Pathogenesis of orally induced flare-up reactions at old patch sites in nickel allergy.
The flare-up reaction of old patch test sites following oral intake of antigen have been shown to be site and antigen specific reactions. Using enzyme and immunohistochemistry, the morphology of 6- to 8-week-old patch test sites, before and after oral challenge with nickel, was investigated. Before oral challenge, small scattered perivascular cell infiltrates consisting of macrophages, mast cells, T-lymphocytes, and OKT6+ dendritic cells were found in old patch test sites. In early and strong flare-up reactions combined with systemic toxicoderma-like reactions, polymorphonuclear leukocytes and lysed granular fragments from these cells were prominent. In slower flare-up reactions with little systemic involvement, T-lymphocytes predominated. We conclude that cells, probably macrophages, which are able to secrete inflammatory mediators promoting chemotaxis for polymorphonuclear leukocytes and/or T-lymphocyte proliferation, may play an important role in initiation of the flare-up reaction.
O B
OB
Christensen
J H
JH
Beckstead
T E
TE
Daniels
H I
HI
Maibach
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000485:Allergens / Q000008:administration & dosage; D003877:Dermatitis, Contact / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D007801:Langerhans Cells / Q000473:pathology; D008264:Macrophages / Q000473:pathology; D008297:Male; D008407:Mast Cells / Q000473:pathology; D008875:Middle Aged; D009532:Nickel / Q000009:adverse effects*; D010328:Patch Tests; D012882:Skin Tests; D013601:T-Lymphocytes / Q000145:classification / Q000473:pathology
D000485:Allergens; D009532:Nickel