Delayed-type hypersensitivity is mediated by a sequence of two different T cell activities.

Classical 24- to -48 hr delayed-type hypersensitivity (DTH) skin reactions are preceded by an early skin swelling reaction that peaks 2 hr after challenge. The ability to elicit this early component of DTH is T cell dependent and is also dependent on tissue mast cells and release of serotonin, mainly from these mast cells. The current study presents pharmacologic and kinetic evidence that the late response depends on the occurrence of the early response. A variety of pharmacological agents known to deplete, prevent release of, or block the activity of serotonin, when given just before skin challenge, blocked both the early and late components of DTH, but had no effect when given (even repeatedly) after the occurrence of the early component. Thus, the serotonin-dependence of the 24-hr component of DTH represents a dependence on the early component in which serotonin release is required. A temporal dependence of the late component of DTH on the early component was also demonstrated. The early and late phases occur at different times in recipients of sensitized T cells, depending on the interval between transfer and challenge, but there is a fixed 10- to 12-hr gap. Delayed onset of the late component occurs in recipients challenged immediately after transfer and appears to be due to a delay in the onset of the early component. This delay can be abolished by adoptive cell transfer into mice that are able to elicit a normal early component because of prior transfer of T cells that are able to mediate just an early component. On the basis of these findings, we conclude that DTH consists of a cascade of events. T cells mediating the early aspect of DTH release antigen-specific factors that, upon encountering antigen activate local serotonin-containing cells, such as mast cells, to release serotonin, which opens gaps between adjacent endothelial cells. Through these interendothelial gaps a second T cell population enters the extravascular space and interacts with local antigen to induce the late response by releasing the chemoattractant lymphokines that are classically associated with DTH and that cause recruitment of bone marrow-derived circulating leukocytes to infiltrate the reaction site. The ability of the second T cell population to mediate the late component of DTH is independent of further release of serotonin.