Dvorak H F, Dvorak A M, Simpson B A, Richerson H B, Leskowitz S, Karnovsky M J
J Exp Med. 1970 Sep 1;132(3):558-82. doi: 10.1084/jem.132.3.558.
Delayed onset erythematous skin reactions elicited in guinea pigs early in the course of sensitization with azobenzenearsonate-protein conjugates or with protein antigens in incomplete Freund's adjuvant or in saline were found to have a characteristic morphology which sets them apart from delayed hypersensitivity and the classic antibody mediated reactions. The principle feature was massive dermal infiltration with basophilic leukocytes. Mononuclear cells of several types including activated and small lymphocytes, monocytes, macrophages, and blast cells were also present. Such reactions have in the past been designated Jones-Mote hypersensitivity, but we prefer the descriptive term cutaneous basophil hypersensitivity (CBH) for the reasons given. Occasional basophils extruded their granules, and individual granules, retaining their characteristic ultrastructure, were commonly seen in the interstitium. However, intercellular junctions between endothelial cells were closed except during cell emigration and there was no morphologic evidence of an histamine-like effect. The majority of basophils, moreover, did not degranulate but underwent nuclear pyknosis and cytoplasmic degeneration and were phagocytosed by macrophages. Phagocytosed basophil granules retained their ultrastructure. Skin tests performed at late intervals after sensitization had a different time course and morphology. Animals sensitized with protein antigens in complete Freund's adjuvant developed delayed hypersensitivity; however, reactions elicited in such animals at early (but not late) intervals after sensitization contained a prominent basophil component. We interpret such reactions to be a mixture of delayed hypersensitivity and cutaneous basophil hypersensitivity. The function of the basophil in CBH and its relation to the mononuclear cells which accompany it are unknown, and various possibilities are discussed. We conclude that cutaneous basophil hypersensitivity is a distinct immunologic and morphologic entity, occurring early in the course of sensitization with protein antigens incorporated in any of several vehicles. The mechanism of the reaction is presently unknown, and a general hypothesis to explain its pathogenesis has been proposed.
在用偶氮苯砷酸盐 - 蛋白质结合物或用不完全弗氏佐剂或盐水中的蛋白质抗原致敏豚鼠的早期过程中引发的迟发性红斑皮肤反应，被发现具有一种特征性形态，使其有别于迟发型超敏反应和经典的抗体介导反应。主要特征是嗜碱性白细胞大量浸润真皮。还存在几种类型的单核细胞，包括活化的小淋巴细胞、单核细胞、巨噬细胞和成纤维细胞。过去这种反应被称为琼斯 - 莫特超敏反应，但出于所给原因，我们更喜欢使用描述性术语皮肤嗜碱性粒细胞超敏反应（CBH）。偶尔有嗜碱性粒细胞排出其颗粒，并且在间质中通常可见保留其特征性超微结构的单个颗粒。然而，内皮细胞之间的细胞间连接除了在细胞迁移期间是封闭的，并且没有组胺样作用的形态学证据。此外，大多数嗜碱性粒细胞没有脱颗粒，而是经历核固缩和细胞质变性，并被巨噬细胞吞噬。被吞噬的嗜碱性粒细胞颗粒保留其超微结构。致敏后晚期进行的皮肤试验具有不同的时间进程和形态。用完全弗氏佐剂中的蛋白质抗原致敏的动物出现迟发型超敏反应；然而，在此类动物致敏后早期（但不是晚期）引发的反应含有突出的嗜碱性粒细胞成分。我们将此类反应解释为迟发型超敏反应和皮肤嗜碱性粒细胞超敏反应的混合。嗜碱性粒细胞在CBH中的功能及其与伴随它的单核细胞的关系尚不清楚，并讨论了各种可能性。我们得出结论，皮肤嗜碱性粒细胞超敏反应是一种独特的免疫和形态学实体，发生在用几种载体中的任何一种掺入蛋白质抗原致敏过程的早期。该反应的机制目前尚不清楚，并且已经提出了一个解释其发病机制的一般假设。
