An immunopathological study of herpes-associated erythema multiforme.

Any pathogenetic mechanism proposed for erythema multiforme (EM) must account for the prominent mononuclear cell infiltrate in the skin lesions. The purpose of this study was to characterize immunopathologically, with monoclonal antibodies to human leukocyte antigens, the inflammatory cells in early target lesions of recurrent herpes-associated EM. Cryostat sections of snap-frozen skin biopsies were studied by the avidin-biotin immunoperoxidase technique with use of the following monoclonal antibodies: anti-HLA-DR, anti-Leu M5, anti-Leu 4 + 5b, anti-Leu 3a + 3b, anti-Leu 2a, anti-Leu 14, and anti-Leu 6. The dermal mononuclear inflammatory infiltrate in the EM biopsies consisted of monocyte-macrophages and T-lymphocytes, with both helper and suppressor T cells present. Both the dermal inflammatory infiltrate and the overlying keratinocytes were strongly HLA-DR positive. No definite alteration of Langerhans cell number or distribution was noted. These findings are consistent with the characteristics seen in cell-mediated immune reactions in the skin and point to this as a likely immune mechanism for the tissue damage of EM.

Normal macrophage function in infants receiving Intralipid by low-dose intermittent administration.

The effect of soybean oil emulsion (Intralipid) therapy on serum complement levels was determined in infants who received Intralipid therapeutically (1 gm/kg over 12 hours, every other day). The effect of Intralipid on macrophage priming for increased superoxide anion production was studied in a mouse model. Intralipid administration did not affect either macrophage function. Serum levels of C2 and C4, complement components synthesized and secreted exclusively in macrophages, were not decreased either during the week the infants received Intralipid or in the week following administration. Macrophages from mice that had received Intralipid produced similar amounts of superoxide anion, as did macrophages from mice that had received saline solution. Our data suggest that macrophages in infants receiving Intralipid in this regimen will function normally.

Human peripheral blood monocyte-derived macrophages produce haemolytically active C3 in vitro.

The third component of complement (C3) synthesized by human monocyte-derived macrophages has been shown to have the same size and sub-unit structure as serum C3, but haemolytic activity has not been demonstrated. Human monocyte-derived macrophages were cultured from days 4 to 7 in medium without serum, and the conditioned medium was dialysed to remove inhibitors of the C3 assay and concentrated to enhance detection of low amounts of C3. Using these techniques C3 activity was detected routinely. The amount of C3 was 3.4 x 10(7) effective C3 molecules/ml of concentrated tissue culture medium (range 1.0-7.5 x 10(7)), and the number of C3 molecules synthesized by each cell was 4.4 x 10(5), assuming that each cell synthesized C3. The specific activity of the C3 synthesized by the monocytes was the same as the specific activity of C3 that had been purified from serum and then incubated with the cells and processed in the same manner as the monocyte media. Synthesis as the basis for the presence of the C3 activity in the medium was indicated by an inhibition of production of the C3 activity of 66 +/- 16% by cycloheximide, 2 micrograms/ml. Thus, human blood monocytes that migrate into areas of inflammation can mature into cells capable of producing C3 which can participate in the complement sequence and thus potentiate inflammation.

Contact with specific surfaces stimulates the production of the second component of complement (C2) in human peripheral blood monocytes via a lymphocyte factor.

Whole mononuclear cells plated on surfaces coated with the polymer, poly (2-hydroxyethyl methacrylate) (poly-HEMA) produced significantly less C2 when compared to production by cells on tissue culture plastic dishes. The reduction in C2 production was dependent on the amount of poly-HEMA used to coat the dishes and was not due to nonspecific damage of the cells or effects of the poly-HEMA on the hemolytic activity of C2. T and B lymphocytes, but not monocytes, plated on tissue culture plastic produced a soluble factor that increased the production of C2 in freshly adherent monocytes. Lymphocytes plated on the poly-HEMA surface did not produce this soluble factor, which was termed surface-dependent factor (SDF). Whole mononuclear cells plated on poly-HEMA were able to respond to SDF by increasing C2 production by the same percentage as cells on the tissue culture plastic. This suggested that the primary basis for the decreased production of C2 by monocytes in the whole mononuclear cells plated on the poly-HEMA was decreased production of SDF by the lymphocytes. The effect of the poly-HEMA surface on C2 production was probably related to a generalized alteration in maturation of monocytes into macrophages, for SDF had the same type of effect on beta-glucosaminidase levels in monocytes as seen with C2, except that the magnitude of the effect was less. These studies suggest that interaction of lymphocytes with surfaces may modulate the function of the lymphocytes. In addition, interaction of lymphocytes with surfaces and the production of SDF in vivo may be responsible for enhancing maturation of monocytes in tissues.

Complement synthesis by guinea pig peritoneal macrophages: failure to detect chemical carcinogens.

In vitro production of the second and fourth components of complement (C2 and C4, respectively) by peritoneal macrophages from noninbred Hartley guinea pigs was tested after the animals had been inoculated with known carcinogens. The system demonstrated the capacity of N-nitrosodimethylamine to decrease C2 and C4 production. However, a similar decrease in C2 and C4 production was seen with only CCl4, 1 of the 10 chemical carcinogens studied. This system had little usefulness as a short-term screening procedure for the detection of carcinogenicity. The effect of the carcinogens on several other functions of peritoneal macrophages was also determined. The number of peritoneal exudate cells (PEC) was significantly lower in carcinogen-inoculated animals than in solvent-inoculated controls for three carcinogens: BeSO4, P < 0.005; CHCl3, P < 0.025; and CCl4, P < 0.01. However, the capacity of the PEC to adhere to plastic was decreased by only CHCl3 (P < 0.05), and adherent cells from all guinea pigs produced normal amounts of total secreted protein.