Immunotoxicity and allergenic potential induced by topical application of perfluorooctanoic acid (PFOA) in a murine model.

Perfluorooctanoic acid (PFOA) is a per- and polyfluoroalkyl substance (PFAS) once used as a surfactant in the polymerization of chemicals. Because of its ubiquitous nature and long half-life, PFOA is commonly detected in the environment, wildlife, and humans. While skin exposure to PFOA is of concern, studies evaluating the immunotoxicity of dermal exposure are lacking. These studies evaluated the immunotoxicity of PFOA (0.5-2% w/v, or 12.5-50 mg/kg/dose) following dermal exposure using a murine model. PFOA (0.5-2%) was not identified to be an irritant or sensitizer using the local lymph node assay. The IgM antibody response to sheep red blood cell. was significantly reduced in the spleen following 4-days of dermal exposure (2%). PFOA exposure produced a significant decrease in thymus (1 and 2%) and spleen (0.5-2%) weight along with an increase in liver weight (0.5-2%). Immune cell phenotyping identified a reduction in the frequency (1 and 2%) and number (0.5-2%) of splenic B-cells. To further define the mechanism of immunotoxicity, gene expression was also evaluated in the skin. The findings support a potential involvement of the nuclear receptor PPARα. These results demonstrate that dermal exposure to PFOA is immunotoxic and raise concern about potential adverse effects from dermal exposure.

PFOS mediates immunomodulation in an avian cell line that can be mitigated via a virus infection.

BACKGROUND: Per- and polyfluoroalkyl substances (PFASs) are environmentally persistent and bioaccumulative chemicals. Immunomodulation is among the most concerning of toxic effects linked with PFAS exposure in mammalian models. However, no studies had yet shown this to be true in birds. Thus, we designed and conducted the first study to determine if PFASs could cause immunomodulation in birds. Secondly, we wanted to determine the effects on an avian host when exposed not only to immunomodulating chemicals, but also to a viral challenge. The aim, to determine if PFAS mediated immunmodulation functionally affects a pathogen challenge for a host. As innate immune system signalling pathways initiate crucial responses against a pathogen challenge, and are lesser studied than their adaptive counterparts, we focused on these pathways. To provide the first information on this, an in vitro experiment was designed and performed using chicken embryo fibroblasts exposed to perfluorooctane sulfonate (PFOS) (22 ppm) and immune markers characterised before and after being infected with gallid herpesvirus-2 (GaHV-2). RESULTS: The expression of two pro-inflammatory cytokines, namely interleukin 8 (IL-8) and tumor necrosis factor alpha (TNF-α), the nuclear factor 'kappa-light-chain-enhancer' of activated B-cells (NF-κB), and the anti-inflammatory cytokine interleukin 4 (IL-4) were investigated in various scenarios. These results showed that exposure to PFOS decreased immune gene expression in chicken fibroblasts from 36 h post-exposure. Next, it was shown that this decrease could be mitigated by infection with gallid herpesvirus-2, which increased gene expression back to the baseline/control levels. CONCLUSIONS: Not only is this the first study to provide the expected evidence that PFOS has immunomodulatory potential in birds, it also provides unexpected data that virus infections can mitigate this negative effect. Thereby, further research, including in vivo and in situ studies, on the impact of PFOS on host-virus interactions is now warranted, as it has been overlooked and might contribute to our understanding of recent disease outbreaks in wildlife. The mechanisms by which gallid herpesvirus mitigates immunomodulation were beyond the scope of this study, but are now of interest for future study.

Perfluorinated substances, risk factors for multiple sclerosis and cellular immune activation.

Perfluorinated alkylated substances (PFASs) have immunomodulatory effects but the impact on multiple sclerosis (MS) and cellular immune functions is only sparsely described. In the present study, we found lower concentrations of the long chain PFAS perfluorooctane sulfonic acid (PFOS) in MS than in healthy controls (HC). In HC, we did not detect associations between PFOS concentrations and immune phenotypes. Analyzing the impact of known MS risk factors on cellular immune functions, we found that smoking and Epstein-Barr nuclear antigen 1 antibodies were associated with distinct circulating immune cell changes. In summary, current background PFAS exposure is not an important risk factor for MS.

Estimated exposures to perfluorinated compounds in infancy predict attenuated vaccine antibody concentrations at age 5-years.

Perfluorinated alkylate substances (PFASs) are highly persistent and may cause immunotoxic effects. PFAS-associated attenuated antibody responses to childhood vaccines may be affected by PFAS exposures during infancy, where breastfeeding adds to PFAS exposures. Of 490 members of a Faroese birth cohort, 275 and 349 participated in clinical examinations and provided blood samples at ages 18 months and 5 years. PFAS concentrations were measured at birth and at the clinical examinations. Using information on duration of breastfeeding, serum-PFAS concentration profiles during infancy were estimated. As outcomes, serum concentrations of antibodies against tetanus and diphtheria vaccines were determined at age 5. Data from a previous cohort born eight years earlier were available for pooled analyses. Pre-natal exposure showed inverse associations with the antibody concentrations five years later, with decreases by up to about 20% for each two-fold higher exposure, while associations for serum concentrations at ages 18 months and 5 years were weaker. Modeling of serum-PFAS concentration showed levels for age 18 months that were similar to those measured. Concentrations estimated for ages 3 and 6 months showed the strongest inverse associations with antibody concentrations at age 5 years, particularly for tetanus. Joint analyses showed statistically significant decreases in tetanus antibody concentrations by 19-29% at age 5 for each doubling of the PFAS exposure in early infancy. These findings support the notion that the developing adaptive immune system is particularly vulnerable to immunotoxicity during infancy. This vulnerability appears to be the greatest during the first 6 months after birth, where PFAS exposures are affected by breast-feeding.

Immunomodulatory effects of exposure to polychlorinated biphenyls and perfluoroalkyl acids in East Greenland ringed seals (Pusa hispida).

To better elucidate the potential immune-related health effects of exposure to environmentally persistent organic pollutants (POP), such as polychlorinated biphenyls (PCBs) and perfluoroalkyl substances (PFASs), in ringed seals (Pusa hispida), a sentinel Arctic species, we assessed 1) associations between mitogen-induced lymphocyte proliferation and in vivo tissue contaminant burdens, and 2) the concentration-response effects of in vitro exposure to PFASs and PCB congeners on mitogen-induced lymphocyte proliferation. Upon in vitro contaminant exposure, the non-coplanar PCB congeners CB 138, 153, and 180, but not the coplanar CB 169, significantly reduced lymphocyte proliferation between 10 and 20µgg-1 ww. The respective in vitro EC50 values for these congeners were 13.3, 20.7, 20.8, and 54.6µgg-1 ww. No modulation of lymphocyte proliferation was observed upon in vitro exposure to two individual PFASs, perfluorooctane sulphonic acid (PFOS) and perfluorooctanoic acid (PFOA), at concentrations up to 1000ngg-1. In addition, no significant correlations were found between lymphocyte proliferation and any blood or blubber contaminant measured. Taken together, these data suggest this population of ringed seals is not currently at high risk of altered lymphocyte proliferation from exposure to the POPs or PFASs in this study.

Application of a hemolysis assay for analysis of complement activation by perfluorocarbon nanoparticles.

Nanoparticles offer new options for medical diagnosis and therapeutics with their capacity to specifically target cells and tissues with imaging agents and/or drug payloads. The unique physical aspects of nanoparticles present new challenges for this promising technology. Studies indicate that nanoparticles often elicit moderate to severe complement activation. Using human in vitro assays that corroborated the mouse in vivo results we previously presented mechanistic studies that define the pathway and key components involved in modulating complement interactions with several gadolinium-functionalized perfluorocarbon nanoparticles (PFOB). Here we employ a modified in vitro hemolysis-based assay developed in conjunction with the mouse in vivo model to broaden our analysis to include PFOBs of varying size, charge and surface chemistry and examine the variations in nanoparticle-mediated complement activity between individuals. This approach may provide the tools for an in-depth structure-activity relationship study that will guide the eventual development of biocompatible nanoparticles. FROM THE CLINICAL EDITOR: Unique physical aspects of nanoparticles may lead to moderate to severe complement activation in vivo, which represents a challenge to clinical applicability. In order to guide the eventual development of biocompatible nanoparticles, this team of authors report a modified in vitro hemolysis-based assay developed in conjunction with their previously presented mouse model to enable in-depth structure-activity relationship studies.

[Cytotoxicity of PFOB nanoparticle coupled with ICAM-1 antibody on cardiomyocytes and its targeted adhesion to injured cardiomyocytes in vitro].

OBJECTIVE: To synthesize perfluorooctylbromide (PFOB) nanoparticle coupled with intercellular adhesion molecule-1 (ICAM-1) monoclonal antibody, and to investigate the characteristics of the nonoparticle and its cytotoxcity on and targeted adhesion to injured cardiomocytes in vitro. METHODS: PFOB nanoparticle (control group) biotinylated PFOB nanoparticle (experimental group) were coupled with biotinylated ICAM-1 antibody. The combination of ICAM-1 antibody and the nanoparticle was detected by immunofluorescent assay. The cytotoxicity of the nanoparticle on rat cardiomyocytes was determined with MTT assay in vitro. The adhesion of the nanoparticle to normal and TNF-alpha injured cardiomyocytes were observed and semiquantified with optical microscope. RESULTS: ICAM-1 antibody was successfully coupled with biotinylated PFOB nanoparticle at a rate around 95%, which showed green fluorescence under the laser Confocal Scanning Microscope, with (385.3 +/- 88.9) nm in size, - (60.3 +/- 6.11) mV in electric potential, and 7.0 x 10(8)/mL in concentrations. No fluorescence was observed with the nonoparticle in the control group. No cytotoxicity of the nonoparticle on rat cardiomyocytes was found. There was limited adhesion of the nanoparticle in the control group to cardiomyocytes, normal or injured. A 10-fold increase in adhesion was detected when the nanopaticle in the experimental group was exposed to the injured cardiomyocytes compared with those exposed to the normal cardiomyocytes [(5.1 +/- 0.22) vs. (0.5 +/- 0.3) nanopaticle per cell, P < 0.05]. CONCLUSION: ICAM-1 monoclonal antibody is successfully coupled with PFOB nanoparticle, which can effectively bind to the cardiomyocytes overexpressing ICAM-1 without showing ctytotoxicity in vitro.

Immunomodulatory and physical effects of oil composition in vaccine adjuvant emulsions.

Squalene-based oil-in-water emulsions have been used for years in some seasonal and pandemic influenza vaccines. However, concerns have been expressed regarding squalene source and potential biological activities. Little information is available regarding the immunomodulatory activity of squalene in comparison with other metabolizable oils in the context of oil-in-water emulsions formulated with vaccines. The present work describes the manufacture and physical characterization of emulsions composed of different classes of oils, including squalene, long chain triglycerides, a medium chain triglyceride, and a perfluorocarbon, all emulsified with egg phosphatidylcholine. Some differences were apparent among the non-squalene oils in terms of emulsion stability, including higher size polydispersity in the perfluorocarbon emulsion, more rapid visual instability at 60°C for the long-chain triglyceride and perfluorocarbon emulsions, and an increased creaming rate in the medium-chain triglyceride emulsion at 60°C as detected by laser scattering optical profiling. The biological activity of each of these emulsions was compared when formulated with either a recombinant malaria antigen or a split-virus inactivated influenza vaccine. Overall, vaccines containing the squalene emulsion elicited higher antibody titers and more abundant long-lived plasma cells than vaccines containing emulsions based on other oils. Since squalene-based emulsions show higher adjuvant potency compared to the other oils tested, non-squalene oils may be more suitable as carriers of amphiphilic or hydrophobic immunostimulatory molecules (such as TLR agonists) rather than as stand-alone adjuvants.

The effect of prenatal perfluorinated chemicals exposures on pediatric atopy.

BACKGROUND: The role of perfluorinated compounds (PFCs) in the immune system and allergic diseases is not well-known. This study examined the effects of pre-natal exposure to PFCs on immunoglobulin E (IgE) levels and atopic dermatitis (AD). METHODS: In Taiwan Birth Panel cohort study, newborns with cord blood and peri-natal factors (i.e. birth body weight, weeks of gestation, and type of delivery) gathered at birth were evaluated. At the age of 2 years, information on the development of AD, environmental exposures, and serum total IgE were collected. The AD and non-AD children were compared for the concentration of cord blood serum PFCs measured by Ultra-performance liquid chromatography/triple-quadrupole mass (UPLC-MS/MS). Correlations among cord blood IgE, serum total IgE at 2 years of age, and cord blood PFC levels were made. RESULTS: Of 244 children who completed the follow-up and specimen collections, 43 (17.6%) developed AD. Concentrations of cord blood serum perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorononanoic acid (PFNA), and perfluorohexane sulfonic acid (PFHxS) were median (range) 1.71 (0.75-17.40), 5.50 (0.11-48.36), 2.30 (0.38-63.87), and 0.035 (0.035-0.420)ng/mL, respectively. PFOA and PFOS levels positively correlated with cord blood IgE levels (per ln-unit: ß=0.134 KU/l, p=0.047 for PFOA; ß=0.161 KU/l, p=0.017 for PFOS). Analyses stratified by gender revealed that PFOA and PFOS levels positively correlated with cord blood IgE levels only in boys (per ln-unit: ß=0.206 KU/l, p=0.025 for PFOA; ß=0.175 KU/l, p=0.053 for PFOS). When dividing cord blood serum PFCs into quartiles in the fully adjusted models, AD had no significant association with PFOS. CONCLUSIONS: Pre-natal PFOA and PFOS exposures positively correlated with cord blood IgE levels.

[In vitro experimental study of rat cardiomyocyte injury with targeting of perfluorocarbon lipid particles].

The present study was to investigate in vitro the rat cardiomyocyte injury with targeting of home-made perfluorocarbon lipid particles with avidin-biotin interaction. Neonatal rat cardiomyocytes were cultured in vitro and divided into two groups: TNF-alpha activated group and non-activated group. Those in the TNF-alpha activated group were exposed to 200 ng/ml TNF-alpha solution for 6 hours and then cardiomyocytes in both groups were pretargeted with biotinylated ICAM-1 monoclonal antibodies, and were exposed to streptavidin, and then to homemade green fluorescently-labeled biotinylated perfluorocarbon lipid particles. Cardiomyocytes nucleus stained with Hoechst. The results were detected with fluorescence microscope. As a result, in TNF-alpha activated group, around blue fluorescent cardiomyocytes nucleus, a great amount of green fluorescent particles were found, while there were few green fluorescent particles in non-TNF activated group. It has been shown that ICAM-1 is expressed in the surface of cardiomyocytes when they are stimulated by TNF-alpha. Perfluorocarbon lipid particles associated with ICAM-1 monoclonal antibodies can be targeted to injured cardiomyocytes by avidin-biotin interaction.

In vitro evaluation of the immunotoxic potential of perfluorinated compounds (PFCs).

There is evidence from both epidemiology and laboratory studies that perfluorinated compounds may be immunotoxic, affecting both cell-mediated and humoral immunity. The overall goal of this study was to investigate the mechanisms underlying the immunotoxic effects of perfluorooctane sulfonate (PFOS) and perfluorooctane acid (PFOA), using in vitro assays. The release of the pro-inflammatory cytokines IL-6, IL-8, and TNF-α was evaluated in lipolysaccharide (LPS)-stimulated human peripheral blood leukocytes and in the human promyelocytic cell line THP-1, while the release of IL-4, IL-10 and IFN-γ was evaluated in phytohaemagglutinin (PHA)-stimulated peripheral blood leukocytes. PFOA and PFOS suppressed LPS-induced TNF-α production in primary human cultures and THP-1 cells, while IL-8 was suppressed only in THP-1 cells. IL-6 release was decreased only by PFOS. Both PFOA and PFOS decreased T-cell derived, PHA-induced IL-4 and IL-10 release, while IFN-γ release was affected only by PFOS. In all instances, PFOS was more potent than PFOA. Mechanistic investigations carried out in THP-1 cells demonstrated that the effect on cytokine release was pre-transcriptional, as assessed by a reduction in LPS-induced TNF-α mRNA expression. Using siRNA, a role for PPAR-α could be demonstrated for PFOA-induced immunotoxicity, while an inhibitory effect on LPS-induced I-κB degradation could explain the immunomodulatory effect of PFOS. The dissimilar role of PPAR-α in PFOA and PFOS-induced immunotoxicity was consistent with the differing effects observed on LPS-induced MMP-9 release: PFOA, as the PPAR-α agonist fenofibrate, modulated the release, while PFOS had no effect. Overall, these studies suggest that PFCs directly suppress cytokine secretion by immune cells, and that PFOA and PFOS have different mechanisms of action.

Immunotoxicity of perfluorooctanoic acid and perfluorooctane sulfonate and the role of peroxisome proliferator-activated receptor alpha.

Perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) are environmentally widespread and persistent chemicals with multiple toxicities reported in experimental animals and humans. These compounds can trigger biological activity by activating the alpha isotype of peroxisome proliferator-activated receptors (PPARs), ligand-activated transcription factors that regulate gene expression; however, some biological effects may occur independently of the receptor. Activation of the peroxisome proliferator-activated receptor alpha (PPARalpha) modulates lipid and glucose homeostasis, cell proliferation and differentiation, and inflammation. Reported immunomodulation in experimental animals exposed to PFOA and PFOS has included altered inflammatory responses, production of cytokines and other proteins, reduced lymphoid organ weights, and altered antibody synthesis. Mounting experimental animal evidence suggests PPARalpha independence of some immune effects. This evidence originates primarily from studies with PPARalpha knockout models exposed to PFOA that demonstrate hepatic peroxisome proliferation, reduced lymphoid organ weights, and altered antibody synthesis. As human PPARalpha expression is significantly less than that of rodents, potential PPARalpha independence indicates that future research must explore mechanisms of action of these compounds, including PPARalpha-dependent and -independent pathways. This multiauthored review contains brief descriptions of current and recently published work exploring immunomodulation by PFOA and PFOS, as well as a short overview of other PPARalpha ligands of therapeutic and environmental interest.

Perfluorooctanoic acid-induced immunomodulation in adult C57BL/6J or C57BL/6N female mice.

BACKGROUND: Perfluorooctanoic acid (PFOA), an environmentally persistent compound of regulatory concern, has been reported to reduce antibody responses in mice at a single dose. OBJECTIVE: The aim of this study was to evaluate PFOA effects on humoral and cellular immunity using standard assays for assessing immune function, and to derive dose-response data. METHODS: C57BL/6J mice received 0 or 30 mg PFOA/kg/day for 10 days; half of the exposed groups were switched to vehicle and half continued on PFOA for five days. C57BL/6N mice received 0-30 mg/kg/day of PFOA in drinking water for 15 days. Mice were immunized with sheep red blood cells or sensitized to bovine serum albumin in Freund's complete adjuvant on day 10 of exposure; immune responses were determined 1 day post-exposure. RESULTS: We found that 30 mg PFOA/kg/day given for 10 or 15 days reduced IgM synthesis; serum collected 1 day postexposure contained 8.4 x 10(4) or 2.7 x 10(5) ng PFOA/mL, respectively. IgM synthesis was suppressed at exposures > or = 3.75 mg PFOA/kg/day in a dose-dependent manner, and IgG titers were elevated at 3.75 and 7.5 mg PFOA/kg/day. Serum PFOA at 3.75 mg/kg/day was 7.4 x 10(4) ng/mL 1 day postexposure, or 150-fold greater than the levels reported in individuals living near a PFOA production site. Using a second-degree polynomial model, we calculated a benchmark dose of 3 mg/kg/day, with a lower bound (95% confidence limit) of 1.75 mg/kg/day. Cell-mediated function was not affected. CONCLUSIONS: IgM antibodies were suppressed after PFOA exposure. The margin of exposure for reduced IgM antibody synthesis was approximately 150 for highly exposed human populations.

Novel ethanol-in-fluorocarbon microemulsions for topical genetic immunization.

PURPOSE: Traditionally, vaccines have been administered by needle injection. Topical immunization through the intact skin with either protein- or DNA-based vaccines has attracted much attention recently. We sought to enhance the immune responses induced by DNA-based vaccines after topical application by developing novel ethanol-in-fluorocarbon (E/F) microemulsion systems to aid in the delivery of plasmid DNA (pDNA). METHODS: Ten different fluorosurfactants were selected or synthesized and screened by pseudo-phase-diagram construction for their ability to form E/F microemulsions. Plasmid DNA was successfully incorporated into E/F microemulsions using several different fluorosurfactants and perfluorooctyl bromide as the continuous fluorocarbon phase. For several reasons, Zonyl FSN-100 (an ethoxylated nonionic fluorosurfactant) was selected for further studies. In vivo studies were performed in mice to assess pDNA expression in skin and immunologic responses after topical application of this system using a luciferase-encoding plasmid (CMV-luciferase) and a CMV-beta-galactosidase-encoding plasmid, respectively. RESULTS: Plasmid DNA incorporated into E/F microemulsion using FSN-100 as the surfactant was found to be stable. After topical application of this E/F microemulsion system, significant enhancements in luciferase expression and antibody and T-helper type-1 biased immune responses were observed relative to those of "naked" pDNA in saline or ethanol. For example, with the E/F microemulsion system, the specific serum IgG and IgA titers were increased by 45-fold and over 1000-fold, respectively. CONCLUSION: A novel fluorocarbon-based microemulsion system for potential DNA vaccine delivery was developed.

Diminution of phagocytosed perfluorocarbon emulsions using perfluoroalkylated polyethylene glycol surfactant.

Perfluorocarbon emulsions have been considered as potential blood substitutes for years due to their high capacity of dissolving respiratory oxygen and carbon dioxide. However, they have been reported to associate with side effects (e.g., flu-like syndrome) after being injected into animal's bloodstream. The cause of these side effects is related to the phagocytosis of perfluorocarbon emulsions by cells (e.g., macrophages). Inspired by the approach of using polyethylene glycol (PEG) to camouflage liposomes, we synthesized a perfluoroalkylated PEG (R(F)-PEG) surfactant to provide steric hindrance for decreasing phagocytosis of perfluorocarbon emulsions. The R(F)-PEG surfactant along with Pluronic F-68 and egg yolk phospholipid mediated perfluorocarbon emulsions were incubated individually with J774A.1 macrophages to examine the degree of phagocytosis. 19F NMR studies were used to quantitatively determine the amount of perfluorocarbon emulsions phagocytosed by macrophages. Results showed that the degree of phagocytosis was diminished to a large extent for perfluorocarbon microparticles emulsified by the R(F)-PEG surfactant.

Biocompatibility of silicone oil and high-density liquids. An immunologic study.

Silicone oil and high-density liquids can be useful tools in the treatment of complicated retinal detachments. To test whether these substances induce specific and/or unspecific inflammatory responses, we performed immunoassays on 60 rats of two different inbred strains. After sensitization, each rat was injected in the right foot pad with either silicone oil, fluorosilicone oil, perfluorooctane, or perfluoropolyether. Depending on the inbred strain, the volume of the foot pads increased up to the fifth day, indicating an injection-induced inflammatory reaction. Histopathological examination of rats injected with silicone oil showed infiltration by mononuclear cells and occasional giant cells. In rats receiving fluorosilicone oil, additional eosinophilic reactions were observed. The most pronounced reactions occurred after injection of the two perfluorocarbons, which induced a greater number of giant cells and a slight granulomatous reaction. The degree of tissue response was independent of the type of sensitization; the majority of the draining popliteal lymph nodes showed no enlargement. Our findings demonstrate that all substances tested induced inflammatory though unspecific responses.

Perfluorinated analogues of poison ivy allergens. Synthesis and skin tolerogenic activity in mice.

3-(Tridecafluoroundecyl)catechol (8) and 3-(nonafluoropentadecyl)catechol (9), perfluorinated analogues of pentadecylcatechol (PDC), a constituent of poison ivy, have been synthesized. These compounds were nonsensitizers in mice. Compounds 8 and 9, however, were elicitors of allergic contact dermatitis in PDC-sensitized animals. Moreover, compound 9 exhibited tolerogenic properties to sensitization by poison ivy allergens, i.e. mice pretreated with perfluorinated compounds could not be sensitized to PDC.

Biocompatibility studies with a novel perfluorochemical emulsion.

Biocompatibility studies with a novel perfluorochemical (PFC) emulsion have been performed in rats. Injection of the emulsion was followed by changes in lymphoid tissue weights, comparable but not identical to those produced by the commercial formulation, Fluosol-DA 20% (F-DA). Peritoneal injection of either the novel emulsion or F-DA enhanced the humoral immune response to intraperitoneally-injected sheep red blood cells (SRBC) suggesting immunopotentiating properties of emulsion components.

Anaphylactoid reactions induced by fluorocarbon blood substitute.

The potential mechanism of fluorocarbon emulsion (FCE)-induced anaphylactoid reactions characterized by transient flush and respiratory disturbance in a few patients were elucidated by detecting the immunological response and the blood vessel vasoactive amine content. The passive cutaneous anaphylaxis (PCA) test in rats immunized with FCE was negative. The precipitating FCE reaction antibody (FRA) in sera of rabbits at 20 min and 24 h after i.v. infusion of FCE 10 ml/kg by reversible single radioactive immunodiffusion (RSRI) was positive, the densities of FRA were negatively related to the dilution of FCE (24 h, r = -0.9998). Histamine and 5-hydroxytryptamine (5-HT) content in peripheral blood of rabbits using fluorochromatography were decreased by 79% and 92% respectively at 10 min after i.v. infusion of FCE 10 ml/kg. Platelet counts fell to 67%, WBC to 47% and the ratio of polymorphonuclear cells and lymphocytes (P/L) was depressed by as much as half of that before infusion. Small arterioles of lungs were filled with macrophages. These results indicated that the mechanisms of FCE-induced anaphylactoid reactions did not involve IgE-dependent mediator release (histamine and 5-HT), but was associated with FCE-FRA complex formation and macrophage-stasis in pulmonary vessels.