Comparisons of inflammatory responses in IgE-mediated and codeine-induced skin reactions

Abstract

The allergic inflammatory cell response has been shown to be an important component in allergic rhinitis and some skin disorders.‘* ’ Using skin chamber and skin biopsy approaches we have found that: (1) gross late-phase reactions (LPRs) occur commonly in the sites of immediate IgE-mediated skin reactions; and (2) continued antigen challenge induces a prominent local accumulation of granulocytes during the next several hours when LPRs are developing.3 Because such LPRs to antigen challenge are practically always preceded by prominent immediate wheal and flare, it is believed that the pathogenesis of LPRs depends on prior mast cell activation. However, LPRs occur very infrequently in the sites of previous immediate wheal and flare reactions to codeine,4 even though we have recently observed very prominent release of histamine into overlying skin chambers during the first hour of codeine challenge.5 To enhance our understanding of the reasons for the different patterns of gross human skin responses to codeine and antigens we obtained biopsy specimens 6 hours after intradermal injection of antigen and codeine to compare inflammatory cell responses during developing LPRs .