Tvermoes BE, Unice KM, Winans B, Kovochich M, Christian WV, Donovan E, Fung ES, Finley BL, Kimber I, Paustenbach DJ. 2016. A preliminary evaluation of immune stimulation following exposure to metal particles and ions using the mouse popliteal lymph node assay. Toxicol Appl Pharmacol 308:77–90; doi: 10.1016/j.taap.2016.07.020.
Abstract
The objective of this preliminary study was to evaluate in mice the threshold for immune stimulation following local exposure to metal particles and ions representative of low-wear, well-functioning cobalt-chromium (CoCr) metal-on-metal (MoM) hip implants. The popliteal lymph node assay (PLNA) was used in this study to assess immune responses in BALB/c mice following treatment with chromium-oxide (Cr2O3) particles, metal salts (CoCl2, CrCl3, and NiCl2), or Cr2O3 particles together with metal salts using single-dose exposures representing approximately 10 days (0.000114 mg), 19 years (0.0800 mg), and 40 years (0.171 mg) of normal implant wear. The immune response elicited following treatment with Cr2O3 particles together with metal salts was also assessed at four additional doses equivalent to approximately 3 months (0.0005 mg), 0.6 years (0.0025 mg), 5 years (0.01 mg), and 9.5 years (0.04 mg) of normal implant wear. Mice were injected subcutaneously (50 μL) into the right hind foot with the test article, or with the relevant vehicle control. The proliferative response of the draining lymph node cells (LNC) was measured four days after treatment, and stimulation indices (SI) were derived relative to vehicle controls. The PLNA was negative (SI < 3) for all Cr2O3 particle doses, and was also negative at the lowest dose of the metal salt mixture, and the lowest four doses of the Cr2O3 particles with metal salt mixture. The PLNA was positive (SI > 3) at the highest two doses of the metal salt mixture and the highest three doses of the Cr2O3 particles with the metal salt mixture. The provisional NOAEL and LOAEL values identified in this study for immune activation corresponds to Co and Cr concentrations in the synovial fluid approximately 500 and 2000 times higher than that reported for well-functioning MoM hip implants, respectively.