The sensitizing properties of metals widely used in medical and dental
care have been studied with the help of an optimized lymphocyte proli
ferative assay, MELISA. MELISA (memory lymphocyte immuno-stimulation a
ssay) was originally developed for the screening of allergenic epitope
s of drugs and other chemicals of low molecular weight, but has recent
ly been adapted for the study of metal-induced sensitization. The pati
ents studied suffered from various oral mucosal problems which were su
spected to be caused by the release of metal ions from dental restorat
ions. They were also troubled by chronic fatigue persisting over many
years. One patient was also occupationally exposed to metals while wor
king in a dental practice. Healthy subjects without any discomfort due
to metal devices served as controls. In addition to metals used in de
ntistry, lymphocyte responses to organic mercurials used widely as pre
servatives in vaccines, eye/nose drops and contact lense fluids were s
tudied. The results indicated that mercurials, as well as other metals
such as gold or palladium, induce strong lymphocyte proliferative res
ponses in patients with oral or systemic symptoms, but not in similarl
y exposed unaffected subjects. The results of MELISA performed with a
pair of identical twins with chronic fatigue syndrome (CFS) indicated
that metal specific responses may be dependent on the genetics of the
patient. Thus, many metals that are today accepted for use in medicine
and dentistry carry a definite sensitizing risk for certain genetical
ly predisposed individuals. Therefore, the use of these metals should
be limited in the future.