Further Studies on Heterophilic Antibodies in Serum Sickness

[摘要] 1. 1. Eighty-three patients were treated with normal horse serum or horse immune sera. Twenty-seven had agglutinins for sheep cells before the treatment. Of the fifty-six remaining, all but five developed agglutinins for sheep red blood cells in titers from 1:4 upward. The five negative cases were apparently tested too early or too late following treatment. Many of the cases showed a very marked increase of their sheep hemolysin titer. In a control series of 810 normal cases 9 per cent agglutinated sheep red cells in a dilution of 1:4, and the highest titer for the hemolysin for sheep cells was 1:128 in a very small number of cases (six of 381), the highest titer in most sera being 1:16.2. 2. All forty-five patients who developed serum sickness showed agglutinins and many a very high hemolysin for sheep blood. The agglutinins were present at the onset of the disease whenever the blood was then obtained. In a series of 6 cases, they appeared in each of them before the onset of the initial symptoms, the intervals being six hours to eight days.3. 3. The average titers for the agglutinins and hemolysins were very much higher in the cases who have had serum sickness than in those who did not have it. The difference is so marked that a hemolysin titer of 1:128 or higher and an agglutinin titer of 1:32 or higher is suggestive of serum sickness in a more or less recent past.4. 4. Of ten patients who developed an immediate or accelerated reaction, eight had agglutinins before the injection of the serum, and the two remaining showed them three days after the injection.5. 5. The incidence of immediate or accelerated reactions was 30 per cent among patients with agglutinins before the injections of the horse sera, and only 5 per cent among those without agglutinins before the injection.6. 6. Three out of four patients, who reacted with a late local reaction, had agglutinins demonstrable in a dilution 1:4 before the injection.7. 7. Only one of the patients responding with an immediate or accelerated reaction, and none of those responding with local reactions developed serum sickness.8. 8. There seems to be a relation between the pre-existence of agglutinins for sheep cells before the injections of horse sera and the type of reaction. The rôle of the agglutinins may be merely that of an indicator of some changes predisposing for such type of reactions.9. 9. Agglutinins for ox blood are normally present in a relatively high percentage of cases, and when absent they frequently appeared in immunized patients after the onset of serum sickness. Agglutinins for guinea pig red cells are present in a very large number of normal sera, and almost all sera agglutinate rabbit blood cells. This gives the agglutinins for sheep blood a unique significance.

[学科分类] 生物科学（综合）