Metal Allergens

The enclosed article represents “State of the Arts”  regarding  the growing importance of metal allergens. The author, Dr G.Forte is  the director of research   group at Instituto Superiore di Sanita in Rome (, major Health  State Institute in Italy.

This work summarizes  allergy- inducing properties of old (Ni, Co, Cr)  and new emerging metal allergens, such gold and titanium. It also reviews  existing diagnostic tests, patch tests and LTT’s and others .  The article deals with visible changes, such as  skin and oral  lesions caused by metals . This is current State of the Arts.


In addition, it emphasizes  mechanisms behind the  skin and oral lesions, especially  the key role of T cells in the metal-induced process. By this, it opens the way to understanding of metal-induced systemic diseases such as CFS, fibromyalgia and other diseases where etiology is unknown. Those diseases are characterized by  profound fatigue and multiple symptoms  all of those  can be explained by cytokine-induced deregulation of HPA axis.The authors also  mention  metal-induced  autoimmunity-through altered-self, described in susceptible rodent systems.


We are now on the verge paradigmatic shift, leading to undestanding of the origin of many allergic and autoimmune diseases in man.The prospective  studies in susceptible subjects (selected on the basis of functional phenotype) and combined with genotype testing  will facilitate this process. As a result, economic and human savings will be enormous.


The paradigm shift is also facilitated by recent FDA acknowledgement of amalgam risks for suceptible populations, among others for chidlren, pregnant women, patients with neurologic diseases and patient sensitive to mercury.


I urge you to contribute to this process by publishing your clin ical experience and spreading the information to you collegues.

Kind regards

Vera Stejskal