthritis affects one, predefined paw in which acute inflammation and severe arthritis rapidly develop and peak after 4-7 days. Disease is self-resolving over the course of around 3 weeks. Disease manifestations resemble those seen in other arthritis models and include bone erosion, cartilage destruction, oedema, pannus and new bone formation. Induction of DTHA is dependent on CD4 T cells while B cells are dispensable. The DTHA model is set apart from other murine arthritis models in that it can be induced in B6 mice with 100% incidence and with high and consistent severity. This is the clearest advantage of the model, as the mechanisms of disease and clinical manifestations can be found in other arthritis models. The model holds potential for future modifications that may improve the lack of chronicity.
Topics: Animals; Antibodies; Antirheumatic Agents; Arthritis, Experimental; Arthritis, Rheumatoid; Collagen Type I; Hypersensitivity, Delayed; Joints; Mice, Inbred BALB C; Mice, Inbred C57BL; Serum Albumin, Bovine; Severity of Illness Index; Species Specificity; Time Factors
PubMed: 27553641
DOI: 10.1111/bcpt.12657 -
Clinical and Experimental Dermatology Jan 2022Several individuals have developed delayed localized cutaneous vaccine reactions to the two novel mRNA Covid-19 vaccines. Clinical and histopathologic results of this...
Several individuals have developed delayed localized cutaneous vaccine reactions to the two novel mRNA Covid-19 vaccines. Clinical and histopathologic results of this case series study confirm that the localized injection-site reactions to the mRNA COVID-19 vaccines are delayed hypersensitivity reactions that, unlike immediate hypersensitivity reactions, are not a contraindication to vaccination.
Topics: 2019-nCoV Vaccine mRNA-1273; Adult; Aged; Aged, 80 and over; COVID-19; Drug Hypersensitivity; Female; Humans; Hypersensitivity, Delayed; Injection Site Reaction; Male; Middle Aged; Retrospective Studies; SARS-CoV-2
PubMed: 34288056
DOI: 10.1111/ced.14856 -
Dermatology Online Journal May 1999Although the delayed type hypersensitivity (DTH) reaction was discovered over 100 years ago, the exact nature of the reaction has been the subject of contentious debate... (Review)
Review
Although the delayed type hypersensitivity (DTH) reaction was discovered over 100 years ago, the exact nature of the reaction has been the subject of contentious debate over the years. The reaction was discovered in 1882 by Robert Koch, but it was not until the 1940s that Landsteiner and Chase proved that the reaction was mediated by the cellular and not the humoral arm of the immune system. The first DTH reaction described used only the tuberculin antigen (tuberculin reaction), but the definition was later expanded to include cell mediated reactions to other bacterial and viral antigens, responses to pure protein with adjuvant or haptens, and host responses to allograft. The DTH skin test is used to test if prior exposure to an antigen has occurred. When small quantities of antigen are injected dermally, a hallmark response is elicited which includes induration, swelling and monocytic infiltration into the site of the lesion within 24 to 72 hours. This reaction has been shown to be absolutely dependent on the presence of memory T cells. Both the CD4+ and CD8+ fractions of cells have been shown to modulate a response. Contemporary debate regarding the reaction is focused on the role of the Th1 and Th2 cells originally discovered by Mosmann. It has been postulated that the Th1 cell is the "inducer" of a DTH response since it secretes interferon gamma (IFN ), a potent stimulator of macrophages, while the Th2 cell is either not involved or acting as a downregulator of the cell mediated immune response. Despite the early experimental success of this theory, experiments have shown that Th2 cells may be involved in certain types of proinflammatory cell mediated immunity. This review focuses on the nature of the different forms of DTH that can be elicited and the different experimental evidence that has led to the current theories regarding DTH and its role in cell mediated immunity.
Topics: Antigen-Presenting Cells; Graft vs Host Disease; History, 20th Century; Humans; Hypersensitivity, Delayed; Immunity, Cellular; T-Lymphocytes
PubMed: 10673450
DOI: No ID Found -
Journal of Investigational Allergology... Feb 2023
Topics: Humans; Anti-Inflammatory Agents, Non-Steroidal; Dipyrone; Drug Hypersensitivity; Hypersensitivity, Delayed; Ibuprofen; Lymphocyte Activation
PubMed: 35416155
DOI: 10.18176/jiaci.0814 -
The New England Journal of Medicine Sep 1968
Review
Topics: Animals; Humans; Hypersensitivity, Delayed; Immunosuppressive Agents; Lymphocytes; Transplantation Immunology; gamma-Globulins
PubMed: 4174895
DOI: 10.1056/NEJM196809262791309 -
Physiology & Behavior Jan 2020Stable behavioral traits (temperament, personality) often predict health outcomes. Temperament-specific differences in immune function could explain temperament-specific...
Stable behavioral traits (temperament, personality) often predict health outcomes. Temperament-specific differences in immune function could explain temperament-specific health outcomes, however, we have limited information on whether immune function varies by personality. In the present study, we examined the relationship between a basic behavioral trait (behavioral-inhibition vs. non-inhibition) and two immune responses (innate inflammation and delayed-type hypersensitivity, DTH) in a rodent model. In humans, behavioral inhibition (fearful temperament) is associated with altered stress physiology and allergies. In laboratory rats, the trait is associated with elevated glucocorticoid production. We hypothesized that behavioral inhibition is associated with glucocorticoid resistance and dampened T-helper 1 cell responses often associated with chronic stress and allergies. Further, this immune profile would predict poorly-regulated innate inflammation and dampened DTH. In male Sprague-Dawley rats, we quantified consistent behavioral phenotypes by measuring latency to contact two kinds of novelty (object vs. social), then measured lipopolysaccharide(LPS)-induced innate inflammation or keyhole limpet hemocyanin(KLH)-induced DTH. Behaviorally-inhibited rats had heightened glucocorticoid and interleukin-6 responses to a low/moderate dose of LPS and reduced DTH swelling to KLH re-exposure compared to non-inhibited rats. These results suggest that behavioral inhibition is associated with a glucocorticoid resistant state with poorly regulated innate inflammation and dampened cell-mediated immune responses. This immune profile may be associated with exaggerated T-helper 2 responses, which could set the stage for an allergic/asthmatic/atopic predisposition in inhibited individuals. Human and animal models of temperament-specific immune responses represent an area for further exploration of mechanisms involved in individual differences in health.
Topics: Animals; Behavior, Animal; Glucocorticoids; Hemocyanins; Hypersensitivity, Delayed; Inflammation; Inhibition, Psychological; Interleukin-6; Lipopolysaccharides; Male; Phenotype; Rats; Temperament
PubMed: 31629765
DOI: 10.1016/j.physbeh.2019.112693