By Peter J Frosch
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Extra info for Contact dermatitis with 180 tables [CD-ROM included]
Thus, like the very early events in the effector phase reaction, the final response to a contact allergen is antigen-nonspecific. It is therefore not surprising that allergic and irritant reactions are histologically alike. 3 Early Phase Reactivity The role of an antibody-mediated early phase reaction in the development of ACD is still unclear in humans, although Askenase and his colleagues have generated robust data to support this view in murine models [219–222]. Hapten-specific IgM, produced upon immunization by distant hapten-activated B-1 cells [223, 224], can bind antigen early after challenge [223, 225] and activate complement .
With increasing density of MHC–hapten complexes on the surface of APC activating “signal 1” T-cell pathways, multiple levels of T-cell tolerance might be induced phase). Apparently, allergic contact hypersensitivity is the result of a delicate balance between effector and regulatory mechanisms [284, 310]. depending among other things on the nature of the allergen and route of exposure, ACD can be mediated by both CD4+ and CD8+ T-cells, either or both releasing type-1 or type-2 cytokines. Probably, given a predominant effector phenotype for a particular allergen, each of the other phenotypes can act as regulatory cells .
Allergen-specific T-cells isolated from skin test sites of sensitized individuals, as compared to blood, showed a strong bias towards type-2 cytokine profiles . Additional local IFN-γ release seems, however, indispensable, since for a broad panel of contact allergens, clinical ACD reactions were characterized by increased expression of mRNA en- 27 28 2 Thomas Rustemeyer et al. coding IFN-γ-inducible chemokines . In addition, transgenic mice expressing IFN-γ in the epidermis showed strongly increased ACD reactivity .
Contact dermatitis with 180 tables [CD-ROM included] by Peter J Frosch