{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T12:22:58Z","timestamp":1777810978551,"version":"3.51.4"},"reference-count":37,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[1999,8,1]],"date-time":"1999-08-01T00:00:00Z","timestamp":933465600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Dent Res"],"published-print":{"date-parts":[[1999,8]]},"abstract":"<jats:p>\n                    Dental amalgam is suspected, by some exposed individuals, to cause various systemic psychological, sensory, and neurological symptoms. Since not all amalgam-bearers experience such reactions, an individual characteristic\u2014for example, a susceptible immune system\u2014might explain these conditions. In vitro lymphocyte proliferation is a valuable tool in the diagnosis of allergy. With HgCl\n                    <jats:sub>2<\/jats:sub>\n                    as the antigen, however, the test is hampered, because Hg\n                    <jats:sup>2+<\/jats:sup>\n                    can cause unspecific lymphocyte proliferation, optimal at 1.4 to 9.5 \u03bcg HgCl\n                    <jats:sub>2<\/jats:sub>\n                    \/mL. Recently, the use of suboptimal HgCl\n                    <jats:sub>2<\/jats:sub>\n                    concentrations (\u2264 0.5 \u03bcg\/mL) has been suggested to circumvent these problems. The main aim of this study was to investigate whether patients with systemic symptoms alleged to result from the presence of dental amalgam differ from healthy controls, with reference to in vitro lymphoproliferative responses to HgCl\n                    <jats:sub>2<\/jats:sub>\n                    \u2264 0.5 \u03bcg\/mL. Three different test protocols\u2014lymphocyte transformation test (LTT) in micro- and macro-cultures, and the memory lymphocyte immunostimulation assay (MELISA\u00ae)\u2014were used. Other immune parameters\u2014such as a standard patch test for dental materials, the number of T- and B-lymphocytes, monocytes, granulocytes, and NK cells in peripheral blood, allergic symptoms, and predisposition-were also investigated. Twenty-three amalgam patients, 30 healthy blood donors with amalgam, ten healthy subjects without amalgam, and nine patients with oral lichen planus (OLP) adjacent to dental amalgam and a positive patch test to Hg\n                    <jats:sup>0<\/jats:sup>\n                    were tested. None of the investigated immune parameters revealed any significant differences between amalgam patients and controls. The sensitivity of in vitro lymphocyte proliferation ranged from 33 to 67%, with the OLP patients as a positive control group, and the specificity from 0 to 70% for healthy controls with a negative patch test to Hg\u00b0. Thus, despite the use of HgCl\n                    <jats:sub>2<\/jats:sub>\n                    \u2264 0.5 \u03bcg\/mL, a high frequency of positive results was obtained among healthy subjects with or without dental amalgam. Consequently, in vitro lymphocyte proliferation with HgCl\n                    <jats:sub>2<\/jats:sub>\n                    cannot be used as an objective marker for mercury allergy in dental amalgam-bearers.\n                  <\/jats:p>","DOI":"10.1177\/00220345990780081101","type":"journal-article","created":{"date-parts":[[2009,1,8]],"date-time":"2009-01-08T19:39:42Z","timestamp":1231443582000},"page":"1450-1458","source":"Crossref","is-referenced-by-count":30,"title":["In vitro Lymphoproliferative Assays with HgCl2 Cannot Identify Patients with Systemic Symptoms Attributed to Dental Amalgam"],"prefix":"10.1177","volume":"78","author":[{"given":"K.","family":"Cederbrant","sequence":"first","affiliation":[{"name":"Department of Health and Environment, Division of Molecular and Immunological Pathology, Linkoping University, Linkoping, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.-G.","family":"Gunnarsson","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurophysiology and Centre for Environmental Sensitivity, Orebro Medical Centre Hospital, Orebro, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Hultman","sequence":"additional","affiliation":[{"name":"Department of Health and Environment, Division of Molecular and Immunological Pathology, Linkoping University, Linkoping, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Norda","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine and Immunohaemotherapy, Orebro Medical Centre Hospital, Orebro, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Tibbling-Grahn","sequence":"additional","affiliation":[{"name":"Department of Nerve System and Locomotion, Division of Otorhinolaryngology, Linkoping University, Linkoping, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[1999,8,1]]},"reference":[{"key":"atypb1","doi-asserted-by":"publisher","DOI":"10.3109\/00016359209012752"},{"key":"atypb2","doi-asserted-by":"publisher","DOI":"10.1136\/oem.52.2.124"},{"key":"atypb3","first-page":"627","volume":"90","author":"Bolewska J.","year":"1986","journal-title":"Tandlaegebladet"},{"key":"atypb4","first-page":"506","volume":"89","author":"Brune D.","year":"1981","journal-title":"Scand J Dent Res"},{"key":"atypb5","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1996.36696269517.x"},{"key":"atypb6","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410320308"},{"key":"atypb7","doi-asserted-by":"publisher","DOI":"10.1159\/000230222"},{"key":"atypb8","doi-asserted-by":"publisher","DOI":"10.1159\/000237456"},{"key":"atypb9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.1998.tb03835.x"},{"key":"atypb10","doi-asserted-by":"publisher","DOI":"10.1016\/0022-1759(91)90394-U"},{"key":"atypb11","volume-title":"IPCS Joint Symposia No. 15"},{"key":"atypb12","doi-asserted-by":"publisher","DOI":"10.1007\/BF00918083"},{"key":"atypb13","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bdj.4804741"},{"key":"atypb14","doi-asserted-by":"publisher","DOI":"10.1159\/000236843"},{"key":"atypb15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.1992.tb05219.x"},{"key":"atypb16","doi-asserted-by":"publisher","DOI":"10.1159\/000234705"},{"key":"atypb17","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2842.1990.tb00012.x"},{"key":"atypb18","doi-asserted-by":"crossref","unstructured":"Jiang Y., Moller G. (1995). In vitro effects of HgCl2 on murine lymphocytes. I. Preferable activation of CD4+ T cells in a responder strain. 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