Morphology of endogenous flare-up reactions in contact allergy to gold.
In a double-blind study, 20 patients with contact allergy to gold were given an intramuscular injection of gold sodium thiomalate or placebo, inducing a clinical and histological flare-up of healed patch test sites in the gold-injected but not in the placebo group. The test area of the placebo group showed some perivascular lymphocytic foci (UCHL-1+) and vascular endothelial ELAM-1 staining. The gold group, with flare-up, showed larger and more extensive lymphocytic foci with ELAM-1+ endothelium as well as lymphocytic epidermotropism. CD1a+ LC cells were downgraded, tryptase+ mast cells accumulated and CD68+ monocytes/macrophages markedly increased. Probably, a significant part of the tissue priming as a result of patch testing comprises memory T-cells and endothelial ELAM-1 upgrading, but blood-borne CD68+ monocytes may also be instrumental in the flare-up.
Larsson
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A
Department of Oral Pathology, Malmö University Hospital, Lund University, Sweden.
Möller
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Björkner
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Bruze
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M
D015703:Antigens, CD / Q000097:blood; D015214:Antigens, Differentiation, Myelomonocytic / Q000097:blood; D001707:Biopsy, Needle; D053818:Chymases; D046508:Culture Techniques; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis / Q000473:pathology* / Q000503:physiopathology; D004311:Double-Blind Method; D019040:E-Selectin / Q000032:analysis; D006052:Gold Sodium Thiomalate / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007150:Immunohistochemistry; D007273:Injections, Intramuscular; D008407:Mast Cells / Q000378:metabolism; D009000:Monocytes / Q000276:immunology; D010328:Patch Tests; D012016:Reference Values; D012697:Serine Endopeptidases / Q000378:metabolism; D012867:Skin / Q000276:immunology / Q000473:pathology*; D053802:Tryptases; D000097382:CD68 Molecule
D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D053818:Chymases; D019040:E-Selectin; D006052:Gold Sodium Thiomalate; D012697:Serine Endopeptidases; D053802:Tryptases; C067980:CD68 antigen, human; D000097382:CD68 Molecule; C083294:chymase 2