Human leucocyte migration: studies with an improved skin chamber technique.

An improved skin chamber technique has been developed for the study of localized leucocyte mobilization (LLM). Uniform "windows" of denuded dermis were produced by a suction device applied to the forearm skin, eliciting delineated areas of epidermal separation by blister formation. The acellular blister fluid, roof and basement membrane were removed, and the blister base was covered with a rubber chamber containing autologous serum as leucocyte attractant. Duplicate chambers were harvested at prescribed intervals during the first 24 hours. In 15 healthy individuals, virtually no cells were observed after 2 hours, a median of 1.9 X 10(6) after 4 hours, increasing to 3.8 X 10(7) after 24 hours. Subnormal LLM was demonstrated in three of seven patients with severe bacterial infections and in three of seven leukaemia patients. LLM was normal in eight patients with other malignancies. Ninety to 98 per cent of the cells were polymorphonuclear neutrophils and less than 1 per cent were erythrocytes. In the chamber neutrophils, vacuolization of the cytoplasm was prominent, bactericidal capacity reduced and nitroblue tetrazolium reduction increased, thus indicating functional derangement of emigrated cells compared to peripheral blood neutrophils. Simplicity and good reproducibility should make this method a valuable tool in the study of leucocyte migration.