Oral Induction of Immunological Tolerance to Chromium in the Guinea Pig

Abstract

Metal alloys used in dentistry may elicit adverse side-effects. Contact allergic reactions to metals released from such alloys are among the most frequently encountered problems. In an earlier study, we observed that oral contacts with nickel or chromium salts did not sensitize, but rather decreased the risk of subsequent sensitization to these metals. In the present study, we focused on chromium allergy and extended our earlier observations by further dose-response studies. In addition, we compared different chromium valencies as to their potential oral tolerogenic effects. Development of immunological tolerance in chromium-fed guinea pigs was demonstrated by their inability to develop chromium hypersensitivity after a subsequent immunization attempt. For these studies, the techniques of immunization and skin testing were first improved.

One feeding with a high dose of K₂Cr₂O₇, (containing hexavalent chromium) was effective in full tolerance induction. In contrast, trivalent chromium (CrCl₃) induced a distinctly lower degree of tolerance, whereas metallic chromium powder was not detectably tolerogenic after a limited number of feedings. Dose-frequency-response studies with K₂Cr₂O₇, showed that full tolerance could also be induced by an increase in the number of feedings with sub-optimal tolerogenic doses. The present results therefore support our hypothesis that long-lasting oral contact with chromium-releasing metal alloys may ultimately result in strong immune tolerance to this metal in subjects without previous skin contact with it. This view is further supported by recent insights into the unique tolerogenicity of oral, as compared with gastro-intestinal, allergenic contacts.

Get full access to this article

View all access options for this article.

References

Andersen, K.E. (1987): Testing for Contact Allergy in Experimental Animals , Pharmacol & Toxicol 61:1-8.

Asherson, G.L. ; Zembala, M. ; Perera, M.A.C. C.; Mayhew, B. ; and Thomas, W.R. (1977): Production of Immunity and Unresponsiveness in the Mouse by Feeding Contact Sensitizing Agents and the Role of Suppressor Cells in the Peyer's Patches, Mesenteric Lymph Nodes and Other Lymphoid Tissue , Cell Immunol 33:145-155.

Baranowska-Dutkiewicz, P.B. (1981): Absorption of Hexavalent Chromium by Skin in Man , Arch Toxicol 47:47-50.

Brune, D. (1986): Metal Release from Dental Biomaterials, Biomaterials 7:163-175.

Chase, M.W. (1946): Inhibition of Experimental Drug Allergy by Prior Feeding of the Sensitizing Agent, Proc Soc Exp Biol Med 61:257-259.

Cronin, E. (1980): Contact Dermatitis, Edinburgh : Churchill Livingstone, pp. 287-313.

Doisy, R.J. ; Streeten, D.H. ; Freiberg, J.M. ; and Schnei-Der, A.J. (1976): Chromium Metabolism in Man and Biochemical Effects. In: Trace Elements in Human Health and Disease, A.S. Prasad , Ed., San Diego: Academic Press, pp. 79-104.

Donaldson, R.M. and Barreras, R.F. (1966): Intestinal Absorption of Trace Quantities of Chromium , J Lab Clin Med 68 :484-493.

Greene, M.I. ; Sugimoto, M. ; and Benaceraf, B. (1978): Mechanisms of Regulation of Cell-Mediated Immune Responses. I. Effect of the Route of Immunization with TNP-coupled Syngeneic Cells on the Induction and Suppression of Contact Sensitivity to Picryl Chloride , J Immunol 120:1604-1611.

10.

Hildebrand, H.F. ; Veron, C. ; and Martin, P. (1989): Les Alliages Dentaire en Metaux non Precieux et l'Allergie, J Biol Buccale 17:227-243.

11.

Holt, P.G. ; Vines, J. ; and Britten, D. (1988): Sublingual Allergen Administration. 1. Selective Suppression of IgE Production in Rats by High Allergen Doses, Clinical Allergy 18:229-234. Horak, E. and Sunderman, F.W., Jr. (1977 ): Fecal Nickel Excretion by Healthy Adults, Clin Chem 19:429-430. Kagnoff, M.F. (1978): Effects of Antigen Feeding on Intestinal and Systemic Immune Responses. Priming of Precursor Cytotoxic T-Cells by Antigen Feeding, J Immunol 120:395-399.

12.

Kraal, G. ; Weissman, I.L. ; and Stobo, E.C. (1983): Differences in in vivo Distribution of and Homing of T cell Subsets to Mucosal vs Non-Mucosal Lymphoid Organs, J Immunol 130 :1097-1102.

13.

Lachapelle, J.M. ; Lauwerys, R. ; Tennstedt, D. ; An-Danson, J. ; Benezra, C. ; Chabeau, G. ; Ducombs, G. ; Foussereau, J. ; Lacroix, M. ; and Martin, P. (1980): Eau de Javel and Prevention of Chromate Allergy in France, Contact Dennatitis 6:107-110.

14.

Menne, T. and Bachmann, E. (1979): Permanent Disability from Hand Dermatitis in Females Sensitive to Nickel, Chromium and Cobalt, Dermatosen 5:129-135.

15.

Menne, T. ; Borgan, O. ; and Green, A. (1982): Nickel Allergy and Hand Dermatitis in a Stratified Sample of the Danish Female Population: An Epidemiological Study Including a Statistic Appendix, Acta Derm (Stockholm ) 62:35-41.

16.

Mowat, A. Mcl. (1987): The Regulation of the Immune Response to Dietary Protein Antigens, Immunology Today 8:93-98.

17.

Polak, L. (1980): Immunological Aspects of Contact Sensitivity; An Experimental Study. In: Monographs in Allergy, Vol. 15, R. Dukor , P. Kalós , Z. Trnka , R.H. Waksman , and A.L. De Weck , Eds., Basel: S. Karger AG, pp. 1-170.

18.

Polak, L. (1983): Immunology of Chromium. In: Chromium Metabolism and Toxicity, D. Burrows , Ed., Boca Raton, FL: CRC Press Inc., pp. 51-136.

19.

Scheper, R.J. ; Von Blomberg, M.B.E. ; Vreeburg, K.J.J. ; and Van Hoogstraten, I.M.W. (1989): Recent Advances in Immunology of Nickel. In: Nickel and the Skin: Immunology and Toxicology, H.I. Maibach and T. Menné , Eds., Boca Raton, FL: CRC Press Inc., pp. 55-64.

20.

Scheper, R.J. ; Noble, B. ; Parker, D. ; and Turk, J. (1977): The Value of an Assessment of Erythema and Increase in Thickness of the Skin Reaction for a Full Appreciation of the Nature of Delayed Hypersensitivity in the Guinea Pig, Int Archs Allergy Appl Immunol 54:58-66.

21.

Shelley, W.B. and Juhlin, L. (1976): Langerhans Cells Form a Reticuloepithelial Trap for External Contact Allergens, Nature ( London) 261:46-47.

22.

Titus, R.G. and Chiller, J.M. (1981): Orally Induced Tolerance, Int Arch Allergy. Appl Immun 65:323-338.

23.

Turk, J.L. and Parker, D. (1977): Sensitization with Cr, Ni and Zr Salts and Allergic Type Granuloma Formation in the Guinea Pig, J Invest Dermatol 68:341-345.

24.

Van Den Burg, C.K.H. ; Bruynzeel, D.P. ; Vreeburg, K.J.J. ; Von Blomberg, B.M.E. ; and Scheper, R.J. (1986): Hand Eczema in Hairdressers and Nurses; a Prospective Study. I. Evaluation of Atopy and Nickel-Hypersensitivity at the Start of Apprenticeship, Contact Dennatitis 14:275-279.

25.

Van Everdingen, J.J.E. and Van Joost, Th. (1982): Hypersensitivity for Nickel, Chromium and Cobalt; a Continuous Problem, Ned T Geneesk 126:1088-1092.

26.

Van Hoogstraten, I.M.W. ; Andersen, K.E. ; Von Blomberg, B.M.E. ; Boden, D. ; Bruynzeel, D.P. ; Burrows, D. ; Camarasa, J.M.G. ; Dooms-Goossens, A. ; Lahti, A. ; Rycroft, R. ; Todd, D. ; Vreeburg, K.J.J. ; Wil-Kinson, J.D. ; and Scheper, R.J. (1989): Preliminary Results of a Multicenter Study on the Incidence of Nickel Allergy in Relationship to Previous Oral and Cutaneous Contacts. In: Current Topics in Contact Dermatitis, P.J. Frosch , A. Dooms-Goossens , J.M. Lachapelle , R.J.G. Rycroft , and R.J. Scheper , Eds., Berlin: Springer Verlag, pp. 178-183.

27.

Van Ketel, W.G. (1978): Patch Testing with NiSO4 in DMSO, Contact Dermatitis 4:167-168.

28.

Van Loon, L.A.J. (1989): Allergic Contact Stomatitis to Metals in Dentistry: An Empirical Clinical Investigation, Academisch proefschrift. U. V.A. Amsterdam.

29.

Vreeburg, K.J.J. ; De Groot, K. ; Von Blomberg, B.M.E. ; and Scheper, R.J. (1984): Induction of Immunological Tolerance by Oral Administration of Nickel and Chromium, J Dent Res 63:124-128.

30.

Zembala, M. and Asherson, G.L. (1976): The Effect of Cyclophosphamide and Irradiation on the Cells which Suppress Contact Sensitivity in the Mouse, Clin Exp Immunol 23:544-561.