Abstract
Hidradenitis suppurativa (HS) affects the apocrine sweat glands, giving chronic recurrent abscesses of axillary and perineal areas. We report a patient who had a defect in polymorphonuclear leukocyte killing of bacteria associated with low levels of intracellular cyclic GMP. This defect was corrected with a cholinergic agonistin vitro. Treatment of the patient with a cholinergic agonist, bethanechol chloride, resulted in prolonged clinical improvement, normal bactericidal function, and normal levels of intracellular cyclic GMP. The possible mechanisms responsible for the bactericidal defect and for the patient's improvement are discussed.
This is a preview of subscription content, log in via an institution to check access.
References
Hurley HJ: Apocrine glands.In Dermatology in General Medicine, TB Fitzpatrick (ed). New York, McGraw-Hill, 1979, pp 480–483
Abdou NI, Napombejara C, Sagawa A, Watanabe I, Stechschulte DJ, Lindsey N, Allen M: Malakoplakia: Evidence for monocyte lysosomal abnormality correctable by cholinergic agonist in vitro and in vivo. N Engl J Med 297:1413–1419, 1977
Jondal M, Holm G, Wigzell H: Surface markers on human T and B lymphocytes. I. A large population of lymphocytes forming non-immune rosettes with sheep red blood cells. J Exp Med 136:207–215, 1972
Abrahamsohn I, Nilsson UR, Abdou NI: Relationship of immunoglobulin to complement receptors of human B cells. J Immunol 112:1931–1938, 1974
Abdou NI, Lisak RP, Zweiman B, Abrahamsohn I, Penn AS: The thymus in myasthenia gravis: evidence for altered cell populations. N Engl J Med 291:1271–1275, 1974
Gilman AG: A protein binding assay for adenosine 3′5′ cyclic monophosphate. Proc Natl Acad Sci USA 67:305–309, 1970
Oliver JM, Zurier RB: Correction of characteristic abnormalities of microtubule function and granule morphology in Chediak-Higashi syndrome with cholinergic agonists; Studies in vitro and in vivo in the beige mouse. J Clin Invest 57:1239–1247, 1976
Boxer LA, Rister M, Allen JM, Baehner RL: Improvement of Chediak-Higashi leukocyte function by cyclic guanosine monophosphate. Blood 49:9–17, 1977
Babior BM: Oxygen-dependent microbial killing of phagocytes. N Engl J Med 298:659–668, 1978
Zurier RB, Weissermann G, Hoffstein S, Kammerman S, Tai HH: Mechanisms of lysosomal enzyme release from human leukocytes. II. Effects of cAMP and cGMP, autonomic agonists and agents which affect microtubule function. J Clin Invest 53:297–309, 1974
Gallin JI, Elin RJ, Hubert RT, Fauci AS, Kaliner MA, Wolff SM: Efficacy of ascorbic acid in Chediak-Higashi Syndrome (CHS): Studies in humans and mice. Blood 53:226–234, 1979
Gardner JD, Ousley M, Godfrey W, Lindsey NJ, Abdou NI: Mycobacterium fortuitum infection. Evidence for bactericidal defect due to hyperactive antigen specific suppressor cells. Correction in vitro and in vivo by cholinergic agonist and indomethacin. Am J Med (in press), 1982
Boxer LA, Watanabe AM, Rister M, Besch HR, Allen J, Baehner RL: Correction of leukocyte function in Chediak-Higashi syndrome by ascorbate. N Engl J Med 295:1041–1045, 1976
Oliver JM: Impaired microtuble function correctable by cyclic GMP and cholinergic agonists in the Chediak-Higashi syndrome. Am J Pathol 85:395–418, 1976
Frankel FR, Tucker RW, Bruce J, Stenberg R: Fibroblasts and macrophages of mice with the Chediak-Higashi-like syndrome have microtubules and actin cables. J Cell Biol 79:401–408, 1978
Touw J, Stoner GJ, Belehu A: Effect of mycobacterium leprae on lymphocyte proliferation: suppression of mitogen and antigen responses of human peripheral blood mononuclear cells. Clin Exp Immunol 41:397–402, 1980
Fischer A, Durandy A, Griscelli C: Prostaglandin E2-mediated monocyte suppressive activity—Role in immunoregulatory disorders.In Primary Immunodeficiencies, M Seligmann, WH Hitzig (eds). New York, Elsevier North-Holland, 1980, pp 363–372
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ginder, P.A., Ousley, M., Hinthorn, D. et al. Hidradenitis suppurativa: Evidence for a bactericidal defect correctable by cholinergic agonistin vitro andin vivo . J Clin Immunol 2, 237–241 (1982). https://doi.org/10.1007/BF00915227
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00915227