Introduction & Objectives:
Cutaneous and systemic reactions to various metal implants and
medical devices have been well documented. The aim of this review was to focus on the probable
common mechanisms of allergy and autoimmunity that may lead to similar clinical outcomes following
the growing evidence in the literature of metal and nickel-related systemic, autoimmune or autoinflammatory
disorders.
Methods:
Detailed search of the available electronic databases (PubMed-Medline) was conducted for
review of the literature on that topic till the present moment.
Results:
Multiple reports on the immunological effects of metals including immunomodulation, allergy,
or autoimmunity were identified. It was found that metals may act through immunosuppression,
immunotoxicity, or as immune adjuvants thus provoking allergy and autoimmunity in susceptible individuals.
Both external or internal exposure to metals was observed. Nickel has been identified as the
most common sensitizer, and also the most studied one. The coexistence of both allergic and autoimmune
symptoms, induced by nickel, has been published, suggesting the autoimmune potential of nickel
compounds.
Conclusions:
Clinical experience and scientific literature together demonstrate that metals may play an
important role in the development of autoimmune diseases. While metal implant allergies and complications
are on the rise, they remain a diagnostic and therapeutic challenge. Elucidation of their possible
mechanisms will contribute to the more successful and safer treatment of affected individuals.
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