Experimental bullous pemphigoid in guinea pigs: the role of pemphigoid antibodies, complement, and migrating cells.

Dermal-epidermal separation (DES) could be produced in vivo, 6 h after the injection of sera taken from patients with bullous pemphigoid into the dorsal skin of Hartley guinea pigs. DES did not occur when antihuman IgG rabbit serum was injected prior to the injection of the sera taken from patients with bullous pemphigoid. When IgG fraction from the patient's sera was injected, DES was also observed. Histologic findings in the skin specimens in vivo with concentrated sera or IgG fraction have shown DES, some cell infiltrations of neutrophils, eosinophils, and some lymphocytes similar to the skin lesions of bullous pemphigoid patients. Various reagents, such as colchicine, cytochalasin B, EDTA, and steroid were injected prior to the IgG fraction injection. DES and the migration of polymorphonuclear (PMN) leukocytes were inhibited by the preinjection of these reagents. These observations suggest that the migration of PMN leukocytes was necessary for the formation of DES. When IgG fraction was injected into C3-inactivated guinea pigs with cobra venom factor, DES was inhibited, whereas DES was not completely inhibited when IgG fraction was injected into C4-deficient guinea pigs. These results suggested that an alternative pathway may be necessary for DES.