Publication details

Delayed-Type Hypersensitivity to Metals of Environmental Burden in Patients with Takotsubo Syndrome - Is There a Clinical Relevance?

Authors

MANOUSEK Jan STEJSKAL Vera KUBENA Petr JARKOVSKÝ Jiří NĚMEC Petr LOKAJ Petr DOSTALOVA Ludmila ZADAKOVA Andrea PAVLUŠOVÁ Marie BENEŠOVÁ Klára KALA Petr MIKLÍK Roman ŠPINAR Jindřich PAŘENICA Jiří

Year of publication 2016
Type Article in Periodical
Magazine / Source Plos one
MU Faculty or unit

Faculty of Medicine

Citation
Web http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0164786
Doi http://dx.doi.org/10.1371/journal.pone.0164786
Field Cardiovascular diseases incl. cardiosurgery
Keywords heart-failure; cardiomyopathy; allergy; progesterone; association; replacement; lymphocytes; sensitivity; dermatitis; pregnancy
Attached files
Description Objective Takotsubo syndrome (TS) is a heart condition characterised by a sudden transient left ventricular dysfunction; its pathophysiology is probably associated with elevated levels of catecholamines but the exact mechanism is not known as yet. Literature and clinical experience suggest that TS affects persons with various comorbidities. This pilot work aims to evaluate the frequency of comorbidities with potential pathological immune reactivity, and to evaluate the potential association between TS and hypersensitivity to metals assessed by LTT-MELISA (R). Methodology, Results A total of 24 patients (23 women, 1 man) with a history of TS attack and 27 healthy controls were evaluated. Hypersensitivity was evaluated by a lymphocyte transformation test (LTT-MELISA (R)); a questionnaire of environmental burden was used to select evaluated metals. A total of 19 patients (79%) had at least one condition that might potentially be associated with pathological immune reactivity (autoimmune thyroid disease, drug allergy, bronchial asthma, cancer, contact dermatitis, rheumatoid arthritis). Hypersensitivity to metals was identified significantly more frequently in TS patients than in healthy controls (positive reaction to at least one metal was identified in 95.8% of TS patients and in 59.3% of controls; p = 0.003); the difference was statistically significant for mercury (45.8% and 14.8%, respectively; p = 0.029). Conclusion Our work shows that conditions with pathological immune reactivity occur frequently in TS patients, and our data suggest a possible association between TS and hypersensitivity tometals (mercury in particular) evaluated by LTT-MELISA (R). We also suggest that apart from the triggering stress factor, potential existence of other serious conditions should be considered when taking medical history of TS patients.
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