Abstract
The purpose of this study was to clarify the etiological role of immune responses in tonsillar lymphocytes of the patients with pustulosis palmaris et plantaris (PPP). In order to determine their immune response to S. pyogenes T4, S. pyogenes T12, S mitis, S. salivarius, S. sanguis I, S. sanguis II and S. pneumoniae, tonsillar lymphocytes from patients with PPP, CT, and sleep apnea syndrome (control) were cultured with formalinized streptococcal cellular antigens. Blastoid transformation was investigated by [3H] -thymidine uptake, while antistreptococcal antibody production were measured by an enzyme-linked immunosorbent assay (ELISA). The results were as follows. 1. Tonsillar lymphocytes from PPP patients underwent blastoid transformation and accelerated the production of immunoglobulin G following the addition of S. sanguis I, S. sanguis II S. mitis, S. pyogenes T4, and S. pyogenes T12, while those form CT patients and controls did so only with S. pyogenes T4 and S. pyogenes T12. 2. The spontaneous production of specific IgG against various streptococci, including S. sanguis I, S. sanguis II and S. mitis by tonsillar lymphocytes from patients with PPP was already higher than that from CT patients and controls. The specific IgM production was also increased above that in PPP patients without any antigens. 3. S. sanguis I, S. sanguis II and S. salivarius antigens stimulated antigen-specific IgM production in tonsillar lymphocytes from PPP patients. 4. The levels of specific IgG production against S. sanguis I and S. sanguis II by tonsillar lymphocytes from PPP patients showed a relationship with the serum levels of the PPP patients. These results suggested that the sensitization of alpha-streptococci, especially S. sanguis, in the tonsillar lacunae may lead to the specific production of anti-S. sanguis antibodies in patients with PPP, and these may be involved in the pathogenesis of PPP.
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