Studies on the mechanisms of delayed type hypersensitivity and anergy.

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1.Leukocyte procoagulant activity (LPCA) was studied in order to determine the clinical usefulness of evaluating cell-mediated immunity in vitro and also clarify what the effector mechanims were.LPCA was stimulated by purified protein derivative(PPD) and varicella virus antigen(VVA) specifically and seemed to be a useful assay method for evaluating the delayed-type hypersensitivity(DTH) in vitro. Concerning the effector mechanisms of LPCA,LPCA of T cells stimulated by PPD decreased significantly compared to the LPCA of peripheral mononuclear cells. On the other hand,a significant increase of LPCA by VVA was found in both the T cells and the monocytes.It is suggested that PPD and VVA have different pathways as efferctor mechanisms.2.DTH and LPCA were studied clinically on measles,mycoplasma pneumoniae,streptococcosis and Kawasaki disease.LPCA by PPD was decreased in both measles and mycoplasma pneumoniae. LPCA by VVA was decreased significantly in mycoplasma pneumoniae,but not in measles. It is suggested that the mechanisms of anergy in measles and mycoplasma pneumoniae are different. LPCA by PPD was also decreased in Kawasaki disease.3.As for Kawasaki disease,the production of active oxygen of neutrophils was measured by chemiluminescence(CL). The generation of active oxygen was significantly increased on admission in all patients compared with those in healthy controls.The CL of the patients with coronary lesions had higher production than in the patients without coronary lesions. These significant increase in generation of active oxygen could be found before the detection of coronary lesions by echocardiography. Thus the measurement of neutrophils CL is useful for predicting the formation of coronary lesions in Kawasaki disease. Further studies are necessary to clarify the relationship between the inflammation and DTH.