Friedmann P S
Dermatopharmacology Unit, Southampton General Hospital, Southampton SO16 6YD, UK.
Br J Dermatol. 2007 Dec;157(6):1093-102. doi: 10.1111/j.1365-2133.2007.08162.x. Epub 2007 Sep 13.
Like all physiological systems, the human immune system exhibits dose-response relationships in its reactions. The strength of sensitization is related to the potency of the immunogen and the dose that reaches the immune system. In skin, as sensitizing dose per unit area (mug cm(-2)) is increased on a log scale, there is a sigmoid dose-response curve for subsequent reactivity. Similarly, the response to elicitation shows a classical sigmoid response to increasing challenge dose, with the dose per unit area again being the determinant. There is a clear inverse correlation between the strength of sensitization and the subsequent dose of antigen to which an individual will respond. This is reflected in the different challenge systems used to diagnose the existence of allergic contact sensitization to a given allergen. The occluded patch test aims to use the highest concentration possible to detect the weakest degrees of allergy, whereas the repeated open application test uses much lower concentrations similar to those encountered in real life, applied repeatedly but without occlusion, to assess clinical relevance. Many authors have attempted to use the lowest concentrations to which rare, highly sensitized individuals can react to define the concentrations which might be free of risk in terms of inducing allergic sensitization. However, it is clear that the dose-response relationships for induction of sensitivity by repeated low-dose exposures must be carefully defined in future studies. This article reviews the dose-response relationships of human contact sensitization.
与所有生理系统一样，人类免疫系统在其反应中呈现剂量反应关系。致敏强度与免疫原的效力以及到达免疫系统的剂量有关。在皮肤中，当以对数尺度增加每单位面积的致敏剂量（μg/cm²）时，后续反应性会呈现S形剂量反应曲线。同样，激发反应对增加的激发剂量呈现典型的S形反应，每单位面积的剂量再次成为决定因素。致敏强度与个体随后会产生反应的抗原剂量之间存在明显的负相关。这反映在用于诊断对给定变应原的过敏性接触致敏存在的不同激发系统中。封闭斑贴试验旨在使用尽可能高的浓度来检测最轻微的过敏程度，而重复开放应用试验则使用与现实生活中遇到的浓度相似的低得多的浓度，反复应用但不封闭，以评估临床相关性。许多作者试图使用罕见的高度致敏个体能够产生反应的最低浓度来确定在诱导过敏性致敏方面可能无风险的浓度。然而，很明显，未来的研究必须仔细界定通过反复低剂量暴露诱导敏感性的剂量反应关系。本文综述了人类接触致敏的剂量反应关系。
