Antigen-presenting cells in the induction of contact hypersensitivity in mice: evidence that Langerhans cells are sufficient but not required

Skin sensitization induced Langerhans' cell mobilization: variable requirements for tumour necrosis factor-α

Upon antigen/allergen recognition, epidermal Langerhans' cells (LC) are mobilized and migrate to the local lymph node where they play a major role in initiating or regulating immune responses. It had been proposed that all chemical allergens induce LC migration via common cytokine signals delivered by TNF-α and IL-1β. Here the dependence of LC migration on TNF-α following treatment of mice with various chemical allergens has been investigated. It was found that under standard conditions the allergens oxazolone, paraphenylene diamine, and trimellitic anhydride, in addition to the skin irritant sodium lauryl sulfate, were unable to trigger LC mobilization in the absence of TNF-α signalling. In contrast, two members of the dinitrohalobenezene family (2,4-dinitrochlorobenzene [DNCB] and 2,4-dinitrofluorobenzene [DNFB]) promoted LC migration independently of TNF-R2 (the sole TNF-α receptor expressed by LC) and TNF-α although the presence of IL-1β was still required. However, increasing doses of oxazolone overcame the requirement of TNF-α for LC mobilization, whereas lower doses of DNCB were still able to induce LC migration in a TNF-α-independent manner. These novel findings demonstrate unexpected heterogeneity among chemical allergens and furthermore that LC can be induced to migrate from the epidermis via different mechanisms that are either dependent or independent of TNF-α. Although the exact mechanisms with regard to the signals that activate LC have yet to be elucidated, these differences may translate into functional speciation that will likely impact on the extent and quality of allergic sensitization.

Chemical allergy: translating biology into hazard characterization

The induction by chemicals of allergic sensitization and allergic disease is an important and challenging branch of toxicology. Skin sensitization resulting in allergic contact dermatitis represents the most common manifestation of immunotoxicity in humans, and many hundreds of chemicals have been implicated as skin sensitizers. There are far fewer chemicals that have been shown to cause sensitization of the respiratory tract and asthma, but the issue is no less important because hazard identification remains a significant challenge, and occupational asthma can be fatal. In all areas of chemical allergy, there have been, and remain still, intriguing challenges where progress has required a close and productive alignment between immunology, toxicology, and clinical medicine. What the authors have sought to do here is to exemplify, within the framework of chemical allergy, how an investment in fundamental research and an improved understanding of relevant biological and biochemical mechanisms can pay important dividends in driving new innovations in hazard identification, hazard characterization, and risk assessment. Here we will consider in turn three specific areas of research in chemical allergy: (1) the role of epidermal Langerhans cells in the development of skin sensitization, (2) T lymphocytes and skin sensitization, and (3) sensitization of the respiratory tract. In each area, the aim is to identify what has been achieved and how that progress has impacted on the development of new approaches to toxicological evaluation. Success has been patchy, and there is still much to be achieved, but the journey has been fascinating and there have been some very important developments. The conclusion drawn is that continued investment in research, if coupled with an appetite for translating the fruits of that research into imaginative new tools for toxicology, should continue to better equip us for tackling the important challenges that remain to be addressed.

Langerhans cell migration: not necessarily always at the center of the skin sensitization universe

Since their discovery in 1868, the role of Langerhans cells (LCs) in skin immunity has been researched extensively. Recent data deriving from transgenic animals that are deficient in LCs have begun to challenge the dogma that there is a universal requirement for these cells in the development of skin sensitization. This Commentary addresses relationships between LC mobilization, draining lymph node activation, and skin sensitization using immunomodulators agonistic for a family of sphingosine-1-phosphate (S1P) receptors.

New aspects of the molecular basis of contact allergy

PURPOSE OF REVIEW

The aim of the review is to provide an up-to-date scenario of the mechanisms governing contact allergy, a widely diffused immune response to small chemicals (haptens) penetrating the skin.

RECENT FINDINGS

The availability of animal models for contact allergy, such as murine contact hypersensitivity, is of great importance in understanding the pathomechanisms of the allergic response, although all these findings need confirmation in humans. Contact allergy is the result of the activation of both innate and adaptive immunity in response to haptens. Both skin resident cells, such as keratinocytes and mast cells, and immigrating leucocytes, including T lymphocytes and natural killer cells, actively participate in the reaction. Different types of T-regulatory cells appear to be crucial in the prevention of contact allergy or in the early termination of the reaction. Understanding the mechanisms that regulate immune responses to haptens is critical for the development of innovative therapeutic approaches.

SUMMARY

Although contact allergy is predominantly a T-cell-mediated disease, humoral immune responses and innate immunity actively participate in the initiation and expression of the allergic disease.

Identification of a radio-resistant and cycling dermal dendritic cell population in mice and men

In this study, we explored dermal dendritic cell (DC) homeostasis in mice and humans both in the steady state and after hematopoietic cell transplantation. We discovered that dermal DCs proliferate in situ in mice and human quiescent dermis. In parabiotic mice with separate organs but shared blood circulation, the majority of dermal DCs failed to be replaced by circulating precursors for >6 mo. In lethally irradiated mice injected with donor congenic bone marrow (BM) cells, a subset of recipient DCs remained in the dermis and proliferated locally throughout life. Consistent with these findings, a large proportion of recipient dermal DCs remained in patients' skin after allogeneic hematopoietic cell transplantation, despite complete donor BM chimerism. Collectively, our results oppose the traditional view that DCs are nondividing terminally differentiated cells maintained by circulating precursors and support the new paradigm that tissue DCs have local proliferative properties that control their homeostasis in the steady state. Given the role of residual host tissue DCs in transplant immune reactions, these results suggest that dermal DC homeostasis may contribute to the development of cutaneous graft-versus-host disease in clinical transplantation.

Skin irritants and contact sensitizers induce Langerhans cell migration and maturation at irritant concentration

Skin irritants and contact allergens reduce the number of Langerhans cells (LCs). It has been assumed that this reduction is due their migration to the draining lymph node (LN) for initiating immune sensitization in a host. Skin irritation, however, as opposed to contact allergy is not considered to be an immunological disease. Nevertheless, skin irritants are also known for their adjuvant-like effects on contact allergy, resulting in skin hypersensitivity reactions like toxic dermatitis. The human organotypic skin explant culture (hOSEC) model is used to study the characteristics of chemical-induced migration of CD1a(+) LCs out of the epidermis in relation to irritancy or toxicity. We analysed cells emigrating out of hOSEC for CD1a(+) LCs, CD83(+) mature dendritic cells (DCs) and CCR7(+) LN homing cells. After exposure to a toxic concentration of a non-immunogenic irritant, an increase of CD1a(+)CD83(+) LCs was found in the culture medium. A non-toxic concentration of an sensitizer induced an increase of CD1a(+) cells. About 50% of skin emigrating CD1a(+) LCs were CD83(-) (immature) but all were CCR7(+). Skin irritation by both non-allergenic and allergenic compounds induces LC migration and maturation. In contrast, only allergenic compounds induced LC migration with partial maturation at subtoxic concentration. This effectively demonstrates that irritation is physiologically needed stimuli for inducing LC maturation.

Epidermal Langerhans cells--changing views on their function in vivo

New experimental models and methods have rendered the field of Langerhans cells very lively. An interesting and productive scientific debate as to the functions of Langerhans cells in vivo is currently going on. We have not yet reached the point where the "pros" would weigh out the "cons", or vice versa. There is good evidence for a lack of Langerhans cell function and for down-regulatory Langerhans cell function in some models. On the other hand, there is also evidence for an active immunogenic and tolerogenic role of Langerhans cells. These recent developments will be discussed.

UVA Radiation Impairs Phenotypic and Functional Maturation of Human Dermal Dendritic Cells

There is now strong evidence that the ultraviolet A (UVA) part of the solar spectrum contributes to the development of skin cancers. Its effect on the skin immune system, however, has not been fully investigated. Here, we analyzed the effects of UVA radiation on dermal dendritic cells (DDC), which, in addition, provided further characterization of these cells. Dermal sheets were obtained from normal human skin and irradiated, or not, with UVA at 2 or 12 J per cm2. After a 2 d incubation, the phenotype of emigrant cells was analyzed by double immunostaining and flow cytometry. Results showed that migratory DDC were best characterized by CD1c expression and that only few cells co-expressed the Langerhans cell marker Langerin. Whereas the DC extracted from the dermis displayed an immature phenotype, emigrant DDC showed increased expression of HLA-DR and acquired co-stimulation and maturation markers. We showed here that UVA significantly decreased the number of viable emigrant DDC, a process related to increased apoptosis. Furthermore, UVA irradiation impaired the phenotypic and functional maturation of migrating DDC into potent antigen-presenting cells, in a concentration-dependent manner. The results provide further evidence that UVA are immunosuppressive and suggest an additional mechanism by which solar radiation impairs immune response.

Migratory Langerhans cells in mouse lymph nodes in steady state and inflammation

Dendritic cells cells induce immunity or-in the steady state-maintain peripheral tolerance. Little is known in that regard about Langerhans cells. Therefore, we investigated migrating Langerhans cells in the steady-state versus inflammation. Increased numbers of Langerhans cells, as determined by immunostaining for Langerin/CD207, appeared in the lymph nodes in response to a contact allergen. Whereas a large proportion of Langerhans cells expressed CD86 in the steady state, CD40, and CD80 were found on a smaller percentage. During inflammation, more CD40(+), CD80(+), CD274/B7-H1/PD-L1(+), and CD273/B7-DC/PD-L2(+) Langerhans cells were found in the lymph nodes, and they expressed higher levels of these molecules. CD275/inducible T cell co-stimulator (ICOS) ligand was not detected. Langerhans cells in the nodes of contact allergen-treated mice produced more IL-12p40/70. This correlated with more interferon-gamma being produced by activated lymph node T cells. Epicutaneous immunization with ovalbumin under inflammatory conditions led to a more vigorous proliferation of antigen-specific CD4 T cells in vitro and in vivo as compared with immunization in the steady state. The latter modality, however did not induce strong CD4 T cell tolerance in this model. Thus, the overall phenotype of Langerhans cells is not an indicator for their immunogenic or tolerogenic potential.

Macrophages and Dendritic Cells Constitute a Major Subpopulation of Cells in the Mouse Dermis

Macrophages and dendritic cells (DC) in tissues with close contact to the environment are of essential importance in host defense and are therefore present in sizeable numbers. Therefore, it is surprising that mononuclear phagocyte populations of the dermis have rarely been investigated in a quantitative manner. In this study, we examined mouse dermal skin immunophenotypically and related the observed numbers of observed cells to the total number of nucleated cells. These analyses show that about 70% of all dermal cells represent CD45+ leukocytes. The vast majority of these cells (approximately 60% of total) expresses the mononuclear phagocyte markers mMGL (ER-MP23), F4/80 and CD11b. In addition, these cells show avid phagocytic capacity and thus are identified as dermal macrophages. Different subpopulations can be defined using markers such as sialoadhesin, ER-HR3 and mSIGN-R1 (ER-TR9). Interestingly, MHC class II expression differs significantly between dermal cells from ear versus back skin. Moreover, we have identified small populations of dermal DC and migrating Langerhans cells (together approximately 10% of total). In summary, our findings show that mononuclear phagocyte populations form the majority of dermal cells and thus have been clearly underestimated so far.

Correlation of factor XIIIa+ dermal dendrocytes with paracoccidioidomycosis skin lesions

We demonstrated and quantified by immunohistochemistry the factor XIIIa+ dermal dendrocytes (FXIIIa+ DD) in paracoccidioidomycosis skin lesions. Sixty-one biopsies were classified according to the tissue response in well-organized granulomas (group 1), poorly organized granulomas (group 2) and samples showing both kinds of granuloma (group 3). Ten biopsies from normal skin were used as controls. In order to verify the internalization of Paracoccidioides brasiliensis antigens by FXIIIa+ DD, we performed a double immunostaining technique. FXIIIa+ DD were hypertrophied with prominent dendrites and their number in the test groups was higher than in the control group, especially in the dermal papillae. P. brasiliensis yeasts were seen within the cytoplasm of FXIIIa+ DD in 40% of the immunostained biopsies. We could correlate these findings with the probable role of FXIIIa+ DD as antigen-presenting cells in the pathogenesis of skin lesions in paracoccidioidomycosis.

IL-1beta is essential for langerhans cell activation and antigen delivery to the lymph nodes during contact sensitization: evidence for a dermal source of IL-1beta

IL-1beta(-/-) mice manifest an impaired contact hypersensitivity response to the hapten trinitrochlorobenzene, with the principle defect expressed during the sensitization phase of this response. Following application of hapten to the skin, epidermal Langerhans cells of IL-1beta(-/-) mice failed to demonstrate the classical phenotype of activation. In addition, the delivery of epicutaneously applied fluorescein isothiocyanate to draining lymph nodes was decreased in IL-1beta(-/-) mice. Hapten delivery to draining lymph nodes could be restored by intradermal injection of recombinant IL-1beta. Reconstitution of lethally irradiated IL-1beta(-/-) mice by transfer of wild-type bone marrow restored hapten-stimulated IL-1beta mRNA expression, demonstrating that IL-1beta production was dependent on bone marrow-derived cells. In wild-type skin, IL-1beta expression was upregulated in a time- and dose-dependent fashion following hapten application. Interestingly, prominent IL-1beta expressing cells were found in the dermis, suggesting that dermal cells may contribute significantly to the contact hypersensitivity response.

Phenotypic and functional outcome of human monocytes or monocyte-derived dendritic cells in a dermal equivalent

The dermis harbors a true dendritic cell population that could elicit primary allogeneic T cell responses in vitro and contact hypersensitivity reactions in vivo. The origin of dermal dendritic cells remains poorly understood, however. In this study, we analyzed the fate of monocytes or monocyte-derived dendritic cells in a dermal equivalent. Freshly isolated monocytes or monocytes cultured for 6 d with either GM-CSF/IL-4 or GM-CSF/IL-4/TGF-beta 1 (TGF-DC) were seeded in a collagen solution with normal human fibroblasts. The lattices were cultured for 7--14 d in the presence, or absence, of the exogenous cytokines, before phenotypic and functional studies were performed. Supply of exogenous cytokines allows the appearance of typical CD1a(+)/CD14(-)/CD68(low) dendritic cells with significant allostimulatory property, regardless of the cell type incorporated into the lattices. In cytokine-free conditions, monocytes and GM-CSF/IL-4-derived dendritic cells give rise to a CD1a(-)/CD14(+)/CD68(high) monocyte/macrophage population with no allostimulatory property. When incorporated into the lattices in the absence of exogenous cytokines the TGF-DC express few CD68 and FXIIIa. Interestingly, these cells do not all convert into the CD14(+)/CD1a(-) population. Indeed, a small HLA-DR(+)/CD1a(+)/CD14(-) subset was consistently found, which represents about one-third of the HLA-DR(+) cells. Moreover, TGF-DC recovered from the lattices after culture without cytokines do display a significant allostimulatory function. Thus, in the absence of exogenous cytokines, only Langerhans-cell-like dendritic cells can retain the typical dendritic cell features when inserted in a dermal environment. Taken together, these results may provide evidence supporting an epidermal origin of dermal dendritic cells.

An automated method for the quantification of immunostained human Langerhans cells

Allergic contact dermatitis is a frequent and increasing health problem. For ethical reasons, the current animal tests used to screen for contact sensitizers should be replaced by in vitro alternatives. Contact sensitizers have been shown to accelerate Langerhans cell (LC) migration from human organotypic skin explant cultures (hOSECs) more rapidly than non-sensitizers and it has been proposed that the hOSEC model could be used to screen for sensitizers. However, chemically induced decreases in epidermal LC numbers need to be accurately quantified if the alterations in epidermal LC numbers are to form the basis of an alternative system for screening contact sensitizers in vitro. As manual counting of LCs is labour intensive and subject to intra- and inter-personal variation we developed an image analysis routine, using the Leica QWin image analysis software, to quantify LCs in situ using immunohistochemically stained skin sections. LCs can be identified using antibodies against the membrane molecule CD1a or the Lag antibody, which recognises cytoplasmic Birbeck granules. Quantification of epidermal LC number using the image analysis software had a much lower inter-person variation than when the same specimens were counted manually, using both the anti-Lag and CD1a antibodies. The software-aided quantification of epidermal LCs provides an accurate method for measuring chemically-induced changes in LC numbers.

Suprathreshold doses of hapten are required to induce both contact hypersensitivity and tolerance

Whereas both high (conventional) and low (optimal) doses of epicutaneously applied hapten induce contact hypersensitivity in normal mice, only conventional doses retain their capacity to induce contact hypersensitivity after acute, low dose ultraviolet B radiation in UVB-resistant mice. Recent evidence indicates that conventional doses of hapten as well as acute, low dose ultraviolet B radiation destroy virtually all epidermal Langerhans cells, which leads to the conclusions that (a) dermal antigen presenting cells have a prominent role to play in contact hypersensitivity induction, and that (b) Langerhans cell provide this function only in normal skin, and only if non-toxic amounts of hapten are present. We have now explored the ability of suprathreshold, threshold, and sub-threshold doses of hapten to induce tolerance when painted on or injected into normal skin or skin exposed to ultraviolet B radiation. Our results indicate that a single exposure of low dose, ultraviolet B radiation generated tolerance-promoting signals within the epidermis when a threshold dose of hapten was painted on the exposed site. By contrast, suprathreshold doses of hapten painted on skin after four consecutive daily doses of ultraviolet B radiation led to tolerance that arose exclusively from cells within the dermis. In absence of ultraviolet B radiation, epicutaneously applied hapten failed uniformly to induce tolerance, whether applied at suprathreshold, threshold or sub-threshold doses. We conclude that normal skin lacks cells with inherent tolerance-promoting capacity, but that cells of this type can emerge within either epidermis or dermis after exposure to acute, low dose ultraviolet B radiation.

Heterogeneous reactivity of murine epidermal Langerhans cells after application of FITC: a histochemical evaluation

To elucidate the detailed kinetics of epidermal Langerhans cells after topical contact sensitizer stimulation, we examined ATPase or Ia positive epidermal cells of BALB/c mice in a time-spaced manner after the topical application of fluorescein isothiocyanate (FITC). We also performed double labeling of Langerhans cells in epidermal sheets with ATPase activity and Ia antigen or costimulatory molecules (B7-1 and B7-2) after the same stimulation. Observations showed that the density of ATPase positive cells and Ia positive cells decreased following a different time course; the former reached a nadir (77.4% of control) at 4 h but the latter reached a minimum (82.8% of control) at 16 h after the application of FITC. A double labeling technique revealed an increase in Ia single positive cells at 4 h as opposed to that of ATPase single positive cells at 16 h after application. Both costimulatory molecules were expressed on the dendritic processes of many Langerhans cells as a dotty pattern at 4 h after application; B7 positive and ATPase negative areas were observed at this time. On electron microscopic observation, a few activated Langerhans cells found in the dermis at 4 h after application had distinctive profiles compared with residual Langerhans cells in the epidermis. These findings suggest that there is a heterogeneity of reactivity to FITC in epidermal Langerhans cells, and that only a small portion of them migrates from the epidermis during sensitization. The findings also indicate the importance of the interaction between the Langerhans cell and its surrounding microenvironment in the epidermis for its activation. In addition, the results indicate that the enzymatic and the phenotypic markers do not definitively reflect the presence (or absence) of Langerhans cells.

Contribution of Dermal Macrophage Trafficking in the Sensitization Phase of Contact Hypersensitivity

We investigated cellular trafficking of dermal macrophages that express a macrophage calcium-type lectin (MMGL) during the sensitization of delayed-type hypersensitivity. In skin, dermal macrophages, but not epidermal Langerhans cells, have been shown to express MMGL. Epicutaneous sensitization by FITC produced a transient increase in MMGL-positive cells in regional lymph nodes. To directly investigate whether the increase was due to cell migration from dermis, MMGL-positive cells purified from skin were intradermally injected into syngeneic mice after labeling with a fluorescent cell tracer, followed by epicutaneous sensitization over the site of injection. MMGL-positive cells containing the tracer were found in the regional lymph nodes after sensitization. The majority of the MMGL-positive cell migrants were negative for FITC fluorescence despite the presence of FITC-labeled cells that included Langerhans cell migrants. Because the extent of MMGL-positive cell migration was greatly influenced by the selection of vehicles to dissolve FITC, the efficiency of sensitization was compared using the ear swelling test. Migration of both Langerhans cells (FITC-labeled cells) and MMGL-positive cells contributed positively to the efficiency of sensitization. Interestingly, MMGL-positive cell migration was induced by vehicle alone, even in the absence of FITC. These results suggest that migration of dermal MMGL-positive cells accounts for the adjuvant effects of vehicles at least in part.

Dermal dendrocytes participate in the cellular pathology of experimental acute graft-versus-host disease

In a well established murine model relevant to human disease, graft-versus-host disease results from recognition of recipient minor histocompatibility antigens by donor bone marrow-derived T lymphocytes. Previous studies suggest that factor XIIIa-positive dermal dendrocytes may be involved in the pathogenesis of disorders involving antigen presentation to T cells and dermal fibrosis. This study was undertaken to determine (i) whether normal murine skin contains factor XIIIa-positive dermal dendrocytes, and (ii) whether such cells participate in the pathophysiology of acute graft-versus-host disease. Graft-versus-host disease was produced using B10.BR CD8+ donor T cells administered to CBA recipients. Skin samples were collected weekly for a 5-week period and evaluated by immunohistochemistry and electron microscopy. Our data indicate that normal murine dermis contains factor XIIIa-positive cells localized primarily around deep dermal microvessels. Ultrastructural analyses reveal these cells to have long processes, pinocytotic vesicles, fibronexuses, and intimate associations with mast cells. During graft-versus-host disease, factor XIIIa-positive dendrocytes appeared within the superficial dermis. By ultrastructure, the dendrocytes were hypertrophic and highly branched, and demonstrated an intimate relationship with neighboring cells. In conclusion, factor XIIIa-positive dendrocytes comprise a normal component of the murine dermis and undergo alterations in experimental acute graft-versus-host disease consistent with participation in disease pathophysiology.

Quantitative immunohistochemical differences in Langerhans cells in dermatitis due to internal versus external antigen sources

Cutaneous hypersensitivity reactions can develop against antigens delivered through the epidermis (contact dermatitis) or through the blood vessels (e.g., drug eruptions). On routine histology alone, it is not always possible to determine the route of the antigen. Langerhans cells (LC) are the main antigen-presenting cells in contact dermatitis. Dermal dendrocytes (DC) are antigen-presenting cells and may be involved in dermal reactions. We tested the hypothesis that there is a difference between dermatitis due to external and internal antigen sources with regard to the number or function of LC and DC. In 85 cases of dermatitis, numbers of S100 and HLA-DR reactive cells per linear millimetre of epidermis were counted. The amount of epidermal spongiosis was evaluated qualitatively. In 35 cases, the number of DC per mm2 (as defined by Factor XIIIa expression) was evaluated. The patients were then divided into two groups based on whether the final clinical evaluation considered the dermatitis to be secondary to an external (35 cases) or internal antigen (50 cases). Dermatitis due to external antigens had significantly more LC/mm and more frequent HLA-DR expression than dermatitis due to internal antigens, mean +/- SEM; 21.2+/-2.04 vs. 9.1+/-1.02 (p<0.00001) and 16.3+/-2.49 vs. 6.0+/-0.92 (p=0.0001), respectively. Spongiosis was more marked in external antigen cases. DC were more numerous in internal than in external antigen cases, but the differences were not statistically significant. In our model, determination of numbers of LC/mm is the variable with the highest power to discriminate between internal and internal sources. Quantification of HLA-DR+ LC and degree of spongiosis provide little additional discriminatory power.

Human dermal dendritic cells process and present soluble protein antigens

Recently, a novel type of dendritic antigen-presenting cell has been identified in the dermis of normal human and mouse skin. These dermal dendritic cells (DDC) occur in higher numbers than epidermal Langerhans cells, represent a distinct differentiation pathway of dendritic cells, and are as potent as Langerhans cells in the activation of superantigen specific T cells. As yet, nothing is known about their capacity to take up, process, and present soluble protein antigens. We used the model of tetanus toxoid (TT) driven T cell proliferation to address these questions. To test for active internalization of TT protein, gold labeled TT was incubated with Langerhans cells and DDC and could be traced to multivesicular endo-lysosomal compartments. DDC internalize TT through a receptor-mediated, clathrin-independent pathway, whereas Langerhans cells predominantly use macropinocytosis. To verify that DDC process TT by the exogenous pathway of antigen presentation, we pulsed DDC with TT protein or TT peptide after preincubation with chloroquine. Preincubation with chloroquine diminished the capacity of DDC to induce TT protein specific T cell proliferation (70-80%), but was not effective to suppress TT peptide induced T cell responses. DDC were as potent as Langerhans cells and 5-10 x more potent than plastic adherent monocytes in the presentation of TT to autologous resting T cells. Furthermore, as few as 50 DDC (stimulator:responder ratio of 1:1000) were able to induce a significant TT specific T cell proliferation. Because a subpopulation of DDC expresses low levels of CD1a, a phenotypic marker of Langerhans cells, sorting of CD1a positive and negative DDC was performed. On a per cell basis, CD1a positive and negative DDC were equally potent at mediating TT specific T cell proliferation. Thus, DDC are able to internalize, process, and present soluble protein antigens such as TT and may therefore play an important role in the regulation of skin immune responses.

Entry into afferent lymphatics and maturation in situ of migrating murine cutaneous dendritic cells

An important property of dendritic cells (DC), which contributes crucially to their strong immunogenic function, is their capacity to migrate from sites of antigen capture to the draining lymphoid organs. Here we studied in detail the migratory pathway and the differentiation of DC during migration in a skin organ culture model and, for comparison, in the conventional contact hypersensitivity system. We report several observations on the capacity of cutaneous DC to migrate in mouse ear skin. (i) Upon application of contact allergens in vivo the density of Langerhans cells in epidermal sheets decreased, as determined by immunostaining for major histocompatibility complex class II, ADPase, F4/80, CD11b, CD32, NLDC-145/DEC-205, and the cytoskeleton protein vimentin. Evaluation was performed by computer assisted morphometry. (ii) Chemically related nonsensitizing or tolerizing compounds left the density of Langerhans cells unchanged. (iii) Immunohistochemical double-staining of dermal sheets from skin organ cultures for major histocompatibility complex class II and CD54 excluded blood vessels as a cutaneous pathway of DC migration. (iv) Electron microscopy of organ cultures revealed dermal accumulations of DC (including Birbeck granule containing Langerhans cells) within typical lymphatic vessels. (v) Populations of migrating DC in organ cultures upregulated markers of maturity (the antigen recognized by monoclonal antibody 2A1, CD86), but retained indicators of immaturity (invariant chain, residual antigen processing function). These data provide additional evidence that during both the induction of contact hypersensitivity and in skin organ culture, Langerhans cells physically leave the epidermis. Both Langerhans cells and dermal DC enter lymphatic vessels. DC mature while they migrate through the skin.

Factor XIIIa-positive dendrocytes are increased in number and size in recurrent aphthous ulcers (RAU)

The factor XIIIa-positive (FXIIIa+) cell is a potent antigen-presenting cell, which has been described as increasing in numbers in various chronic inflammatory conditions. The purpose of this study was to investigate the distribution and frequency of FXIIIa+ cells in acute recurrent aphthous ulcer (RAU) lesions compared with induced traumatic ulcer (TU) lesions and with clinically healthy oral mucosa. Samples were labeled with polyclonal rabbit anti-human FXIIIa antibodies in avidin-biotin-peroxidase complex (ABC) staining. Most of the FXIIIa-immunoreactive cells in TUs and normal mucosa were spindle-shaped, whereas a relatively large, dendritic-like cell was predominant in RAU lesions. FXIIIa+ cells were quite frequent within mononuclear cell-rich inflammatory cell infiltrates and in perivascular areas in RAU lesions. In contrast, FXIIIa+ cells were not found in mucosal epithelium or in the neutrophil-rich areas. RAU mononuclear cell-rich inflammatory cell infiltrates appeared to have greater numbers of positively stained cells than the TU-inflammatory cell infiltrates (199 +/- 67 vs 110 +/- 31 cells/mm2, P < 0.001). Overall, FXIIIa+ dendrocytes were increased in numbers, and apparently also in size, in RAU lesions (274 +/- 68/mm2) as compared to controls (177 +/- 74/mm2, P < 0.01), and to TU lesions (183 +/- 50 mm2, P < 0.01). Interestingly, relatively high numbers of FXIIIa+ dendrocytes were also found in deep connective tissue in RAU sections compared with TUs (281 +/- 80 vs 166 +/- 57, P < 0.01). The characteristic changes in the size and shape of individual FXIIIa+ cells, their typical distribution and increase in frequency in RAU lesions indicate active involvement in the local pathogenic mechanisms. Localization to perivascular areas/inflammatory cell infiltrates would be compatible with a role in antigen presentation.

Pattern of cytokine receptors expressed by human dendritic cells migrated from dermal explants

Different reasons account for the lack of information about the expression of cytokine receptors on human dendritic cells (DC): (a) DC are a trace population; (b) the proteolytic treatment used to isolate DC may alter enzyme-sensitive epitopes; and (c) low numbers of receptors per cell. In the present work the expression of cytokine receptors was analysed by flow cytometry on the population of dermal DC (DDC) that spontaneously migrate from short-term culture dermal explants. DDC obtained after dermal culture were CD1alow, CD1b+, CD1c+, human leucocyte antigen (HLA)-DR+, CD11chigh, CD11b+ and CD32+. The DC lineage was confirmed by ultrastructural analysis. DDC expressed interleukin (IL)-1R type 1 (monoclonal antibody (mAb) hIL-1R1-M1; and 6B5); IL-1R type 2 (mAb hIL-1R2-M22); IL-2R alpha chain (mAb anti-Tac; and hIL-2R-M1) and IL-2R gamma chain (mAb 3B5; and AG14C). DDC did not stain for IL-2R beta chain using four mAbs recognizing two different epitopes of IL-2R beta (mAb 2R-B; Mik-beta 1; and CF1; Mik-beta 3, respectively). DDC were also positive for the cytokine binding chains (alpha chains) of IL-3R (mAb 9F5); IL-4R (mAb hIL-4R-M57; and S456C9); and IL-7R (mAb hIL-7R-M20; and R3434). DDC showed low levels of IL-6R alpha chain (mAb B-F19; B-R6; and B-E23) and its signal transducer gp130 (mAb A2; and B1). DDC strongly expressed interferon-gamma receptor (IFN-gamma R) (mAb GIR-208) and were negative for IL-8R (mAb B-G20; and B-F25). All DDC were highly positive for granulocyte-macrophage colony-stimulating factor receptor (GM-CSFR) alpha chain (mAb hGM-CSFR-M1; SC06; SC04, and 8G6) and to a lesser extent for the common beta chain of GM-CSFR, IL-3R and IL-5R (mAb 3D7). On the other hand, reactivity was not found for granulocyte colony-stimulating factor receptor (G-CSFR) (mAb hGCSFR-M1) nor macrophage colony-stimulating factor receptor (M-CSFR) (mAb 7-7A3-17) confirming the DC lineage of DDC. As previously reported for lymphoid DC, DDC expressed tumour necrosis factor receptort (TNFR) 75000 MW (mAb utr-1; hTNFR-M1; and MR2-1) but lacked TNFR 55000 MW (mAb htr-9; MR1-1; and MR1-2). In summary, DDC express receptors for a broad panel of cytokines, even receptors for cytokines whose effects on DC are still unknown (i.e. IL-2R alpha gamma; IL-6R alpha/gp 130; IL-7R alpha gamma).

High and low doses of haptens dictate whether dermal or epidermal antigen-presenting cells promote contact hypersensitivity

In the induction of contact hypersensitivity (CH) to an epicutaneously applied hapten, we have previously proposed that low doses of hapten sensitize primarily through epidermal Langerhans' cells (LC), whereas high doses rely largely on dermal antigen-presenting cells (APC). To examine this issue further, we applied either high or low doses of dinitrofluorobenzene (DNFB) epicutaneously to mice. We observed reduced LC density at the site after 12 h (nadir), which returned to normal levels at 24 h only after a low dose of hapten. When a low dose of an unrelated hapten, oxazolone, was painted on skin that had been painted 12 h previously with high dose of DNFB, oxazolone-specific CH was impaired. When grafts of whole skin, dermis alone, and epidermis alone prepared from skin painted 2 h previously with low or high doses of DNFB were placed onto naive, syngeneic mice, CH was induced by whole skin after both types of doses, by epidermis only after a low dose, and by dermis only after high dose. When epidermal cell suspensions were derivatized in vitro with low or high doses of DNFB, only cells exposed to a low dose induced proliferation of hapten-specific Tcells. Thus, only a low dose of hapten reveals the APC functions of LC without the participation of dermal APC.

Perivascular dendritic cells of the human dental pulp

The morphological and phenotypical features of the class II molecule (HLA-DR) expressing cells in human dental pulps were compared with those of previously characterized perivascular dendritic cells in the dermis. We have further investigated how these pulpal cells are structurally related to the vascular system. Double-immunofluorescence staining revealed that a substantial portion of the pulpal HLA-DR expressing cells also expressed factor XIIIa, a marker for dendritic cells. The cells usually had a highly dendritic appearance and formed a reticular network in the pulpal connective tissue. The majority of cells also expressed macrophage-related antigens (CD14 and CD68). A small but distinct population of pulpal cells, representing approximately 13% of the class II molecule expressing cells, was devoid of a typical macrophage phenotype. This subpopulation of pulpal cells may be similar to dendritic cells present in the dermis. Confocal laser scanning microscopy showed that highly dendritic cells, found in close relation to the endothelium, had dendritic processes which were found to be in contact with the peripheral cell membrane of the endothelial cells. These cells formed a three-dimensional structure around the microvessel resembling a cellular conduit. We conclude that the human dental pulp is equipped with class II molecule-expressing perivascular dendritic cells composed of a heterogeneous cell population.

Temporal correlation between UV radiation locally-inducible tolerance and the sequential appearance of dermal, then epidermal, class II MHC+CD11b+ monocytic/macrophagic cells

We performed a time course study in order to define the in vivo relationship between the induction of active suppression of contact sensitization and the presence of various cells in ultraviolet-exposed dermis and epidermis implicated in locally inducible immune tolerance: class II major histocompatibility complex (MHC)+CD11b(lo)Gr-1- Langerhans cells (LC), class II MHC-CD45+CD3+ dendritic epidermal T cells, class II MHC+CD11b+Gr-1- monocytes or class II MHC+CD11b+Gr-1+ monocytic/macrophagic cells. Partial tolerance (50%) was first detectable 6 h after a single 72 mJ/cm2 ultraviolet B exposure and maximum tolerance at 48 h post-ultraviolet exposure. By flow cytometry, a low granularity LC subset had disappeared from the epidermis within 6 h after ultraviolet exposure, followed by a slower decrease in the high granularity Langerhans cells subset. Within the dermis at the 6-h time point, small numbers of infiltrating monocytic/macrophagic cells are already apparent. By 24 h post-ultraviolet exposure, at which time tolerance has increased to 70%, the infiltrating monocytic/macrophagic population had risen to 1.2% of the total dermal cell population and was observed for the first time in the epidermis along with other infiltrating leukocytes (i.e., polymorphonuclear leukocytes). By 48 h post-ultraviolet exposure, when a state of maximum tolerance is obtained, both constitutive epidermal and dermal antigen-presenting cell populations were at or near their nadir of depletion. The infiltrating monocyte/macrophage population, however, exhibited a dramatic increase in the epidermis at 48 and 72 h. Thus, the ability to locally induce a state of in vivo tolerance is closely associated with the expansion of class II MHC+CD11b+Gr-1+ and -monocytic/macrophagic cells in the dermis and epidermis.

Cell-mediated immunosuppressive mechanisms induced by UV radiation

Soon after UV exposure, mast cells degranulate, possibly because of the release of the mediators and cytokines from the epidermis, and there are subsequent vascular changes and cellular infiltration. Within a few hours, the soluble mediator milieu of UV-exposed skin becomes exceedingly complex and replete with interactions. Leukocytes newly entering the skin, as well as those already in the skin, must respond to these inflammatory signals. Altered antigen presentation and immune suppression likely derive from alterations induced in the APC that comprise the post-UV leukocyte population of the skin. Many of these mechanisms may explain the effectiveness of phototherapy in atopic dermatitis and psoriasis.

The role of dendritic cells in cutaneous immunity

This article reviews the role of dendritic cells in cutaneous immunity. Langerhans cells (LC) found in the epidermis are the best-characterized dendritic cell population. They have the ability to process antigen in the periphery, transport it to the draining lymph nodes (DLN) where they are able to cluster with, and activate, antigen-specific naive T cells. During migration LC undergo phenotypic and functional changes which enable them to perform this function. There are other less well-characterized dendritic cells including dendritic epidermal T cells, dermal dendrocytes and dermal "LC-like' cells. Although there is no evidence that dendritic epidermal T cells (DETC) can present antigen or migrate to lymph nodes, they do influence the intensity of cutaneous immune responses to chemical haptens. Antigen-presenting cells (APC) in the dermis may provide alternative routes of antigen presentation which could be important in the regulation of skin immune responses. Therefore, dendritic cells are vital for the induction of immune responses to antigens encountered via the skin. LC are particularly important in primary immune responses due to their ability to activate naive T cells. The faster kinetics of secondary responses, and the ability of nonprofessional APC to induce effector function in previously activated cells, suggest that antigen presentation in the DLN may be less important in responses to previously encountered antigens. In these secondary responses, dendritic and nondendritic APC in the skin may directly induce effector functions from antigen-specific recirculating cells.

Immunity at the surface: homeostatic mechanisms of the skin immune system

The coordinated function of multiple epidermal and dermal cell populations allows the skin immune system to respond rapidly and effectively to a wide variety of insults occurring at the interface of the organism and its environment. Keratinocytes are the first line of defense in the skin immune system, and keratinocyte-derived cytokines are pivotal in mobilizing leukocytes from blood and signaling other cutaneous cells. Cytokine-mediated cellular communication also enables dermal fibroblasts and endothelial cells lining the cutaneous vasculature to participate in immune and inflammatory responses. Skin is an important site for antigen presentation, and both epidermal Langerhans cells and dermal dendritic cells play pivotal roles in T cell-mediated immune responses to antigens encountered in skin. Proinflammatory signaling pathways are necessarily balanced by a variety of regulatory pathways that help maintain the homeostatic functioning of the skin immune system.

Macrophages, but not Langerhans cell-like cells of dendritic lineage, express the CD36 molecule in normal human dermis: relevance to downregulatory cutaneous immune responses?

The CD36 molecule has been shown to be associated with subsets of peripheral blood monocyte/macrophages and, in cells isolated from either ultraviolet (UV)-irradiated or diseased skin, to induce downregulatory immune responses. Although macrophages are certainly present within normal human dermis, whether they normally express CD36 is still a matter of debate. In this study, we investigated dermal CD36-expressing macrophages in situ using the gold immunoelectron microscopic technique on tissue ultracryosections. This is a very sensitive and specific method, and its results clearly reflect the in vivo immunophenotypic constitutive situation. Macrophages in normal human dermis were variously shaped from round to dendritic and were localized either immediately beneath the epidermis, in perivascular areas, or in intervascular zones. Macrophages showed consistent gold-positive staining on their cell surface. In contrast, other dermal cells, including fibroblasts, lymphocytes, and mast cells, as well as dermal fibers, were not decorated with gold; dermal Langerhans cell-like dendritic cells (LC/DC), though they did show gold labeling in some intracytoplasmic organelles, did not show any gold particles along their plasma membranes. Therefore, although macrophages in normal human dermis exhibit variability with regard to their localization and shape, they regularly and constitutively expressed CD36. CD36 molecules may be considered a useful marker for macrophages in normal human dermis and may furthermore confer on macrophages, or a subpopulation thereof, intriguing functional properties (e.g., downregulatory capacity versus upregulatory capacity subserved by LC/DC) within the cutaneous immune system.

In human dermis, ultraviolet radiation induces expansion of a CD36+ CD11b+ CD1- macrophage subset by infiltration and proliferation; CD1+ Langerhans-like dendritic antigen-presenting cells are concomitantly depleted

Antigen-presenting (APC), suppressor T-cell-inducing macrophages infiltrate both human and murine epidermis after ultraviolet radiation (UVR) exposure. To determine their derivation, we prepared epidermal cell and dermal cell suspensions from human keratome biopsy specimens obtained from nonexposed skin and from UVB-irradiated sites (3 d after four times the minimal erythema dose). Simultaneous triple-marker flow cytometric analysis established the extended phenotype of macrophages infiltrating sunburned human epidermis (CD1a- CD1c- CD11b+ CD11c+ CD36+ Fc gamma RII+ DR+). This then enabled us to track dermal cells of this phenotype after UVR in relation to the heterogeneous DR+ populations in normal dermis. By both in situ immunohistology and cell suspension flow cytometry, UVR induced an expansion of bone marrow-derived DR+ cells in the perivasculature and sub-basement membrane zone of the papillary dermis. Despite an overall expansion of DR+ cells, the CD1a+ CD1c+ CD36- DR+ Langerhans-cell-like dendritic APC subset of dermal DR+ cells was depleted (p < 0.05), indicating that UVR-induced epidermal Langerhans cell loss (from 95% to 7% of DR+ epidermal cells) is not accounted for by Langerhans cell accumulation in the dermis. By contrast, UVR exposure induced a selective expansion of the dermal macrophage subset, which is phenotypically identical to the monocytic/macrophagic APCs that appear in the epidermis after UV injury (p < 0.01). Cell cycle analysis (to determine whether this expansion was accounted for entirely by infiltration) revealed no increase in the percentage of DR+ CD36+ UVR-exposed dermal cells in S/G2/M phase; however, the expanded DR+ CD36+ subset continued its already substantial level of proliferation unabated. Therefore, epidermal macrophages derive not only from transcapillary migration, but also from in situ proliferation of a dermal precursor. Taken together, these findings show that UVR creates an epidermal and dermal APC milieu which is dominated by monocytic/macrophagic cells, through depletion of cells of dentritic APC phenotype, and concomitant selective dermal expansion of a CD1a- CD1c- CD11b+ CD36+ Fc gamma RII+ DR+ (monocyte/macrophage) population.

A fresh morphological and functional look at dermal dendritic cells

During the past decade, a group of cells located in the dermis and possessing a dendritic morphology have emerged from obscurity and become recognized as important members of the "dermal immune system". This group of cells is characterized by a considerable degree of immunophenotypic and functional heterogeneity. In this review, the salient features of these dermal dendritic cells are put into a dermatopathology perspective, with particular emphasis on a broad group of inflammatory and neoplastic skin diseases. There appear to be multiple subsets of dermal dendritic cells, and 17 different conditions linked to active participation of these newly recognized cells. Exactly how these different subsets of dermal dendritic cells interact amongst each other, as well as with adjacent cells such as T-lymphocytes, endothelial cells, fibroblasts, and keratinocytes in these different diseases is unclear at this time. However, isolation techniques and monoclonal antibodies capable of distinguishing these subsets, as well as functional assays, are currently available and will permit definitive conclusions to be drawn regarding their pathophysiological significance. It is highly likely that, as more data is gathered, dermal dendritic cells will be the focus of further investigative activity by dermatopathologists for the next decade, and well past the year 2000.

Dermal dendritic cells are important members of the skin immune system

In conclusion we have shown that motile cells with a dendritic morphology can be isolated from dermis of normal and diseased human skin. DDC bear high amounts of MHC class II molecules on their surface, and are very potent antigen presenting cells. Subpopulations of these cells acquire certain ultrastructural features of Langerhans cells in-vitro such as Birbeck granule formation and CD1a expression. These newly defined members of the dendritic cell family of APCs may be precursors of epidermal Langerhans cells and may play a role in skin immune responses. Furthermore in inflammatory dermatoses such as psoriasis, a role in the autostimulation and cytokine production of T cells could be demonstrated. Given their number, distribution, and in-vitro functional capacity, it is appropriate at this time to conclude that DDCs are indeed important members of the skin immune system.

Distinction of class II MHC+ Langerhans cell-like interstitial dendritic antigen-presenting cells in murine dermis from dermal macrophages

Dermal cells are capable of initiating contact-hypersensitivity responses but the precise identification of the antigen-presenting cell within murine dermis is lacking. Class II major histocompatibility complex (MHC)+ cells with dendritic shape and lacking endothelial factor VIII but expressing the dendritic antigen-presenting cell marker NLDC-145 were observed in the perivascular and interstitial dermis of BALB/c and C3H/HeN skin. The heterogeneous class II MHC+ cells could be divided into two subsets: each was class II MHC+ CD45+ (bone marrow derived) GR-1- (non-neutrophil/macrophage) CD3- (non T), but one subset was CD11b+ (beta 2 integrin) and the other was CD11b-. Ultrastructural examination of class II MHC+ cells revealed the presence of a Langerhans cell-like/indeterminant cell subset with indented nuclei, dendritic morphology, active cytoplasm, and dense intermediate filaments. Phagolysomes and Birbeck granules were not observed in such cells, indicating these were distinct from dermal macrophages and from classical epidermal Langerhans cells, respectively. Cells with a monocyte/macrophage ultrastructural appearance were also noted, likely representing the class II MHC subset expressing CD11b and Ly6c (monocyte/endothelial antigen). Dermal cells in suspension were capable of processing and presenting large protein antigens to antigen-specific T-cell hybridomas; dermal cells also induced the syngeneic mixed lymphocyte reaction. The dermal antigen-presentation activities were totally abrogated by removal of class II MHC+ cells, but not by removal of CD11b+ cells or Ly6c+ cells, indicating that potent antigen-presenting cell activity was restricted to the class II MHC+ CD11b- Ly6c- subset (Langerhans cell-like/indeterminant cells). In conclusion, within a complex array of dermal leukocytes a murine dermal class II MHC+ cell population expressing a Langerhans cell-like/dendritic antigen-presenting cell phenotype and exhibiting potent antigen processing and presenting activity can be identified. The positioning of potent interstitial dendritic antigen-presenting cells at the interface of the vasculature with the dermal interstitium provides rapid access to an antigen-presenting cell as T cells first egress into the skin.

All-trans retinoic acid induces functional maturation of epidermal Langerhans cells and protects their accessory function from ultraviolet radiation

Retinoids provide some protection against ultraviolet radiation-induced skin damage. We have previously shown that topical all-trans retinoic acid prevents ultraviolet light from reducing the density of epidermal Langerhans cells in the epidermis but does not inhibit the development of immunosuppression to a locally applied contact sensitizer. We therefore investigated the ability of all-trans retinoic acid to modulate Langerhans cell induction of allogeneic T-cell proliferation in the mixed epidermal cell lymphocyte reaction. Langerhans cells isolated from all-trans retinoic acid-treated mice induced an enhanced mixed epidermal cell lymphocyte reaction. This is similar to Langerhans cells cultured with granulocyte-macrophage colony stimulating factor. Retinoic acid treatment also enhanced the allogeneic cell-stimulating capability of Langerhans cells isolated from ultraviolet-irradiated mice. Langerhans cells from all-trans retinoic acid-treated, ultraviolet-irradiated mice which were "matured" by 3 days in culture induced a larger mixed epidermal cell lymphocyte reaction than mice treated with solvent and ultraviolet irradiation. Thus all-trans retinoic acid treatment of mice causes Langerhans cell maturation and inhibits ultraviolet light from reducing their density or impairing their allogeneic cell-stimulating capacity. However, these mice remained immunosuppressed upon application of a contact sensitizer to irradiated or unirradiated skin. It is thus likely that, whereas all-trans retinoic acid protects local Langerhans cell numbers and function, it does not inhibit the production of an ultraviolet radiation-induced photoproduct which causes immunosuppression.

Antigen-bearing Langerhans cells in skin draining lymph nodes: phenotype and kinetics of migration

Application of the fluorescent contact sensitizer Rhodamin B on mouse epidermis was used to study the migration kinetics of Langerhans cells into the draining lymph nodes. The expression of the dendritic cell markers NLDC-145 and MIDC-8 was followed over time to determine the correlation between these markers and Langerhans cell migration. In contrast with its high expression on intraepidermal Langerhans cells, the expression of NLDC-145 on dendritic cells in the draining lymph node was low at 24 h but increased at later times; in contrast, MIDC-8 expression on dendritic cells decreased. Ten days after Rhodamin B application, antigen-bearing Langerhans cells were still present in the epidermis; application of another unrelated contact sensitizer to the epidermis at this time did not lead to migration of these residual Langerhans cells. These results indicate that not all antigen-bearing Langerhans cells migrate from the skin after application of a contact sensitizer, indicating that signals in addition to simple antigen binding are necessary for migration. During this migration from epidermis to lymph nodes Langerhans cells undergo phenotypic changes. The decreased expression of the endosomal antigens MIDC-8 and MOMA-2 correlates with differentiation from predominantly antigen-processing cells to predominantly antigen-presenting cells. The reduced expression of NLDC-145 is discussed in light of a Langerhans cell-independent pathway of antigen transportation from skin to lymph node.

Antigen-presenting capacity in normal human dermis is mainly subserved by CD1a+ cells

A proposed role for antigen-presenting dermal dendrocytes in the pathogenesis of many dermal inflammatory skin diseases remains speculative. We therefore sought to determine the phenotype and functional characteristics of antigen-presenting cells isolated from normal human dermis. Normal adult human skin was incubated overnight with dispase at 4 degrees C, the epidermis was removed, and the residual dermal preparation was then minced and digested with a mixture of hyaluronidase, collagenase, and DNAase at 37 degrees C, prior to filtration through mesh. Dermal cell suspensions thus obtained were stained using specific monoclonal antibodies, and analysed by fluorescence microscopy or flow cytometry. Mean values were as follows: CD45+ leucocytes 39%, HLA-DR+ cells 39%, Ulex europaeus agglutinin I+ endothelial cells 26%, CD1a+ cells 3.9%, CD11b+ cells 16%, CD11c+ cells 6%. Mitomycin C-treated crude dermal cell suspensions induced allostimulation of peripheral blood mononuclear cells in a 7-day culture, as assessed by 3H-TdR incorporation. Depletion of CD1a+ Langerhans-like cells from the dermal cell preparation, by 95, 74 and 90% in three separate experiments using immunomagnetic beads, reduced 3H-TdR incorporation at optimal responder-to-stimulator cell ratios by 90, 64, and 87%, respectively. Our findings suggest that, in normal human dermis, the great majority of the alloantigen-presenting capacity resides in the CD1a+ Langerhans cell-like dendritic antigen-presenting cell population, and not to any great extent in either CD1a- macrophage-like cells, or HLA-DR+ endothelial cells. The relationship of the CD1a+ dermal antigen-presenting cells to the Langerhans cell lineage remains to be determined.

Perturbation of epidermal barrier function correlates with initiation of cytokine cascade in human skin

BACKGROUND

An important function of skin is to serve as a barrier and thus provide protection from the external environment. The epidermal keratinocyte establishes this barrier by producing an intact stratum corneum. In the past, keratinocytes were appreciated only for this rather inert, passive structural responsibility and not for their potential dynamic contribution to inflammatory or immune-mediated reactions.

OBJECTIVE

Our purpose was to examine the cascade of molecular and cellular events that occur when the barrier function of human skin is abrogated by repeated tape stripping, which physically removes the stratum corneum without inducing any cytopathic effects on the underlying epidermal keratinocytes.

METHODS

Eight healthy human volunteers underwent repeated tape stripping and sequential punch biopsy specimens of skin obtained between 1 and 24 hours after tape stripping were analyzed for protein antigens by immunostaining of cryostat-cut sections. The presence or absence of various messenger RNAs (mRNAs) were detected by polymerase chain reaction.

RESULTS

After repeated tape stripping, keratinocytes became activated within hours. The responses included up-regulation of keratin-16 expression and keratinocyte proliferation accompanied by production of a specific profile of cytokine and adhesion molecule mRNAs and proteins in both epidermal and dermal compartments. Polymerase chain reaction amplification of RNA species isolated from the epidermal portion of skin revealed increases 6 hours after tape stripping in mRNA coding for tumor necrosis factor-alpha, IL-8, IL-10, interferon gamma, intercellular adhesion molecule-1, transforming growth factor-alpha, and transforming growth factor-beta. There was no increase in tumor necrosis factor-alpha, IL-8, IL-10, or transforming growth factor-alpha mRNAs in the dermal samples. Immunostaining revealed that keratinocyte intercellular adhesion molecule-1 was increased 6 hours after stripping and was accompanied by endothelial cell expression of E-selectin (endothelial cell adhesion molecule-1) and vascular cell adhesion molecule-1. These molecular events, which occurred after 6 hours in tape-stripped skin, preceded any movement of inflammatory cells from the circulation into dermis or epidermis and hence reflect changes that occur in cells indigenous to normal human skin. None of these changes occurred in persons who underwent limited tape strippings without barrier perturbation.

CONCLUSION

The results highlight the rapid and distinctive responses of epidermal keratinocytes and demonstrate that these cells can actively participate in a far greater number of homeostatic responses other than the production of the epidermal barrier.

An in vitro test for endocytotic activation of murine epidermal Langerhans cells under the influence of contact allergens

Several in vivo and in vitro studies have shown that contact sensitizing agents induce enhanced internalization of cell membrane constituents by epidermal Langerhans cells (LC). However the intracellular distribution of the internalized material has not yet been clearly defined. For this reason we investigated the uptake of gold-labeled antibodies against MHC class II molecules by cultured murine LC under the influence of various contact sensitizing agents, non-sensitizing analogues, and irritants. Antigen-antibody complexes were visualized by light microscopy using the silver enhancement technique and by pre-embedding electron microscopy. Viability was monitored by staining dead cells with propidium iodide. For light-microscopic evaluation of the intracellular distribution pattern of gold particles, a stimulation index was defined and used for the assessment of endocytotic activation. Untreated and solvent treated (control) cells exhibited an accumulation of internalized gold complexes into large aggregates composed of few intracellular vesicles. Cytoplasmic staining was absent and few gold particles were detectable in the endocytotic organelles under these conditions. In contrast to the non-sensitizing compounds DCNB and DNBSO3, which had no effect at all, treatment with subtoxic concentrations of the contact sensitizing agents DNFB, DNCB, TNCB, K2Cr2O7, NISO4 and p-phenylenediamine resulted in diffuse intracellular staining which was most pronounced in the submembraneous region. This was due to the numerous endocytotic vesicles which were closely associated with the cell membrane. Consequently a significant increase in the stimulation index was noted for these compounds. An irritant such as sodium lauryl sulphate used in subtoxic concentrations did not influence the intracellular distribution of internalized gold particles whereas toxic amounts of this compound induced a diffuse intracellular staining pattern indicative of membrane destruction. This approach represents a practical and reliable test for endocytotic activation of murine LC and may be useful for in vitro tests of the activating and possibly sensitizing properties of new chemical compounds.

Human and murine dermis contain dendritic cells. Isolation by means of a novel method and phenotypical and functional characterization

Dendritic cells (DC) comprise a system of cells in lymphoid and nonlymphoid organs that are specialized to present antigens and to initiate primary T cell responses. The Langerhans cell of the epidermis is used as a prototype for studies of DC in the skin. We have characterized a population of DC in human dermis, one of the first examples of these cells in nonlymphoid organs other than epidermis. To identify their distinct functions and phenotype, we relied upon the preparation of enriched populations that emigrate from organ explants of dermis. The dermal cells have the following key features of mature DC: (a) sheet-like processes, or veils, that are constantly moving; (b) very high levels of surface MHC products; (c) absence of markers for macrophages, lymphocytes, and endothelium; (d) substantial expression of adhesion/costimulatory molecules such as CD11/CD18, CD54 (ICAM-1), B7/BB1, CD40; and (e) powerful stimulatory function for resting T cells. Dermal DC are fully comparable to epidermis-derived DC, except for the lack of Birbeck granules, lower levels of CD1a, and higher levels of CD36. DC were also detected in explants of mouse dermis. We conclude that cutaneous DC include both epidermal and dermal components, and suggest that other human nonlymphoid tissues may also serve as sources of typical immunostimulatory DC.

Discrimination between immunoaccessory and phagocytic monocytes/macrophages of the skin in paraffin-embedded tissue by the monoclonal antibody Ki-M1P

The variety of functions performed by monocytes and macrophages is reflected in their phenotypic diversity. Investigation of this complex system is facilitated by Ki-M1P, a new monoclonal antibody which recognizes a differentiation antigen on monocytes/macrophages in paraffin-embedded tissues. To test its usefulness as a pan-macrophage marker in the skin, we immunohistochemically analysed paraffin-embedded biopsy material from seven healthy individuals and 190 patients with a variety of dermatoses. Immunoreactivity was compared with results obtained with the antibodies KP-1, MAC-387, UCHL-1 and S-100. In normal skin, epidermal Langerhans cells were Ki-M1P-. Strong expression of this marker was detected on spindle-shaped as well as dendritic perivascular and intervascular macrophages. Pathological reaction forms such as giant cells and epithelioid cells in granulomatous dermatoses were also Ki-M1P+. The high specificity of Ki-M1P is reflected in the lack of reactivity with tumour cells in non-monocytic neoplasms and Langerhans cell histiocytosis. Thus, Ki-M1P is a useful marker for skin macrophages, discriminating between the immunoaccessory and the phagocytic compartments.

Studies of contact hypersensitivity induction in mice with optimal sensitizing doses of hapten

To avoid unsuspected and unwanted consequences of excess hapten during epicutaneous sensitization, optimal sensitizing doses of dinitrofluorobenzene (DNFB) were determined for several ultraviolet B radiation (UVB)-resistant and UVB-susceptible strains of mice. Using these doses of hapten applied epicutaneously or injected intracutaneously into normal or UVB-exposed body wall skin, it was determined that four consecutive daily exposures to UVB prevented contact hypersensitivity induction in all mice when optimal sensitizing doses of DNFB were applied epicutaneously. By contrast, UVB-resistant, but not UVB-susceptible, mice developed contact hypersensitivity when an optimal sensitizing dose of DNFB was injected intracutaneously into UVB-irradiated skin. Moreover, whereas UVB-susceptible mice failed to develop contact hypersensitivity when an optimal sensitizing dose of DNFB was painted on skin exposed to a single dose of UVB, UVB-resistant mice did develop contact hypersensitivity under similar circumstances. Based on these results, it is concluded that 1) conventional doses of epicutaneously applied haptens induce contact hypersensitivity with the aid of antigen-presenting cells derived from both the epidermis and the dermis, 2) the phenomenon of UVB susceptibility is mediated by cells and molecules within the dermis when conventional doses of hapten and UVB radiation are employed, and 3) UVB susceptibility is mediated by cells and molecules within the epidermis when optimal sensitizing doses of hapten and a single exposure to UVB are employed.