Type Iv Skin Test Reaction in Mustard Gas Exposed Patients



Vossoughi AA¹ ; Baghaei AM² ; Esmaeeli A² Show Affiliations
Source: Iranian Journal of Medical Sciences Published:2000

Abstract

Background: Mustard gas was the most common chemical warfare agent used by Iraq against Iranian fighters during the war between the two countries (1980-1988). Immunosuppressive effects of nitrogen mustard have been reported by some investigators. Objective: To evaluate the effect of nitrogen mustard gas on the cell mediated immunity (CMI). Methods: In a historical cohort study, type IV skin reaction as an index of CMI was studied in 30 patients who had been exposed to nitrogen mustard gas. Results were compared with those of 30 healthy volunteers as a control group. Diameters of reaction (induration) to applied antigens including tetanus plus diphteria (T.D.), toxoid antigens and candida albicans (CA) antigen were recorded 24 and 48 hours after intradermal injection. The mean diameter of two reactions was considered the final number. Results: The mean diameters of induration to CA antigen in exposed and unexposed subjects were 9.4±3.17 mm and 15.16±2.64 mm, respectively (p<0.01). These numbers for T.D. antigen were 8.8.±4.92 mm and 15.33±6.25 mm respectively (p < 0.01). Negative response (< 5 mm) was observed in 9 mustard gas exposed patients but not in any volunteer of the unexposed group. Conclusion: Significant decrease in the type IV skin reaction in patients exposed to nitrogen mustard gas indicated that the cellular immune response in this group is impaired. More studies are needed to identify the site of action of this agent on cell mediated immune response.