Natural and perturbed distributions of Langerhans cells: responses to ultraviolet light, heterotopic skin grafting, and dinitrofluorobenzene sensitization

Failure of periodic ultraviolet radiation treatments to prevent sensitization to nitrogen mustard: a case report

We have reported that prior ultraviolet radiation (UVR) exposure significantly delayed development of contact sensitivity to nitrogen mustard (Halprin et al., 1981). We felt that this effect was due to disruption of functional Langerhans cells in skin by UVR and suggested that periodic UVR treatments might prevent sensitization to the mustard. We now report on a patient with mycosis fungoides whose epidermal Langerhans cell count was monitored with the ATP-ase stain in order to determine when such 'booster" UVR therapy was to be given. Our attempts to interfere with Langerhans cell function in this manner failed to prevent delayed contact sensitivity to nitrogen mustard and may have been partly responsible for the development of contact urticaria to nitrogen mustard after 28 days of use. Whether the reaction was a delayed, cell-mediated reaction, or an antibody mediated reaction is not clear, but the use of UVR did fail to prevent contact sensitivity to the nitrogen mustard in our patient.

Ultraviolet light treatment delays contact sensitization to nitrogen mustard

Contact sensitivity to nitrogen mustard was delayed after first treating patients with u.v. light. While the number of patients becoming sensitive to nitrogen mustard after ultraviolet light exposure was not significantly different from the control, the number of patients who became sensitive in the first 30 days was significantly less than the control group. It is postulated than this delay in sensitization is due to an alteration of the patients' epidermal Langerhans cells, produced by the u.v. light exposure.

Experimental photoimmunology: immunologic ramifications of UV-induced carcinogenesis

The use of animal model systems to investigate the sequence of events which lead to the induction and progression of skin tumors following chronic ultraviolet light (UVL) exposure has clearly shown that the direct mutagenic effects of UVL is only one of the components involved in this process. In spite of the fact that overt carcinogenesis is only one of the many effects produced by UV light, most hypotheses as to the mechanism by which UVL can cause the mutations necessary to achieve the transformed phenotype have focused on the direct effects of UVL on DNA and the generation of carcinogenic compounds. Investigations during the last 5 yr, however, have clearly demonstrated that immunologic factors are also critically important in the pathogenesis of UV-induced skin cancers. A complete understanding of UV-carcinogenesis must therefore consider the mechanisms which allow the transformed cell to evade immunologic rejection by the host in addition to those aspects which deal with conversion of a normal cell to a cancer cell. It is the object of this review to provide both a historical account of the work which established the immunologic consequences of chronic UVL exposure and the results of recent experiments designed to investigate the kinetics and mechanisms by which UVL affects the immunologic apparatus. In addition, a hypothetical model is presented to explain the sequence of events which ultimately lead to the emergence of the suppressor T-cells which regulate antitumor immune responses.

Unusual numbers and distribution of Langerhans cells in skin with unique immunologic properties

Epidermal Langerhans cells resemble macrophages/monocytes in several remarkable ways: both bear surface receptors for the Fc portion of immunoglobulin molecules and for the C3b complement component. They take up, process and present antigen to reactive lymphocytes in an extremely effective fashion. They display on their cell surfaces the alloantigenic determinants encoded by genes of the I region of the major histocompatibility complex. Using ATPase activity, Langerhans cell surface densities are abnormal in 3 cutaneous sites which exhibit unique immunologic properties: markedly reduced numbers in hamster cheek pouch; reduced numbers and uneven distributions in murine tail skin; no Langerhans cells occur within corneal epithelium. As a functional expression of the absence of Langerhans cells from murine corneas, allografts prepared from corneal epithelium fail to sensitize recipients to Ia antigens encoded by I region genes of the donor. Corneal grafts disparate from their hosts at only I region loci are accepted for at least 45 days. The absence of Langerhans cells from cornea may account in part for its property as an immunologically privileged tissue. Subthreshold numbers of Langerhans cells in cheek pouch epithelium may contribute significantly to the observations that the hamster cheek pouch is an immunologically privileged site. We infer that skin deficient in Langerhans cells may be consequently deficient in alloantigenicity. Equally important, Langerhans cell-poor skin may be lacking in certain essential functions relating to the induction and expression of immune reactivity.