Influences of Distress and Alcohol Consumption on the Development of a Delayed-Type Hypersensitivity Skin Test Response

2004 ◽  
Vol 66 (4) ◽  
pp. 614-619 ◽  
Author(s):  
Alison J. Smith ◽  
Ute Vollmer-Conna ◽  
Barbara Bennett ◽  
Ian B. Hickie ◽  
Andrew R. Lloyd
Keyword(s):  
Alcohol Consumption ◽  
Skin Test ◽  
Delayed Type Hypersensitivity ◽  
Test Response ◽  
Hypersensitivity Skin

The effect of homologous blood transfusion on delayed hypersensitivity skin test response has been studied using tetanus and diphtheria toxoids, streptococcus, tuberculin, Proteus, Candida and trichophyton antigens (4). Postoperative skin test response area decreased 57% in transfused patients compared to a 38% decrease in untransfused patients. Since transfused and untransfused patients differed significantly in duration of surgery, preoperative blood hemoglobin and serum albumin, the authors reanalyzed their data with 64 pairs of patients matched for these variables with the same results. The predictive value of delayed hypersensitivity skin testing for sepsis and mortality has not been accepted by all investigators. Brown et al. (5) agree that anergic patients have significantly higher rates of sepsis and mortality than normal responders, however "careful study of the temporal relationship between skin reactions and clinical events in individual patients suggested that these differences were not of value in clinical practice. Abnormal reactions usually followed obvious complications such as sepsis or secondary hemorrhage rather than predicted them. Anergy to skin testing may be related to a circulating serum factor which appears after trauma and causes lymphocyte suppression. There is no proven association of blood transfusion with serum suppressive activity or with anergy. Infectious complications and hospital stay are both significantly related to immunosuppressive serum and anergy. Lymphocyte Subsets Lymphocytes, B cells, T cells, helper cells and suppresser cells drop significantly five days after surgery and the decline is twice as great in the transfused patients compared to the untransfused (6). Helper cell number declines in transfused patients cause the helper/suppresser ratio to decrease significantly despite a significant decline in suppresser cell number. Changes in cell numbers recover somewhat by ten days so the differences between transfused and untransfused patients are no longer statistically significant although cell numbers in transfused patients are still lower than those in untransfused patients. Lymphocyte responses to ConA and PHA decline significantly in transfused groups, remaining below preoperative levels even one year following surgery. Response to ConA and PHA and MLR's in untransfused patients are significantly higher than in transfused patients at 90 days and 45 - 60 days respectively. Significant declines in immunoglobulin G, A and M cells are noted postoperatively in both transfused and untransfused patients. Other authors have not observed consistent changes in lymphocyte subsets in relation to transfusion. Changes in the numbers of lymphocytes in the various subsets in relation to surgery with and without blood transfusions studied in patients tested before and after surgery and in patients tested one week following transfusion alone, surgery alone or both reveal no evidence of suppression of immunity by surgery or blood transfusion (7). Generally surgery is followed by significant decreases in peripheral blood lymphocyte numbers affecting all lymphocyte subsets to some degree. Declines in helper cell numbers are associated with a significant decrease in the helper/suppresser ratio. It is not clear if transfused patients exhibit greater declines in lymphocytes due to the transfusion, due to the operative trauma, or due to pre-existing anemia which caused physicians to transfuse blood.

1995 ◽  
pp. 293-293
Keyword(s):  
Blood Transfusion ◽  
Skin Test ◽  
Lymphocyte Subsets ◽  
Skin Testing ◽  
Cell Number ◽  
Delayed Hypersensitivity ◽  
Helper Cell ◽  
Cell Numbers ◽  
Test Response ◽  
Hypersensitivity Skin

A reliable rat model of the delayed hypersensitivity skin test response

1984 ◽  
Vol 37 (4) ◽  
pp. 264-268 ◽  
Author(s):  
N.V. Christou ◽  
A.F.M. Ing ◽  
D.L. Larson ◽  
J.L. Meakins
Keyword(s):  
Skin Test ◽  
Rat Model ◽  
Delayed Hypersensitivity ◽  
Test Response ◽  
Hypersensitivity Skin

Reliability of tuberculin purified derivative skin testing and delayed-type hypersensitivity skin test anergy in HIV-infected homosexual men, at risk of tuberculosis

AIDS ◽  
1999 ◽  
Vol 13 (13) ◽  
pp. 1784 ◽  
Author(s):  
Jaap J. Maas ◽  
Norbert A. Foudraine ◽  
Peter Th.A. Schellekens ◽  
Marlies E.A.M. Mensen ◽  
Jan Veenstra ◽  
...  
Keyword(s):  
At Risk ◽  
Skin Test ◽  
Skin Testing ◽  
Delayed Type Hypersensitivity ◽  
Homosexual Men ◽  
Hypersensitivity Skin
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