IN VITRO TESTING IN METAL IMPLANT ALLERGY: WHAT IS POSSIBLE?

Metal implants are widely utilized in orthopedics and dentistry but can occasionally trigger allergic reactions, presenting diagnostic and therapeutic challenges. In vitro testing has become a pivotal tool for evaluating metal hypersensitivity, employing methods such as the lymphocyte transformation test (LTT), enzyme-linked immunosorbent assay (ELISA), and cytokine profiling to detect immune responses to common allergens like nickel, cobalt, and chromium. Additionally, genetic testing on certain polymorphisms is emerging as a complementary approach, identifying predispositions to hypersensitivity by analyzing polymorphisms in genes related to immune regulation, such as cytokine- and inflammation related genes. While these techniques offer significant insights, they face challenges, including variability in test sensitivity, specificity, and a lack of standardized protocols. The clinical relevance of positive in vitro results or genetic markers remains complex, necessitating integration with patient history and clinical observations. Advances in these in vitro testing methods and studies with expanded genomic databases, hold potential to improve diagnostic precision. We want to show the current capabilities and limitations of in vitro and genetic testing in metal implant allergy diagnostics, highlighting their combined potential to enhance patient care, personalized risk assessment, and implant biocompatibility.