LATERALIZATION OF CUTANEOUS INFLAMMATORY RESPONSES IN PATIENTS WITH UNILATERAL PARESIS AFTER POLIOMYELITIS

Unilateral paresis remaining after poliomyelitis may affect the expres sion of inflammatory diseases by lateralization of the disease manifes tations. The purpose of this study was to assess the impact of the uni lateral paresis after poliomyelitis on lateralization of neurogenic in flammation and immune responsiveness. The delayed-type hypersensitivit y (DTH) reaction to tuberculin was used as an in vivo measure of antig en-specific T lymphocyte reactivity. Assessment of axon reflex vasodil atation was simultaneously employed to test for neurogenic inflammatio n. Fourteen of the 16 polio patients displayed a positive DTH reaction to tuberculin. All but two showed weaker DTH reaction on the paretic- compared to the contralateral-side (P = 0.001). Magnitude of electric ally evoked axon reflexes significantly correlated to asymmetries of D TH responses. We conclude that damage of lower motor neuron leads to i psilateral down-regulation of T cell-mediated cutaneous inflammation. This lateralization of DTH responses is related to deficiencies in mot or and sympathetic innervation of the paretic extremity.