Stanislaus Ting

Patterns of mast cell alterations and in vivo mediator release in human allergic skin reactions

Patterns of in vivo histamine release in skin sites challenged with ragweed antigen were compared in five human subjects sensitive to this antigen and four nonallergic individuals, using a newly developed skin-chamber technique. These findings were compared with inflammatory cell responses in the reaction sites and patterns of ultramicroscopic mast cell alterations in biopsy specimens of skin tests in the same subjects. Definite mast cell alterations occurred within 15 sec and appeared maximal within 5 to 10 min after antigen injection. Histamine levels in appended chambers increased after a lag of 10 to 30 min and were elevated for at least 60 min after antigen challenge. Eosinophils accumulated only in antigen-induced reaction sites. However, there was no precise quantitative correlation among the degree of change in these three measurements. These appear to be promising approaches to further in vivo studies of human allergic reactions.

Cromolyn does not modulate human allergic skin reactions in vivo

Cromolyn pretreatment frequently reduces antigen inhalation-induced bronchospasm possibly by inhibiting mast cell degranulation and mediator release. However, the local effects of cromolyn on type I hypersensitivity skin reactions are not well understood. We studied the effect of local cromolyn on antigen-induced skin reaction, histamine release, cellular inflammatory response, and ultramicroscopic changes of mast cells in 10 ragweed-sensitized subjects. Results showed that cromolyn 2% (nonirritant dose) does not modulate ragweed-induced skin whealing response, histamine release, and ultramicroscopic changes of mast cells. Thus, unlike the situation in the tracheobronchial tree, allergic skin reactions and associated events are not inhibited by local cromolyn application.

Terbutaline modulation of human allergic skin reactions

Terbutaline, a preferential beta 2-adrenergic agonist, has been shown to inhibit allergen-induced histamine release in vitro. In contrast, orally administered therapeutic doses of terbutaline do not inhibit antigen-induced wheal and flare reactions. We studied the effects of local terbutaline on antigen-induced whealing response, histamine release, cellular inflammatory response, and ultramicroscopic mast cell changes in antigen-challenged skin sites in ragweed-sensitive subjects. Results showed that ragweed challenge significantly induced increased histamine release in all subjects. In contrast, no such histamine release was observed at sites challenged with antigen in the presence of terbutaline. Thus locally applied terbutaline in nontoxic doses modulates mediator release in certain allergic reactions.

Anaphylaxis Caused by the Sodium Succinate Ester of Hydrocortisone and Methylprednisolone

The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of Defense.

Histamine suppression of in vivo eosinophil accumulation and histamine release in human allergic reactions

Although it has been shown that histamine inhibits antigen-induced in vitro histamine release from basophils, it is unclear whether histamine inhibits in vivo mediator release in human allergic reactions. We report effects of exogenous histamine on histamine release and inflammatory cell responses in antigen-challenged skin sites in eight ragweed-sensitive individuals. Four heat-suction blisters in each subject were unroofed, and a collection chamber was appended to each blister base. Chamber A contained 1000 PNU/ml ragweed extract; chamber B contained buffered saline (control fluid); chamber C contained 1000 PNU/ml ragweed and 50 ng (5 x 10(-7) M) of histamine; and chamber D contained histamine alone (50 ng). Comparative analyses of chamber histamine levels in individual subjects showed that (1) histamine levels in chamber A were significantly greater than those in chamber B (p less than 0.01) and that histamine levels in chamber C were not significantly different than those in chamber D (p less than 0.5). Likewise, comparison of eosinophils attaching to membrane filters appended to the chamber bases for 2 hr showed that there were significantly more eosinophils in chamber A than in chamber B (p less than 0.01) and that there was no significant difference in eosinophil numbers on filters appended to chamber C vs chamber D. In three of four subjects studied, addition of exogenous histamine (50 ng/ml) to ragweed before intradermal injection inhibited the ultrastructural mast cell alterations seen within 10 min after injection of ragweed alone. In the one subject in which mast cell alterations were not prevented, exogenous histamine also did not inhibit antigen-induced histamine release or subsequent eosinophil accumulation in the skin chambers.

Analysis of plasma histamine: a modification of the enzymatic isotopic assay

The enzymatic isotopic analysis of histamine requires extraction and concentration of [3H]-1-methylhistamine from the reaction mixture. The assay was modified to include enzymatic reaction at 0 degrees C to reduce blank values and direct application of protein-free reaction mixture to a thin-layer chromatography plate for isolating of the product. The analysis was quantitative down to 100 pg/ml of histamine, adequate for monitoring plasma histamine content.

Effect of cimetidine on exogenous histamine inhibition of histamine release in vivo.

We previously reported that exogenous histamine inhibits in vivo histamine release and eosinophil accmulation in ragweed‐challenged skin sites of sensitive human subjectes. The mechanism(s) involved were unclear. In this study, we repeated similar approaches in of the same subjects pretreated for 3 days with cimetidine, an H2 receptor antagonist. The pattern of exogenous histamine effects was now different in that local exogenous histamine (50 ug/ml) did not significantly alter ragweed‐induced mast cell alteration, histamine release, or the degree of eosinophil accumulation in skin challenge sites. These findings suggest that the observed exogenous histamine inhibitory effects may be mediated through the H2 receptor.