A comparative study between interdermal tests with phytohemagglutinin and delayed hypersensitivity reactions elicited by tuberculin.

Intradermal (i.d.) tests with phytohemagglutinin (PHA) and tuberculin are used in clinical practice to evaluate the cell-mediated immunity. The biologic significance of the skin response to PHA, clinically evaluated by the extent of erythema and induration, was studied histologically after incorporation of tritiated thymidine. It was compared to tuberculin tests. The rate of recruitment and the respective amount of inflammatory cells varied between patients and in time. In PHA tests the inflammatory reaction occurred in two phases, the first one consisting in the predominance of polymorphonuclears, the second one being characterized by chemotactism of lymphoblasts many of which synthesized DNA. The "in vivo" reaction to PHA is therefore complex; the same clinical evaluation corresponds to markedly different stages and events in the biological reaction. The histological grading of the PHA test is therefore desirable in the evaluation of the cell-mediated immunity because only the blastic proliferation is of importance in its rating and not the edema and the accumulation of polymorphonuclears.