# Nickel allergy in CFS and FMS patients



## Mio (Dec 19, 1999)

Nickel Allergy Is Found in a Majority of Women with CFS and Muscle Pain... Full Title: Nickel Allergy Is Found in a Majority of Women with Chronic Fatigue Syndrome and Muscle Pain - And May Be Triggered by Cigarette Smoke and DietaryNickel IntakeJournal: Journal of Chronic Fatigue Syndrome, Vol.8(1) 2001, pp. 57-65Authors: Bjï¿½rn Regland, MD; Olof Zachrisson, MD; Vera Stejskal, PhD; Cari-GerhardGottfries, MDAffiliations: Bjï¿½rn Regland is Assistant Professor, Olof Zachrisson is AssistantProfessor, and Cari-Gerhard Gottfries is Professor, all affiliated with the Departmentof Psychiatry, Sahlgrenska University Hospital/Mï¿½lndal and Institute of ClinicalNeuroscience, Gï¿½teborg, Sweden.Vera Stejskal is Assistant Professor, Department of Clinical Chemistry, Danderyd Hospital and Karolinska Institute, Stockholm.Address correspondence to: Bjï¿½rn Regland, Institute of Clinical Neuroscience,Sahlgrenska University Hospital, SE-431 80 Mï¿½lndal, Sweden (E-mail:bjorn.regland###ms.se).The authors express their thanks to Swiss Serum & Vaccine Institute Berne for providing them with the Staphylococcus vaccine, and to Veronica Nordman for theperformance of in vitro testing.ABSTRACT. Two hundred and four women with chronic fatigue and muscle pain, with no signs of autoimmune disorder, received immune stimulation injections with a Staphylococcus vaccine at monthly intervals over 6 months. Good response was defined as a decrease by at least 50% of the total score on an observer's rating scale. Nickel allergy was evaluated as probable if the patient had a positive history of skin hypersensitivity from cutaneous exposure to metal objects. The patient's smoking habits were recorded. Fifty-two percent of the patients had a positive history of nickel contact dermatitis. There were significantly more good responders among the non-allergic non-smokers (39%) than among the allergic smokers (6%). We also present case reports on nickel-allergic patients who apparently improved after cessation of cigï¿½arette smoking and reducing their dietary nickel intake. Our observations indicate that exposure to nickel, by dietary intake orinhalation of cigarette smoke, may trigger systemic nickel allergy and contribute to syndromes of chronic fatigue and muscle pain.INTRODUCTIONNickel is a common sensitizing agent responsible for the high prevalence of allergic contact dermatitis. However, the health hazards of nickel allergy with regard to diffuse and general symptomatology, such as chronic fatigue and muscle pain, appear not to be fully understood and are probably underestimated.The prevalence of nickel contact dermatitis among women has inï¿½creased remarkably and there is a clear relationship between ear piercing and induction of nickel allergy (1). In two Norwegian unselected populations, the prevalence figures for women were reported to be 27.5 and 31.1%,respectively (2). Although in the same study the prevalence for men was 5%, the modern fashion of piercing also anticipates an increasing prevalence among men (3). Nickel allergy is associated with fatigue syndromes with or without autoimmunity (4). In women with chronic fatigue syndrome the prevalence of nickel contact dermatitis has been reported to be as high as 52% (5).Recently we chanced upon findings regarding nickel allergy in a study set up with quite anotherpurpose. Immune stimulation with a Staphylococcus vaccine was tested in clinical trials of female patients with chronic fatigue and muscle pain (see 6 for a preliminary report). The patients received subcutaneous injections at monthly intervals. The results are interesting, showing clinical improvement in a substantial number of patients. Moreover, we unexpectedly found that nickel allergy influenced the efficiency of the treatment and that nickel allergy was interrelated with cigarette smoking.The primary incidental finding of nickel sensitization came out of a Memory Lymphocyte Immuno Stimulation Assay (MELISAï¿½) in 16 patients who did not improve or had reacted adversely to the vaccine treatment (7). MELISAï¿½ is an optimized lymphocyte proliferation test (8). The purpose ofusing MELISAï¿½ in the study was to check whethï¿½er the unresponsiveness to the vaccine could be due to hypersensitivity to the preservative thiomersal (syn. merthiolate, thimerosal). In addition, reactivity was tested to various metals such as nickel, although the vaccine compound does not contain nickel. The main finding was that 13 of the 16 tested patients (81%) reacted strongly against nickel in vitro (7). Moreover, we found a substantial number of cigarette smokers among the non-responding and MELISAï¿½-positive nickel-allergic patients, whereas the combination of smoking and contact allergy was hardly seen at all in the group of patients rated as good responders. Thus, we were made attentive to the intriguing possibility that a connection might exist between nickel allergy and cigarette smoking. As nickel and a variety of other metals occur in trace amounts in mainstream cigarette smoke (9), it would be a plausible suggestion thatexposure to cigarette smoke may be nickel-sensitizing or, at least, a potential trigger of hyperreactivity in a person already sensitized to nickel.The aim of this study was to further explore the impact of nickel allergy and its interrelation with cigarette smoking in a large number of women with chronic fatigue and muscle pain included in clinical trials of immune stimulation therapy.[Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678.E-mail address: getinfo###haworthpressinc.com Web site: ]www.HaworthPress.com]


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## wanderingstar (Dec 1, 1999)

Intersting.This article doesn't state however that the subjects were suffering from the condition Chronic Fatigue Syndrome, although the title refers to this illness. It only says they suffer from chronic fatigue and muscle pain. Although those two symptoms are classic CFS symptoms, it doesn't mean they have the illness CFS (other causes could by hypothyroidism, and depression to name but two). I'm not being pedantic, this is an important distinction to make. Thanks for posting. You might like to post this also on the CFS & Fibro forum if you haven't already. ------------------susanIBS D/C type & M.E/CFS


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