Increased sensitivity of lymphocytes from atopic individuals to histamine-induced suppression

Systemic T-cell unresponsiveness during rush bee-venom immunotherapy

By rush bee-venom immunotherapy, subjects reacting allergically to the venom can be effectively anergized, although the mechanism of action is not known. Here we analyzed the systemic effects of rush desensitization on the T cells of allergic patients. In most patients, we found reduced frequencies of T cells recalled to express CD69 and the cytokines interleukin (IL)-4 and interferon-gamma (IFN-gamma) after stimulation of peripheral blood mononuclear cells with phorbol 12-myristate 13-acetate (PMA) and ionomycin, as compared with normal donors. These frequencies are progressively reduced during immunotherapy. The frequency of cells expressing IL-2 does not change. A few patients show a different response to immunotherapy: frequencies of cells expressing CD69, IL-4, or IFN-gamma do not change, and remain similar to those of normal donors. However, the frequency of cells able to express IL-2 is increased. The analysis of cytokine expression in CD45RO+ vs CD45RO- T-cell populations revealed differences between normal and allergic donors. In allergic patients, higher frequencies of IL-4- and IFN-gamma-expressing cells among the CD45RO- subpopulation were found than in normal donors. This situation is not modified by immunotherapy. The results reveal a certain degree of heterogeneity in the response of allergic patients to bee-venom rush immunotherapy; however, all are clearly differentiated from normal controls as judged by cytokine expression of CD45RO- T cells. In most allergic patients, a considerable percentage of Th cells become unresponsive to mitogenic stimulation, and may be responsible for the desensitization itself.

A novel fluorescein-histamine reagent to quantitate histamine receptor expression on leucocytes

The expression of histamine receptors on the surface of rat lymph node cells was studied using a reagent made by directly coupling fluorescein isothiocyanate (FITC) to histamine. This approach contrasts with the use of previous reagents, made by coupling histamine and fluorescein separately to a protein carrier, which bind non-specifically to cells and cause staining unrelated to histamine receptor expression. The new reagent was used, in combination with a panel of monoclonal antibodies, for the dual staining of rat lymph node cells for two-colour flow cytometric analysis to investigate the distribution of histamine receptors on different leucocyte subsets. The majority of cells were stained by the FITC-histamine reagent and these constituted two distinct populations, those with the properties of small lymphocytes and a second population which included macrophages. Inhibition studies with the drugs mepyramine and cimetidine, which are antagonists of H1 and H2 receptors, respectively, showed that most lymphocytes possess H1 receptors while the macrophages have H2 receptors. It seems that macrophages have a higher number of histamine receptors than the majority of lymphocytes, but that they are of lower affinity.

In vitro lymphocyte stimulation by concanavalin A and with histamine as a co-mitogen in dogs with atopic dermatitis

Cell-mediated immune function was assessed in a group of dogs with atopic dermatitis by measuring the responses of peripheral-blood lymphocytes (PBL) to various concentrations of Concanavalin A (Con A) and comparing them to those of normal dogs. No difference from normal was found in any of the stimulation indices neither was spontaneous tritium uptake of unstimulated cells different between the groups. We also measured the response to Con A stimulation in vitro of PBL preincubated for 24 h, either in cell-culture medium at 37 degrees C, or in whole blood containing EDTA at room temperature, as an indirect measure of function of a subgroup of suppressor cells. Preincubation caused enhancement of mitogenesis for normal dog lymphocytes but not for the atopic dog cells, particularly for suboptimal concentrations of Con A. No differences were found in the responsiveness following incubation in cell-culture medium between normal and atopic dog cells but for both groups the cells preincubated in whole blood were generally more responsive. Histamine, which is one of the mediators of type 1 hypersensitivities such as atopy, can modulate lymphocyte function. At 10(-4) and 10(-8) M histamine, when added simultaneously with Con A, enhanced mitogenesis of normal dog PBL but suppressed mitogenesis of atopic dog PBL. By using histamine H1 and H2 antagonists, we concluded that histamine enhanced mitogenesis via H1, receptors and suppressed it via H2 receptors. Our results suggest that there are abnormalities in lymphocyte function in dogs with atopic dermatitis which may be important in the pathogenesis of the disease.

Histamine-induced regulation of IL-2 synthesis in man: characterization of two pathways of inhibition

Histamine at molar concentrations ranging from 10(-5) to 10(-7) exerted an inhibitory effect upon IL-2 synthesis by peripheral blood mononuclear cells in normal man; two pathways of inhibition are described. The first pathway was found to alter the T4 lymphocytes which, in the system used in this study, synthesized nearly 90% of the total IL-2 production and had no suppressive activity. This suggests that histamine can act at the level of IL-2-producing cells. The second pathway of inhibition was related to induction of suppressor cells. Peripheral blood lymphocytes pre-incubated for 1 h with histamine 10(-5)-10(-7) M inhibited the IL-2 synthesis of normal autologous lymphocytes in a co-culture system. This activity was radio-resistant (1200 r) and mediated by T8 lymphocytes. These two pathways of inhibition were mediated by the specific interaction of histamine with H1- and H2-receptor-bearing mononuclear cells.

Double phenotyping of immunoregulatory T cell subsets in patients with allergic asthma

In order to determine whether the dissection of helper/inducer (CD4+) and suppressor/cytotoxic (CD8+) lymphocyte subsets with Leu 8 reagent would reveal any differences between allergic asthma patients and non-atopic controls, we compared in both groups the 'true helper' T cell subset (Leu 8- CD4+), responsible for the major helper effect, and one of the suppressor T cell subpopulations (Leu 8- CD8+). Peripheral blood mononuclear cells from sixty-nine individuals, including nineteen extrinsic asthmatics, fifteen intrinsic asthmatics, seventeen patients with chronic obstructive lung disease and eighteen healthy controls, were comparatively analysed. Although total CD4+ cells and total CD8+ cells were similar for all groups, we found in the extrinsic asthma patients group a significant increase in the number of 'true helper' T cell sublineage (Leu 8- CD4+) and of suppressor cells expressing Leu 8- CD8+ phenotype. Such imbalances may be implicated in the pathogenesis of atopic asthma.

Histamine-induced suppressor cell function and nasal sensitivity in hay fever sufferers

Histamine-induced suppressor cell function was measured in a group of twenty-five hay fever suffers and sixteen non-atopic controls. No difference was found in the suppression index between sufferers and controls. There was, however, a significant relationship between the suppression index and nasal sensitivity to grass pollen, whether measured pre- or post-season, but no correlation between specific or total IgE levels and the suppression index. Histamine-induced suppressor cell function may influence pollen sensitivity in the most sensitive subjects, but not via an effect on IgE production.

Effects of long-term treatment with low dose cimetidine on allergen-induced airway responses and selected immunological parameters in atopic asthmatics

Twenty asymptomatic atopic asthmatics were treated with either cimetidine 100 mg orally (13 patients) or placebo (7 patients) once a day for 4 weeks. Bronchial challenges were performed with the pertinent allergen immediately before and 2 and 4 weeks after the initiation of treatment and, finally, 4 weeks after the cessation of treatment. Before each challenge blood was drawn for the determination of specific IgE antibody levels (RAST procedure) and total IgE (PRIST), allergen- and anti-IgE-induced basophil histamine release, and mitogen-induced lymphocyte (3H)-thymidine incorporation. Patients treated with cimetidine were found to be significantly (P less than 0.05) less responsive to bronchial allergen challenge during the treatment than before it; patients treated with placebo were more reactive (P less than 0.05) 14 days after the initiation of treatment. The difference in responsiveness to treatment between the placebo and the cimetidine groups was significant 14 days (P less than 0.01) and 4 weeks (P less than 0.05) after the initiation of treatment; no significant difference in allergen responsiveness was recorded between the groups 1 month after cessation of treatment. No clear-cut changes in specific IgE antibody or total IgE levels, histamine release capacity, or mitogen-induced lymphocyte responsiveness were observed in either group, except that lymphocytes from cimetidine-treated patients tended to show an increased ratio of PHA- to PMA-induced thymidine incorporation. Thus, it was found that the treatment of asymptomatic atopic asthmatics with low-dose cimetidine reduced their allergen sensitivity in bronchial provocation tests by a mechanism which remains to be elucidated.

Changes in bronchial anaphylactic reactivity induced in guinea-pigs by long-term treatment with histamine H2-agents

Guinea-pigs were sensitized to ovalbumin (OA) by immunization regimens chosen to cause antigen-induced bronchial anaphylactic responses mediated mainly either by IgE-like antibodies or by IgG1-like antibodies. Treatment of the IgE-producing animals for three weeks with the histamine H2-receptor antagonist cimetidine (1 mg kg-1 i.p. once a day) or with the H2-agonist dimaprit (0.1, 1.0, or 10 mg kg-1 i.p. once a day) led to a significantly reduced bronchial response capacity compared with that of the saline-treated controls challenged intravenously with antigen one week after the end of treatment. The changes were biphasic and not strictly dose-dependent. In contrast, acute treatment of immunized animals with a single dose of cimetidine (10 or 30 mg kg-1 i.v.) or dimaprit (1 or 10 mg kg-1 i.v.) 2 min before challenge with OA did not significantly affect the bronchial anaphylactic response. However, long-term treatment with cimetidine (10 mg kg-1) or the dimaprit analogue, S-[4-(N, N-dimethylamino)-butyl] isothiourea (SKF Compound 91488) (1 mg kg-1), which is reported not to activate H2-receptors, had no effect on the response capacity. Treatment with cimetidine (1 mg kg-1) or dimaprit (1 mg kg-1) did not influence the response capacity to antigen challenge in IgG1- type animals. Dimaprit (1 mg kg-1) did not affect the responsiveness to intravenous provocation with histamine in 'IgE-type' animals. Antigen-induced release of histamine from chopped lung tissue in vitro was not significantly affected in 'IgE-type' animals treated with cimetidine (1 mg kg-1) or dimaprit (1 mg kg-1). Treatment of immunized animals with cimetidine or dimaprit one week before and one week after a booster injection of antigen also led to reduced response capacity compared with that of saline-treated controls. However, the serum levels of IgE-like homocytotropic antibodies of these animals were not reduced; on the contrary, those of IgG1-antibody were increased in dimaprit-treated animals. These data show that intermittent treatment with histamine H2-agents reduces reagin-mediated anaphylactic response capacity in vivo in actively sensitized guinea-pigs by an as yet undefined mode of action.

Plasma histamine concentrations in atopic eczema

Plasma histamine concentrations were determined using a radio-enzymatic assay in fifty-four patients suffering from atopic eczema and in thirty-nine controls (contact dermatitis, psoriasis and normal non-atopic healthy volunteers). While in none of the controls histamine levels in plasma exceeded 1 ng/ml, seventeen out of fifty-four patients with atopic eczema showed increased plasma histamine concentrations ranging between 1.2 and 5.2 ng/ml. Elevated plasma histamine levels were found mostly in patients with severe eczema and high serum IgE levels. Longitudinal studies in seven patients revealed normal plasma histamine values during clinical remission.

Cutaneous histamine levels and histamine releasability from the skin in atopic dermatitis and hyper-IgE-syndrome

We determined the histamine content in the skin of 22 adults with atopic dermatitis, one patient with hyper-IgE-syndrome, and 20 controls by the enzymatic double isotope assay. In addition, we performed a pilot study of histamine degradation in the skin. We tested, furthermore, the releasability of histamine from skin sections of patients with atopic dermatitis and healthy controls upon challenge with acetylcholine, anti-IgE, and compound 48/80. Histamine was also determined in 13 plasma specimens and was always less than 1 ng/ml. The mean +/- SEM histamine concentration in the skin was 196 +/- 30 ng/mg protein in controls and 262 +/- 68 ng/mg protein in atopic dermatitis (no statistically significant difference). One control and three patients with atopic dermatitis exhibited a slight, the hyper-IgE patient a marked, elevation of the skin histamine content. No gross differences in the degradation rate of histamine were observed between patients and controls. Acetylcholine and 48/80 induced the same histamine release in both groups; with anti-IgE, almost the double amount of histamine was released from the skin of atopic dermatitis patients as compared to controls. These findings suggest an enhanced releasability of histamine upon immunologic challenge in atopic dermatitis.

Immunological studies in patients with alopecia receiving dinitrochlorobenzene and cimetidine therapy

Twenty-one patients with alopecia were screened for the immune reactivity of their peripheral blood lymphocytes. Generally, patients had only eczematous reactions when rather strong solutions of dinitrochlorobenzene (DNCB) were applied. One-third of the patients had lymphocytes with in vitro reactivity towards dinitrofluorobenzene-albumin in a lymphocyte transformation test. The percentage of T lymphocyte subpopulations in blood was normal, together with a normal in vitro function after mitogen and antigen stimulation. Six of the patients were treated with 1 g cimetidine daily for 6 weeks. We could not find clinical or immunological changes during the therapy. The findings are discussed in relation to other immunological studies of patients with alopecia and the eventual effect of cimetidine on the immune system.

Transglutaminase may mediate certain physiological effects of endogenous amines and of amine-containing therapeutical agents

Transglutaminase mediation of the effects of certain primary amines and alcohols may be important in receptor coupling to physiological responses. Many of the therapeutic and toxic side effects of drugs also may be related to their covalent linkage of glutamine residues of key regulatory proteins through the catalytic action of transglutaminase. This paper suggests that important therapeutic agents such as digoxin, tetracycline, adriamycin, and actinomycin D may have some effects related to transglutaminase action.

Abnormal histamine-induced suppressor-cell function in atopic subjects

To detect a potential defect in immunoregulatory function in atopic subjects, we studied histamine-induced suppressor-T-cell activity and histamine Type 1 and Type 2 receptors on T cells. Peripheral-blood mononuclear cells from 16 atopic subjects generated less histamine-induced suppressor activity than did those from 20 nonatopic normal controls (P less than 0.005). The percentage of T lymphocytes bearing histamine Type 2 receptors was lower in the atopic group than in the control group (P less than 0.001), but the percentage of cells with Type 1 receptors was the same in both groups. In the atopic subjects, the functional suppressor-cell abnormality positively correlated with the decreased phenotypic expression of histamine Type 2 receptors. No abnormality in concanavalin A-induced suppressor activity was detected in these subjects. Nonatopic control subjects with systemic mastocytosis had normal functional and phenotypic data, suggesting that chronic activation of atopic T cells in vivo by circulating histamine does not explain the abnormal histamine-induced suppressor response.

Histiocytosis-X

Twelve of 17 patients with histiocytosis-X were immunologically abnormal, as shown by the presence of circulating lymphocytes spontaneously cytotoxic to cultured human fibroblasts or of antibody to autologous erythrocytes. The patients also had a notable lack of histamine H2 surface receptors on their T lymphocytes, suggesting a suppressor-cell deficiency. The lymphocyte abnormalities were reversed in vitro after incubation in a crude extract of calf thymus gland, and therefore all 17 patients were treated with daily intramuscular injections of this extract. With this therapy, 10 patients entered complete remission -- a response at least as good as that observed in historical controls treated with chemotherapy. A positive clinical response was associated with an increase in the number of T-cell histamine H2 receptors to normal levels and with correction of the other immunologic abnormalities. The results of this preliminary study justify a larger prospective clinical trial of thymic extract and further investigation of the immunoregulatory mechanisms in histiocytosis-X.

Evidence of diminished suppressor T cell activity in patients with atopy and SLE

The T cell mitogen concanavalin A (Con A) was added to lymphocytes pre-cultured for 24 hours in vitro in tissue culture medium. Delayed addition of the mitogen resulted in an enhanced lymphocyte activation measured by incorporation of radioactive precursors of DNA. T cells isolated by rosetting with sheep erythrocytes also exhibited this enhancement. In a limited study, lymphocytes from both atopic patients and those with systemic lupus erythematosus (SLE) showed little or no enhanced responsiveness to Con A. The possibility that some patients with atopy and SLE possess defective suppressor T cells is discussed in the light of these data.

Impaired monocyte cyclic AMP responses and monocyte cytotoxicity in atopic dermatitis

Purified monocytes from 21 patients with mild and severe atopic dermatitis (AD) were compared with 22 healthy controls with respect to antibody-dependent cell-mediated cytotoxicity (ADCC) and cyclic adenosine 3',5'-monophosphate (cAMP) responses to stimulatory agents. ADCC was depressed in both severe and mild atopic dermatitis. The patients showed decreased cAMP responses to isoproterenol and histamine, the decrement being more distinct in severe atopic dermatitis. Formation of cAMP was diminished with PGE1 only in patients with severe AD. ADCC is inhibited by the agents that increase cAMP. In the severe dermatitis group reduced inhibition induced by isoproterenol, histamine, but not PGE1, was obtained. It is suggested that a general suppression of membrane activation may explain the reduced cAMP responses to various stimulatory agents and the impaired monocyte cytotoxicity.

Mast cell histamine, a local mitogen acting via H2-receptors in nearby tissue cells

The tissue mast cell is the major storage site of histamine in the body. The present study is concerned with the effect of one histamine H1- and one histamine H2-receptor antagonist on proliferation in the rat mesentery following drug-induced mast-cell secretion. The H2-receptor antagonist, but not the H1-receptor antagonist, significantly suppressed mast-cell-mediated proliferation in vivo and in organ-cultured mesentery. This finding indicates that mast-cell-histamine is a mitogen acting directly on histamine H2-receptors in surrounding tissue cells.

Reversal by cimetidine of histamine-induced inhibition of true chemotaxis in neutrophil polymorphonuclears

The effects of histamine and cimetidine on neutrophil locomotion were studied in vitro in experimental conditions able to dissociate random from truly directional motility. Histamine 10(-4) mol/l inhibited the true chemotactic response. Cimetidine was able to reverse the histamine-induced inhibition of true chemotaxis. Since histamine-induced inhibition of neutrophil chemotaxis may play a role in allergic patients with repeated infections, and since cimetidine has been shown to enhance cell-mediated immunity in vivo, often impaired in such cases, the use of cimetidine is suggested for the prevention of recurrences in these patients.