Photoimmunology

I. Principles of Photoimmunology.- 1. Basic Concepts in Photobiology.- 1.1 Introduction.- 1.2 Absorption of Electromagnetic Radiation and Characterization of Excited-State Molecules.- 1.2.1 Electronic States of Molecules.- 1.2.2 Electromagnetic Radiation.- 1.2.3 Absorption of Electromagnetic Radiation.- 1.3 Reactions of Excited-State Molecules to Form Photoproducts.- 1.3.1 Alternative Processes Available to Excited-State Molecules.- 1.3.2 Types of Photochemical Reactions.- 1.4 The Relationship between Photoproducts and Biochemical and Cellular Changes.- 1.5 References.- 2. Photosensitization in Mammalian Cells.- 2.1 Introduction.- 2.2 Fundamental Aspects of Photosensitized Reactions at the Biomolecular Level.- 2.2.1 Introduction.- 2.2.2 Mechanisms Involved in Photosensitized Reactions in Biologic Systems.- 2.2.3 The Alteration of Biomolecules in Vitro by Photosensitization.- 2.3 Sensitized Photoreactions in Model Cell Systems.- 2.3.1 Introduction.- 2.3.2 Sensitizers Bound to Biologic Macromolecules.- 2.3.3 Aqueous Micellar Systems.- 2.3.4 Liposome Systems.- 2.4 Photosensitization Processes in Mammalian Cells.- 2.4.1 Introduction.- 2.4.2 Effects Mediated by Culture Medium Components and by Endogenous Sensitizers.- 2.4.3 Sensitizer Penetration and Subcellular Localization.- 2.4.4 The Kinetics of Cell Killing.- 2.4.5 Membrane Effects.- 2.4.6 Cytoplasmic Effects.- 2.4.7 Nuclear Effects.- 2.4.8 Immunologic Effects.- 2.4.9 Anaerobic Photosensitized Reactions.- 2.4.10 DNA Damage, Mutation, Transformation, and Carcinogenesis Induced by Photosensitization.- 2.5 References.- 3. Experimental Techniques in Photoimmunology.- 3.1 Introduction.- 3.2 Terminology.- 3.3 Sources of Nonionizing Radiation.- 3.3.1 Germicidal Lamps.- 3.3.2 Fluorescent Lamps.- 3.3.3 Xenon Arc Lamps.- 3.3.4 Other Radiation Sources.- 3.4 Spectral Filtering of Sources.- 3.5 Radiometry.- 3.5.1 Types of Radiometric Instruments.- 3.5.2 Factors of Measurement.- 3.6 References.- 4. Tissue Optics and Photoimmunology.- 4.1 Introduction.- 4.2 The Stratum Corneum and Epidermis.- 4.2.1 Structural Considerations.- 4.2.2 Scattering.- 4.2.3 Absorption.- 4.3 The Dermis.- 4.3.1 Structural Considerations.- 4.3.2 Scattering.- 4.3.3 Absorption and Optical Penetration.- 4.4 Summary and Conclusion.- 4.5 References.- 5. Acute Effects of Ultraviolet Radiation upon the Skin.- 5.1 Introduction.- 5.2 Erythema.- 5.2.1 Introduction.- 5.2.2 Time Course.- 5.2.3 Factors Influencing the Development of Erythema.- 5.2.4 Solar Erythemogenesis.- 5.3 Pathogenesis of UV-Radiation-Induced Erythema.- 5.4 Histopathologic Changes Associated with UV-Radiation-Induced Erythema.- 5.5 Pigmentation.- 5.5.1 Immediate Tanning.- 5.5.2 Delayed Tanning.- 5.6 Changes in the Kinetics of Epidermal Cells.- 5.7 References.- 6. SALT: Skin-Associated Lymphoid Tissues.- 6.1 Introduction.- 6.2 Skin as a Microenvironment for Antigen Presentation.- 6.3 Affinity between T Lymphocyte Subsets and the Skin.- 6.3.1 Preferential Migration of Malignant T Cells to Skin.- 6.3.2 Immunocompetent T Cells in Normal Skin.- 6.3.3 Immunocompetent T Cells in Benign Inflammatory States.- 6.3.4 Factors That Influence Localization of T Lymphocytes within Specific Tissues.- 6.4 Integration of Peripheral Lymph Nodes with T Lymphocytes and the Skin.- 6.5 Consideration of the Mechanisms Whereby Cells Become Skin-Specific.- 6.5.1 Relative Importance of Microenvironment in Which Proliferation Takes Place.- 6.5.2 Potential Contributions of Factors Released by and/or Expressed on the Surface of Keratinocytes That Influence the Migration-Localization of T Cells.- 6.6 A Comparison of SALT and GALT.- 6.7 The Nature and Biologic Meaning of SALT.- 6.8 References.- 7. Factors That Influence Photocarcinogenesis.- 7.1 Introduction.- 7.2 Radiation.- 7.2.1 Amount.- 7.2.2 Type (Quality) of UV Radiation.- 7.3 The Influence of the Animal Model on Tumor Response.- 7.3.1 Anatomic Differences.- 7.3.2 Differences in Tumor Response in the Absence of Anatomic Dissimilarity.- 7.3.3 Effects of Age.- 7.3.4 Indirect Effects.- 7.4 The Environment.- 7.4.1 The Chemical Environment.- 7.4.2 The Physical Environment.- 7.5 Conclusion.- 7.6 References.- II. Experimental Photoimmunology.- 8. Immunobiology of UV-Radiation-Induced Skin Cancer.- 8.1 Experimental Studies in Mice.- 8.2 Tumor Antigens.- 8.2.1 General Considerations.- 8.2.2 Antigens of UV-Radiation-Induced Tumors.- 8.2.3 Comparisons with Other Tumors.- 8.3 Significance of the Experimental Studies.- 8.4 Studies on Human Skin Cancer.- 8.5 Summary.- 8.6 References.- 9. Effects of UV Radiation on Immune Responses in Animals.- 9.1 Introduction.- 9.2 Mechanisms of Contact Hypersensitivity.- 9.2.1 Background.- 9.2.2 Contact Hypersensitivity as a Cell-Mediated Immune Response.- 9.2.3 Role of Antigen-Presenting Cells in Contact Hypersensitivity.- 9.3 Effects of UV Radiation on the Contact Hypersensitivity Reaction.- 9.3.1 Elicitation of Contact Hypersensitivity in UV-Irradiated Skin.- 9.3.2 Induction of Contact Hypersensitivity through UV-Irradiated Skin.- 9.3.3 Systemic Suppression of Contact Hypersensitivity by UV Radiation.- 9.3.4 Mechanisms.- 9.4 Effects of UV Radiation on Other Immune Responses.- 9.4.1 Allogeneic Reactions.- 9.4.2 Other Antigens.- 9.5 Significance of the Experimental Studies.- 9.6 References.- 10. Effects of UV Radiation on Immune Reactions in Humans.- 10.1 lntroduction.- 10.2 In Vivo Immune Responses.- 10.3 Effects of UV Radiation on Lymphocytes.- 10.4 In Vitro Exposure of Lymphocytes to UV Radiation.- 10.5 Significance.- 10.6 References.- III. Clinical Photoimmunology.- 11. Solar Urticaria.- 11.1 Introduction.- 11.2 Etiology.- 11.3 Clinical Features.- 11.4 Diagnosis.- 11.5 Prognosis.- 11.6 Treatment.- 11.7 Pathogenesis.- 11.7.1 Photobiologic Aspects.- 11.7.2 Immunologic Aspects.- 11.7.3 Other Factors.- 11.8 Conclusions.- 11.9 References.- 12. Photoallergy.- 12.1 Introduction.- 12.2 History.- 12.3 Photoallergic Chemicals.- 12.4 Incidence.- 12.5 Clinical Features.- 12.5.1 Photopatch Testing.- 12.5.2 Contact and Systemic Photoallergy.- 12.5.3 Persistent Light Reactor.- 12.6 Pathogenesis.- 12.6.1 Experimental Models.- 12.6.2 Photobiologic Aspects.- 12.6.3 Photochemical Aspects.- 12.6.4 Immunologic Aspects.- 12.7 Conclusions.- 12.8 References.- 13. Autoimmune Disease.- 13.1 Introduction.- 13.2 Lupus Erythematosus.- 13.2.1 Clinical Findings.- 13.2.2 Laboratory Abnormalities.- 13.2.3 Histology and Immunopathology of the Skin.- 13.2.4 Photobiologic Studies.- 13.2.5 Pathogenesis.- 13.2.6 Conclusions.- 13.3 Pemphigus and Bullous Pemphigoid.- 13.3.1 Pemphigus.- 13.3.2 Bullous Pemphigoid.- 13.4 References.- 14. Other Photodermatoses.- 14.1 Introduction.- 14.2 Polymorphic Light Eruption.- 14.3 Actinic Reticuloid-Photosensitive Eczema.- 14.4 References.- 15. Phototherapy and Photochemotherapy.- 15.1 Introduction.- 15.2 Treatment Regimens.- 15.2.1 Goeckerman Regimen.- 15.2.2 UVB Phototherapy.- 15.2.3 PWA Therapy.- 15.3 Clinical Applications.- 15.4 Immunologic Effects.- 15.4.1 Lymphocytes.- 15.4.2 Delayed Hypersensitivity Responses.- 15.4.3 Other Immunologic Functions.- 15.5 Clinical Effects of Immune Alterations.- 15.5.1 Skin Cancer.- 15.5.2 Systemic Lupus Erythematosus.- 15.5.3 Bullous Pemphigoid.- 15.6 Mechanisms.- 15.7 Conclusions.- 15.8 References.