过敏性疾病代表了21世纪全球公共卫生危机中最突出的一种。尽管许多不同物质已知会产生超敏反应，但金属构成了过敏原的主要类别之一，这一类过敏原负责着与过敏有关的疾病负担的不成比例的大部分。最普遍的金属过敏形式之一 - 包括过敏性接触性皮炎 - 已得到广泛认可；但是，据我们所知，在当前科学文献中，还没有一个全面的评估人类金属过敏所引起的许多独特疾病变异的文献。因此，撰写本综述的主要目标是（1）生成最新的参考文献，包含这些信息，以协助实验室研究人员、临床医生、监管毒理学家、工业卫生学家和其他对金属过敏感到关心的科学家们的努力；和（2）确定与疾病有关的知识空白。因此，进行了广泛的科学文献综述 - 在其中，识别、收集和分析了数百篇描述人类患者金属特异性过敏反应的出版物。从这些文章中获得的信息然后被用来编制具有穷尽性的有关金属过敏独特皮肤/眼、呼吸、消化系统和系统性超敏反应的清单。本综述简要讨论了这些疾病变异中的每一种，其中识别了每种反应类型中涉及的特定金属，总结了基础免疫机制，并描述了每种反应的主要临床表现。缩写词：ACD：过敏性接触性皮炎，AHR：呼吸道过敏性反应，ASIA：佐剂诱导的自身免疫/自身炎症综合征，BAL：支气管肺泡灌洗，CBD：慢性铍病，CTCL：皮肤T细胞淋巴瘤，CTL：细胞毒性T淋巴细胞，DRESS：伴有嗜酸性粒细胞综合征和全身症状的药物反应，GERD：胃食管反流病，GI：胃肠道，GIP：巨细胞间质性肺炎，GM-CSF：粒状-巨噬细胞集落刺激因子，HMLD：硬质金属肺病，HMW：高分子量，IBS：肠易激综合征，Ig：免疫球蛋白，IL：白细胞介素，LMW：低分子量，PAP：肺泡蛋白沉积症，PPE：个人防护设备，PRR：病原体识别受体，SLE：系统性红斑狼疮，SNAS：系统性镍过敏综合征，Th：辅助T细胞，UC：溃疡性结肠炎，UV：紫外线。

Allergic disease represents one of the most prominent global public health crises of the 21st century. Although many different substances are known to produce hypersensitivity responses, metals constitute one of the major classes of allergens responsible for a disproportionately large segment of the total burden of disease associated with allergy. Some of the most prevalent forms of metal allergy - including allergic contact dermatitis - are well-recognized; however, to our knowledge, a comprehensive review of the many unique disease variants implicated in human cases of metal allergy is not available within the current scientific literature. Consequently, the main goal in composing this review was to (1) generate an up-to-date reference document containing this information to assist in the efforts of lab researchers, clinicians, regulatory toxicologists, industrial hygienists, and other scientists concerned with metal allergy and (2) identify knowledge gaps related to disease. Accordingly, an extensive review of the scientific literature was performed - from which, hundreds of publications describing cases of metal-specific allergic responses in human patients were identified, collected, and analyzed. The information obtained from these articles was then used to compile an exhaustive list of distinctive dermal/ocular, respiratory, gastrointestinal, and systemic hypersensitivity responses associated with metal allergy. Each of these disease variants is discussed briefly within this review, wherein specific metals implicated in each response type are identified, underlying immunological mechanisms are summarized, and major clinical presentations of each reaction are described.Abbreviations: ACD: allergic contact dermatitis, AHR: airway hyperreactivity, ASIA: autoimmune/ autoinflammatory syndrome induced by adjuvants, BAL: bronchoalveolar lavage, CBD: chronic beryllium disease, CTCL: cutaneous T-cell lymphoma, CTL: cytotoxic T-Lymphocyte, DRESS: drug reaction with eosinophilia and systemic symptoms, GERD: gastro-esophageal reflux disease, GI: gastrointestinal, GIP: giant cell interstitial pneumonia, GM-CSF: granulocyte macrophage-colony stimulating factor, HMLD: hard metal lung disease, HMW: high molecular weight, IBS: irritable bowel syndrome, Ig: immunoglobulin, IL: interleukin, LMW: low molecular weight, PAP: pulmonary alveolar proteinosis, PPE: personal protective equipment, PRR: pathogen recognition receptor, SLE: systemic lupus erythematosus, SNAS: systemic nickel allergy syndrome, Th: helper T-cell, UC: ulcerative colitis, UV: ultraviolet.