Antigen-presenting cell function of epidermal cells activated by hapten application

Differential regulation of free radicals (reactive oxygen and nitrogen species) by contact allergens and irritants in human keratinocyte cell line

Immune responses to chemicals resulting in sensitization and the appearance of allergic responses following subsequent exposures are dependent upon activation of T lymphocytes. On the contrary, irritant responses are independent of immune response. The aim of this project was to identify the differential signaling cascade operated in allergic and irritant contact dermatitis. Recently, we have shown that keratinocyte cell line A431 can function as an antigen presenting cell (APC) and hence can be used as a model to differentiate between an allergen and irritant molecule. Allergen- and irritant-induced regulation of reactive oxygen species (ROS) and nitric oxide (NO) has been explored. Irritants induce release of ROS even at noncytotoxic concentration. ROS generation by allergens was not detected at nontoxic concentration but as the concentration was increased to a toxic dose there was a drastic increase in the ROS level compared to the untreated cells. Hence, the regulation of ROS is not significant in allergic responses but important in irritant responses. The major difference exists in the fact that the source of ROS for irritants is mitochondria, while that of allergens is mostly cytosolic. Antioxidant-induced protection from irritant-induced cell death has also been demonstrated. NO level was found to increase by allergens and irritants in a concentration-dependent manner. Hence, the regulation of ROS and NO can be used as important mediators in contact allergic and irritant dermatitis.

Imunopatologia da dermatite de contato alérgica

A dermatite de contato alérgica é consequência de uma reação imune mediada por células T contra químicos de baixo peso molecular, denominados haptenos. É uma condição frequente que ocorre em todas as raças e faixas etárias e afeta a qualidade de vida de seus portadores. O mecanismo imunológico desta doença vem sendo revisto nas últimas décadas com significativo avanço no seu entendimento. A metabolização e o caminho dos haptenos, bem como a formação e o mecanismo de ação das células responsáveis tanto pela reação quanto pelo seu término, são discutidos neste artigo

Evaluation of the phototoxic potential of plants used in oriental medicine

AIM OF THE STUDY

Phototoxicity can be either harmful or beneficial. Yet the phototoxicity of oriental medicinal plants is an understudied area. The purpose of this study is to fill in this gap.

MATERIALS AND METHODS

The phototoxic potential of oriental medicinal plants was examined in vitro using photohemolysis and the Candida albicans test. Seventeen medicinal plants [Acorus gramineus (ACG), Panax ginseng C.A. (PAG), Platycodon grandiflorum (PLG), Aractylodes japonica (ATJ), Xanthium strumarium (XAS), Dioscorea batatas (DIB), Anemarrhena asphodeloides (ANA), Polygonatum sibiricum Red (PSR), Cocculus trilobus (COT), Ficus carica (FIC), Chelidonium majus var. asiaticum (CMA), Pulsatilla koreana (PUK), Agrimonia pilosa (AGP), Zanthoxylum schinifolium (ZAS), Angelica gigas (ANG), Ledebouriella seseloides (LES), and Cnidium officinale (CNO)] were selected because they showed strong fluorescence in one of our previous studies of 62 plants. We further evaluated in vivo phototoxicity in mice. 0.75 mL/kg of seed oil for Xanthium strumarium (XAS, ), or 1.25 mL/kg of extracted solutions of Atractylodes japonica (ATJ, ), Chelidonium majus var. asiaticum (CMA, ), Zanthoxylum schinifolium (ZAS, ), and Ledebouriella seseloides (LES, ) were given once, and evaluated for sunburn edema, formation of sunburn cell, decrease of epidermal Langerhans cells and local suppression of contact hypersensitivity by UVA irradiation.

RESULTS

Sixteen out of the 17 plants tested except COT showed significant photohemolysis, and 5 of those exhibited phototoxic killing of Candida albicans. The phototoxicity of oriental medicines using those 5 plants was then studied in mice. The 5 plants increased sunburn edema and formation of sunburn cell, and suppressed immune responses locally by decreasing epidermal Langerhans cells and contact hypersensitivity by UVA irradiation.

CONCLUSIONS

More than a quarter of oriental medicinal plants can be phototoxic, and strong fluorescence measured by absorption and fluorescence spectra can be an easier way to screen for phototoxicity. On the other hand, the phototoxicity of the plants may also be used therapeutically. Further studies regarding the phototoxicity of active components extracted from both live and dried oriental medicinal plants are necessary.

Stress-induced modulation of skin immune function: two types of antigen-presenting cells in the epidermis are differentially regulated by chronic stress

BACKGROUND

Inflammatory skin diseases are exacerbated by psychiatric stress. Previous studies have shown that the activity of epidermal antigen-presenting cells (APCs), Langerhans cells (LCs) and keratinocytes (KCs), is affected by stress. Hapten application causes migration of LCs to draining lymph nodes (DLNs). Recently, we found that hapten application also activates epidermal cells (ECs) to mature potent APCs, and that the main APCs in these populations are KCs. Thus, DLN cells and ECs following hapten application are available for estimating the APC function of LCs and KCs in stress studies.

OBJECTIVES

To investigate the mechanism of exacerbation of skin inflammation by chronic stress by observing the effect of isolation stress transversally on the skin immune and neurohormonal systems.

METHODS

Contact sensitivity (CS) was elicited in BALB/c mice. The APC function of LCs and ECs following hapten application was assessed by the CS-inducing activity in the recipient mice. Levels of neurohormonal transmitters and proinflammatory cytokines were measured by enzyme-linked immunosorbent assay. Cell surface molecules were detected using flow cytometry. Expression of mRNA for cytokines, neurohormonal receptors and a differentiation marker by ECs was determined by reverse transcription-polymerase chain reaction.

RESULTS

Acute stress (2-day isolation) suppressed induction of CS, while chronic stress (30-day isolation) markedly enhanced induction of CS. DLN cells from chronically stressed mice contained increased numbers of LCs and exhibited enhanced APC function for inducing CS. In contrast, the APC function of KCs from these mice was markedly suppressed. Serum corticosterone levels were enhanced in acute stress, while substance P (SP) levels were enhanced in chronic stress. Corticotrophin-releasing hormone receptor-1 mRNA expression in ECs was enhanced in acute stress, while SP receptor (i.e. neurokinin-1 receptor) mRNA expression in ECs was enhanced in chronic stress. Production and mRNA expression of the proinflammatory cytokines interleukin-1 alpha and tumour necrosis factor-alpha by ECs following hapten application was markedly suppressed in chronic stress. Expression by ECs of E-cadherin, which adheres LCs and KCs homophilically, was suppressed in chronic stress. In addition, these cells exhibited impaired differentiation, i.e. suppressed spontaneous proliferation and enhanced mRNA expression for transglutaminase-3.

CONCLUSIONS

Chronic isolation stress may enhance CS responses by upregulation of the APC activity of LCs and the SP system. However, dysregulation of KC function and differentiation by chronic stress suggests that KCs may not contribute to the enhancement of the CS response positively. These complex changes suggest that chronic isolation stress in mice may provide a possible model system for studying the mechanism of exacerbation of skin inflammation by stress.

SCHISTOSOMA MANSONI: ANTIGEN-PRESENTING CELLS EMIGRATING FROM SKIN EXPOSED TO ATTENUATED CERCARIAE ACTIVATE LYMPHOID CELLS AND TRANSFER PROTECTION IN C57Bl/6 MICE

C57B1/6 mice develop significant levels of protection to a challenge infection after percutaneous exposure to irradiated Schistosoma mansoni cercariae. Although some circumstantial evidence has suggested that antigen-presenting cells (APCs) within the skin play a role in priming anti-schistosomula effector mechanisms, no direct evidence has been presented. In this study, we describe efforts to directly test whether skin-resident APCs exposed to irradiated cercariae are capable of mediating responses consistent with previously proposed mechanisms associated with delayed-type hypersensitivity reactions. We demonstrate that a population of APCs emigrates from the skin after percutaneous vaccination and that these cells are able to induce proliferation of S. mansoni-specific lymphocytes. We describe our experiments conducted to confirm that proliferation is dependent on major histocompatibility complex (MHC) Class-II interactions and cell-to-cell contact between APCs and lymphocytes. Immunohistological staining of emigrating cells revealed a population of large MHC Class-II+ cells with a morphology characteristic of mature dendritic cells. On recovery and adoptive transfer into naive mice, these cells demonstrated the ability to mediate protection to a challenge infection at levels similar to those in percutaneously vaccinated controls. This confirms that cutaneous APCs can initiate anti-schistosomula effector mechanisms in C57B1/6 mice after percutaneous vaccination.

Role of Keratinocytes in Antigen Presentation and Polarization of Human T Lymphocytes

Allergic contact dermatitis is a T-cell-mediated inflammatory skin disease in which interaction between skin keratinocytes and migrating T lymphocytes may play a critical part. In this study, the role of keratinocytes as allergen-/antigen-presenting cells (APCs) leading to activation of T lymphocytes is investigated using a human epidermal cell line A431. It is known that cultured cells do not express human leucocyte antigen (HLA) and hence can be used as APCs independent of HLA profile of both APCs and T cells from human volunteers. This cell line responded to common allergens and irritants by inducing or upregulating the cell-surface expression of HLA-DR, and intercellular adhesion molecule-1 and B7 mRNA transcripts in keratinocytes. In addition, allergen-primed A431 cells also induced allergen-specific proliferation of human T lymphocytes in cocultures. Anti-HLA-DR, interleukin-1alpha (IL-1alpha) antibodies and lysosomotropic agent chloroquine inhibited the proliferation. Allergens also upregulated cytokines IL-1alpha, granulocyte-macrophage colony-stimulating factor, Gro-alpha and IL-12 in keratinocytes. Further, keratinocytes activated by allergens induced polarization of activated T lymphocytes to the Th1 phenotype.

Proposal for a risk assessment methodology for skin sensitization based on sensitization potency data

In this paper, we propose a quantitative risk assessment methodology for skin sensitization aiming at the derivation of 'safe' exposure levels for sensitizing chemicals, used e.g., as ingredients in consumer products. Given the limited number of sensitizers tested in human sensitization tests, such as the human repeat-insult patch test (HRIPT) or the human maximization test (HMT), we used EC3 values from the local lymph node assay (LLNA) in mice because they provide the best quantitative measure of the skin sensitizing potency of a chemical. A comparison of LLNA EC3 values with HRIPT and HMT LOEL, and NOEL values was carried out and revealed that the EC3, expressed as area dose, can be used as a surrogate value for the human NOEL in risk assessment. The uncertainty/extrapolation factor approach was used to derive (a) an 'acceptable non-sensitizing area dose' (ANSAD) to protect non-allergic individuals against skin sensitization and (b) an 'acceptable non-eliciting area dose' (ANEAD) to protect allergic individuals against elicitation of allergic contact dermatitis. For ANSAD derivation, interspecies, intraspecies and time extrapolation factors are applied to the LLNA EC3. For ANEAD derivation, additional application of a variable sensitization-elicitation extrapolation factor is proposed. Values for extrapolation factors are derived and discussed, the proposed methodology is applied to the sensitizers methylchloroisothiazolinone/methylisothiazolinone, cinnamic aldehyde and nickel and results are compared to published risk assessments.

Mechanistic perspectives on sulfonamide-induced cutaneous drug reactions

PURPOSE OF REVIEW

Idiosyncratic drug reactions continue to limit the therapeutic utility of sulfonamide drugs because of their associated morbidity and mortality. Cutaneous reactions are the predominant reasons for withdrawal of such drugs from use in patients. As a consequence of the recognized metabolic and immunologic capability of the skin, an understanding of the pathogenic role of this tissue in the development of sulfonamide-induced cutaneous drug reactions may provide insight into the mechanisms and risk factors for these and other adverse drug events.

RECENT FINDINGS

In the present review we discuss currently available mechanistic information, including issues related to drug bioactivation and adduct formation, immunoresponsiveness, and immune dysregulation, for the development of sulfonamide-induced (delayed-type) cutaneous drug reactions. The potential application of findings from several related areas of research are also discussed within the context of the pathogenesis of these cutaneous reactions.

SUMMARY

Despite progress, numerous unresolved issues support the testing of novel hypotheses, the search for additional risk factors, and the need for a global approach, including links between laboratory and clinical paradigms. These issues must be addressed if we are to gain an understanding of the mechanistic bases for these cutaneous drug reactions.

Immune mechanisms in oral lichen planus

Although we still don't know the cause, there has been much research into the immune and pathological mechanisms that underlie oral lichen planus (OLP) and it is now possible to piece together a much clearer picture of the disease process. There is consensus that in OLP there is chronic, cell-mediated, immune damage to basal keratinocytes in the oral mucosa that are recognized as being antigenically foreign or altered. In most cases, however, the identity of the target antigen remains unknown. It is likely that cytokines released by the affected keratinocytes, and the associated inflammatory infiltrate, play a key role in the selective recruitment of the T-cell-dominated infiltrate that characterizes OLP, through their ability to induce adhesion molecule expression as well as further cytokine and chemokine release. In susceptible individuals, chronic presentation of antigen by basal keratinocytes may perpetuate the condition and direct cell-mediated immune damage on the keratinocytes.

A role for bioactivation and covalent binding within epidermal keratinocytes in sulfonamide-induced cutaneous drug reactions

Cutaneous reactions are the most common manifestation of delayed-type hypersensitivity caused by sulfamethoxazole and dapsone. In light of the recognized metabolic and immunologic activity of the skin, we investigated the potential role of normal human epidermal keratinocytes in the development of these reactions. Adult and neonatal normal human epidermal keratinocytes metabolized sulfamethoxazole and dapsone to N-4-hydroxylamine and N-acetyl derivatives in a time-dependent manner. The latter was catalyzed by N-acetyltransferase 1 alone as normal human epidermal keratinocytes did not express mRNA for N-acetyltransferase 2. Investigation of metabolism-dependent toxicity of sulfamethoxazole and dapsone, and subsequent incubation of normal human epidermal keratinocytes with the respective hydroxylamine metabolites, demonstrated that these cells were resistant to the cytotoxic effects of sulfamethoxazole hydroxylamine but not dapsone hydroxylamine. With prior depletion of glutathione, however, normal human epidermal keratinocytes became susceptible to the toxicity of sulfamethoxazole hydroxylamine. Covalent adduct formation by sulfamethoxazole hydroxylamine was detected in normal human epidermal keratinocytes, even in the absence of cell death, and was increased with glutathione depletion. Major protein targets of sulfamethoxazole hydroxylamine were observed in the region of 160, 125, 95, and 57 kDa. Dapsone hydroxylamine also caused covalent adduct formation in normal human epidermal keratinocytes. Together, these observations provide a basis for our hypothesis that normal human epidermal keratinocytes are involved in the initiation and propagation of a cutaneous hypersensitivity response to these drugs.