By Peter J Frosch

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Notably, in ongoing ACD reactions, the production of chemokines attracting lymphocytes and monocy- tes/macrophages, in addition to the production of cytokines, adds to the nonspecific recruitment and activation of leucocytes [60, 217, 218]. Thus, like the very early events in the effector phase reaction, the final response to a contact allergen is antigen-nonspecific. It is therefore not surprising that allergic and irritant reactions are histologically alike. 3 Early Phase Reactivity The role of an antibody-mediated early phase reaction in the development of ACD is still unclear in humans, although Askenase and his colleagues have generated robust data to support this view in murine models [219–222].

Along with their migration and settling within the draining lymph nodes, haptenized LC further mature, as char- acterized by their increased expression of costimulatory and antigen-presentation molecules [69, 70]. In addition, they adopt a strongly veiled, interdigitating appearance, thus maximizing the chances of productive encounters with naive T lymphocytes, recognizing altered self [48, 71, 72]. Core Message í Professional antigen-presenting cells of the epidermis, called Langerhans cells, take up penetrated allergens and present them in the context of MHC molecules.

Certainly, pro-inflammatory effects of contact allergens increase, in many ways, the chance of allergen-specific T-cells meeting their targets. , keratinocytes and LC, are thought to represent major sources of pivotal mediators such as IL-1β and TNF-α [46, 209]. First, as described in Sect. 3,“Hapten-Induced Activation of Allergen-Presenting Cells”, these cytokines cause hapten-bearing LC to mature and migrate towards the dermis [34, 48]. But, these cytokines also cause (over)expression of adhesion molecules on dermal postcapillary endothelial cells, and loosen intercellular junctions.

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