Abstract
Metal allergy is a T-cell-mediated delayed type of hypersensitive reaction. The pathogenetic mechanisms underlying the allergy are unclear, although the condition has been reported to be related to oral lichen planus (OLP), despite an absence of immunological studies to support this relationship. In this study, histopathological samples of OLP patients were examined to compare the metal allergy-positive and -negative groups, with a focus on the network of epidermal keratinocytes and T cells induced by thymic stromal lymphopoietin (TSLP) and its receptor, TSLPR. Infiltration of T cells into the epithelium was revealed to be higher in the OLP lesions of metal allergy-positive patients than in those of metal allergy-negative patients. Moreover, TSLP-TSLPR signaling and TNF-α production were higher in the epithelial tissue samples of the metal allergy-positive patients than in the metal allergy-negative patients. Metal allergy is associated with both increased expressions of TSLP in keratinocytes and increased TNF-α levels in the epithelium. We propose that this would promote the accumulation of T cells at the lesion site, contributing to the formation of the disease. These results suggest that metal allergy may be an aggravating factor in the pathogenesis of OLP.
Highlights
Metal allergy is a delayed type of hypersensitive reaction, the pathogenesis of which is mediated by a complex immune network of T-cell-mediated interactions [1,2,3]
As both metal allergy and oral lichen planus (OLP) are caused by the presence of T cells in the skin and mucosa, we consider it vital to focus on the network of interactions between
thymic stromal lymphopoietin (TSLP) was produced in both allergy-negative and -positive patients, TSLP, TSLPR and tumor necrosis factor (TNF)-α were all produced at significantly higher quantities in the mucosal epithelium samples of the former (Figure 3a,b)
Summary
Metal allergy is a delayed type of hypersensitive reaction, the pathogenesis of which is mediated by a complex immune network of T-cell-mediated interactions [1,2,3]. The precise mechanisms by which metal allergy causes disease have not been fully elucidated. Oral lichen planus (OLP) has been posited to be related to dental metal allergy [7]. From epidemiological and clinical perspectives, dentists have suggested that there may be a relationship between metal allergy and OLP, but to date, no immunological studies have been conducted to test this hypothesis. As both metal allergy and OLP are caused by the presence of T cells in the skin and mucosa, we consider it vital to focus on the network of interactions between.
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