Identification of chemoattractant activity for lymphocytes in blister fluid of patients with bullous pemphigoid: evidence for the presence of a lymphokine.

Bullous pemphigoid is characterized by the dermal infiltration of lymphocytes, which precedes the striking influx of eosinophils as the lesion evolves into the bullous phase. This finding prompted a search for chemoattractant activity for lymphocytes in the blister fluid of untreated individuals with bullous pemphigoid. We found such activity in the bullous fluids of 6 consecutive patients but not in a patient with pemphigus vulgaris. This lymphocyte chemoattractant activity separates into 4 peaks upon Sephadex G-100 chromatography and the peak of 56,000 daltons was further evaluated. Upon quaternary aminoethyl Sephadex-anion exchange chromatography this peak elutes at 4-8 ms and with preparative isoelectric focusing it demonstrates an isoelectric point of 8.6-9.0. This activity was susceptible to degradation by trypsin and neuraminidase, but was stable upon heating to 56 degrees C for 30 min. Its chemoattractant activity is predominantly chemokinetic by checkerboard analysis. As defined by chromatography, stability, and functional characteristics, this activity is similar to a recently described human lymphocyte chemoattractant lymphokine. This finding suggests that products of activated lymphocytes are present in blister fluids of patients with bullous pemphigoid and may contribute to the early influx of lymphocytes in this disease.