Summary
A constant and characteristic feature of Behçet's syndrome was the association of macrophages with degenerated prickle cells in the prickle-cell layer of the oral mucosa adjacent to ulcerations. Three types of macrophages could be identified: Thetype I macrophage, rich in cytoplasmic organelles, phagocytosed material from degenerated cells. Thetype II macrophages with scant endoplasmic reticulum came in contact with small lymphocytes which they gave immunological information, inducing them to undergo blastoid transformation. These lymphoblasts produced immunoglobulins. Lymphoid cells that contained numerous ribosomes and polysomes were attached to the prickle cells and probably elaborated a cytotoxic factor, since the cytoplasm of the prickle cells ultimately degenerated and the ulcer expanded. The cytoplasm of prickle cells apparently acts as an auto-antigen. Immune responses against it are mediated by the macrophages and the lymphoid cells. The changes seen are consistent with those of delayed hypersensitivity reactions.Type III macrophages had Birbeck granules and were regarded as Langerhans cells. Thymus-dependenttype III macrophages may have an important role in developing and controlling the ulceration in Behçet's syndrome. The involvement of lysosomes in initiating the ulceration is discussed.
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A preliminary report was given at the 6th Asian-Pacific Dental Congress in Bangkok, Thailand. September 18–21, 1970.
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Saito, T., Honma, T., Sato, T. et al. Auto-immune mechanisms as a probable aetiology of Behçet's syndrome, an electron microscopic study of the oral mucosa. Virchows Arch. Abt. A Path. Anat. 353, 261–272 (1971). https://doi.org/10.1007/BF00545734
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DOI: https://doi.org/10.1007/BF00545734