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The absorption of protein through the skin
69
SOCIETY PROCEEDINGS
The Response of Contact Dermatitis Sites to Subsequent Stimulation MAX GROLNICK, M.D., With Specific Wheal-Inducing Atopens. KATHERINE
BOW&IAN,
A.B., AND MATTHEW
WALZER,
M.D.
(Abstract.)
The present study was made to determine whether, in an atopic individual, an area of skin which has been the site of contact dermatitis is more or less responsive to atopen stimulation after the acute dermatitis reaction has subsided. Atopic patients, who were known to be sensitive by patch test to poison ivy and Krameria, were tested with the fluid extract of Krameria or a 5 to 10 per cent paste of poison ivy in lanolin. In all, 47 sites were used, 20 representing reactions to Krameria, 20 to poison ivy, and 7 to both excitants. After an interval of from twentyeight to one hundred and eight days (average forty-eight days), when no visible evidence of any acute process remained, these dermatitis sites were tested by the intracut,aneous method with atopens to which the subjects were sensitive. Ragweed pollen was used in 40 instances, timothy pollen in 3, silk extract in 3, and goat epithelium in 1. The size of the wheal and the intensity of the erythema surrounding it were compared with those produced by testing adjacent normal skin of the subject with the same atopen. The final computation showed that the wheal at the test site was greater than that at the control site in 71.2 per cent of the tests. The converse relationship was found to apply to the intensity of the erythema, namely, that at the control site it was greater than that at the test site in 77.5 per cent of the reactions. Hence, it may be concluded that when an area of skin is stimulated by a specific excitant of the contact type, subsequent testing at this site after the subsidence of the acute reaction, with specific whealinducing atopens, results in wheals which are usually larger than those produced with the same excitant on normal areas of skin, These results are similar to those obtained by Bowman and Walzer, following the restimulation of skin sites which had been the seat of specific wheal reactions.
The Absorption M.D.
of Protein
Through
the Skin.
ABRAHAM
WALZER,
(Abstract.)
The present communication deals with a direct technique for demonstrating the passage of proteins through the skin into the circulation of human beings and of Rhesus monkeys. With this technique the skin was passively and locally sensitized to a protein by the intracutaneous injection of 0.05 cc. of serum obtained from a patient markedly sensitive to this protein. After twenty-four or forty-eight hours, the antigen, which was incorporated in a grease vehicle, was rubbed into the skin in another part of the body. The indication that the protein had pene-
70
THE JOURNAL 0F ALLERGY
trated the skin and had reached the circulation was the development of a wheal at the sensitized site. In several human subjects the average reaction time following the use of antigen suspended in petrolatum was 16.4 minutes, in anhydrous lanolin 17.2 minutes, and in oil of anise 17 minutes. In the Rhesus monkeys, the average reaction times were 11.7 minutes with petrolatum as the vehicle, 9.4 minutes with anhydrous lanolin, and 7.2 minutes with oil of anise. It was also noted that a slight amount of absorption could occur when the antigen was rubbed into the palms where there are no hair follicles or sebaceous glands, but where there are many sweat glands. It may, therefore, be concluded that proteins can gain access into the circulation through the skin. It was also demonstrated that Rhesus monkeys may be used as experimental animals for the performance of investigations on this subject, which are not feasible in man.
The Allergic Reaction of the Passively Locally Sensitized Gall Bladder in the Rhesus Monkey. MATTHEW WALZER, M.D., IRVING GRAY, M.D.,MAx
HARTEN, M.D., AND SAULLIVINGSTON, M.D. (Abstract.)
The allergic reaction of the passively locally sensitized gall bladder The animal, under nembutal anesin the Rhesus monkey was studied. thesia, was subjected to a laparotomy and the gall bladder was exposed. This organ was sensitized by single or multiple subperitoneal injections of 0.03 to 0.1 cc. of human serum containing reagin antibodies for cottonseed in high titer. A cutaneous site on the thigh was also injected with the same serum for purposes of control and comparison. One week later, the monkey, after being starved for the preceding twentyfour hours, was reoperated upon, and the gall bladder was exposed. The allergic reaction of the passively sensitized gall bladder was then induced by the intravenous injection of 0.5 CC. cottonseed extract (0.57 mg. N per cc.). The allergic reaction, which developed within a minute, was characterized by a pearly-gray pallor of the exterior surface of the gall bladder, most pronounced in the region of the sensitized area. The blood vessels on the surface became more pronounced. In some instances, a bulging of the gall bladder wall was noted at the sensitized area and for some distance around it. From three to seven minutes after the intravenous injection of the antigen, the gall bladder was opened longitudinally, and the allergic reaction of the exposed mucous membrane was observed. The mucous membrane in the region of the sensitized area presented marked pinkish pallor, a pronounced smoothness with a loss of the normal granular markings, localized edema, and increased mucous secretion. Histologic study of the gall bladder, in the region of the allergic reaction, revealed marked edema of the laminu prop&a and cellular infiltration, composed chiefly of small round cells, some large mononuclears and occasional eosinophiles.
SOCIETY PROCEEDINGS
The Response of Contact Dermatitis Sites to Subsequent Stimulation MAX GROLNICK, M.D., With Specific Wheal-Inducing Atopens. KATHERINE
BOW&IAN,
A.B., AND MATTHEW
WALZER,
M.D.
(Abstract.)
The present study was made to determine whether, in an atopic individual, an area of skin which has been the site of contact dermatitis is more or less responsive to atopen stimulation after the acute dermatitis reaction has subsided. Atopic patients, who were known to be sensitive by patch test to poison ivy and Krameria, were tested with the fluid extract of Krameria or a 5 to 10 per cent paste of poison ivy in lanolin. In all, 47 sites were used, 20 representing reactions to Krameria, 20 to poison ivy, and 7 to both excitants. After an interval of from twentyeight to one hundred and eight days (average forty-eight days), when no visible evidence of any acute process remained, these dermatitis sites were tested by the intracut,aneous method with atopens to which the subjects were sensitive. Ragweed pollen was used in 40 instances, timothy pollen in 3, silk extract in 3, and goat epithelium in 1. The size of the wheal and the intensity of the erythema surrounding it were compared with those produced by testing adjacent normal skin of the subject with the same atopen. The final computation showed that the wheal at the test site was greater than that at the control site in 71.2 per cent of the tests. The converse relationship was found to apply to the intensity of the erythema, namely, that at the control site it was greater than that at the test site in 77.5 per cent of the reactions. Hence, it may be concluded that when an area of skin is stimulated by a specific excitant of the contact type, subsequent testing at this site after the subsidence of the acute reaction, with specific whealinducing atopens, results in wheals which are usually larger than those produced with the same excitant on normal areas of skin, These results are similar to those obtained by Bowman and Walzer, following the restimulation of skin sites which had been the seat of specific wheal reactions.
The Absorption M.D.
of Protein
Through
the Skin.
ABRAHAM
WALZER,
(Abstract.)
The present communication deals with a direct technique for demonstrating the passage of proteins through the skin into the circulation of human beings and of Rhesus monkeys. With this technique the skin was passively and locally sensitized to a protein by the intracutaneous injection of 0.05 cc. of serum obtained from a patient markedly sensitive to this protein. After twenty-four or forty-eight hours, the antigen, which was incorporated in a grease vehicle, was rubbed into the skin in another part of the body. The indication that the protein had pene-
70
THE JOURNAL 0F ALLERGY
trated the skin and had reached the circulation was the development of a wheal at the sensitized site. In several human subjects the average reaction time following the use of antigen suspended in petrolatum was 16.4 minutes, in anhydrous lanolin 17.2 minutes, and in oil of anise 17 minutes. In the Rhesus monkeys, the average reaction times were 11.7 minutes with petrolatum as the vehicle, 9.4 minutes with anhydrous lanolin, and 7.2 minutes with oil of anise. It was also noted that a slight amount of absorption could occur when the antigen was rubbed into the palms where there are no hair follicles or sebaceous glands, but where there are many sweat glands. It may, therefore, be concluded that proteins can gain access into the circulation through the skin. It was also demonstrated that Rhesus monkeys may be used as experimental animals for the performance of investigations on this subject, which are not feasible in man.
The Allergic Reaction of the Passively Locally Sensitized Gall Bladder in the Rhesus Monkey. MATTHEW WALZER, M.D., IRVING GRAY, M.D.,MAx
HARTEN, M.D., AND SAULLIVINGSTON, M.D. (Abstract.)
The allergic reaction of the passively locally sensitized gall bladder The animal, under nembutal anesin the Rhesus monkey was studied. thesia, was subjected to a laparotomy and the gall bladder was exposed. This organ was sensitized by single or multiple subperitoneal injections of 0.03 to 0.1 cc. of human serum containing reagin antibodies for cottonseed in high titer. A cutaneous site on the thigh was also injected with the same serum for purposes of control and comparison. One week later, the monkey, after being starved for the preceding twentyfour hours, was reoperated upon, and the gall bladder was exposed. The allergic reaction of the passively sensitized gall bladder was then induced by the intravenous injection of 0.5 CC. cottonseed extract (0.57 mg. N per cc.). The allergic reaction, which developed within a minute, was characterized by a pearly-gray pallor of the exterior surface of the gall bladder, most pronounced in the region of the sensitized area. The blood vessels on the surface became more pronounced. In some instances, a bulging of the gall bladder wall was noted at the sensitized area and for some distance around it. From three to seven minutes after the intravenous injection of the antigen, the gall bladder was opened longitudinally, and the allergic reaction of the exposed mucous membrane was observed. The mucous membrane in the region of the sensitized area presented marked pinkish pallor, a pronounced smoothness with a loss of the normal granular markings, localized edema, and increased mucous secretion. Histologic study of the gall bladder, in the region of the allergic reaction, revealed marked edema of the laminu prop&a and cellular infiltration, composed chiefly of small round cells, some large mononuclears and occasional eosinophiles.