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SKIN REACTIONS OF PATIENTS AND NORMAL INDIVIDUALS TO PROTEIN EXTRACTS OF STREPTOCOCCI.

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SKIN REACTIONS OF PATIENTS AND NORMAL INDIVIDUALS TO PROTEIN EXTRACTS OF STREPTOCOCCI.

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1. The incidence of pneumococcidal power of the whole defibrinated blood in human beings has been shown to vary with age. The age distribution of other type-specific antibodies varies similarly, insofar as they are frequent enough to be compared or technically demonstrable. 2. The incidence of pneumococcidal power of the whole defibrinated blood for Type I, Type II, and Type III differs. Type I is the rarest, Type II is the most frequent, and Type III is of intermediate frequency. The type-specific antibodies responsible for the other tests employed show a similar relative frequency in regard to Types I and II, but some variation in regard to Type III. 3. The skin reactions to the acetic acid-predpitable proteins and autolysates of the pneumococci are negative or rarely positive in infants, infrequently positive in childhood, and positive in a high percentage of adults.
Article
1. Skin reactions to the nucleoprotein of streptococcus seem to indicate a somewhat nonspecific allergic state of the individuals tested with this substance which seems to be common at least to various streptococci, and are not an indication of a specific relationship with certain streptococci. The fact that the allergy to the N.P. runs parallel to the immunity to the essential toxin is due to the structure of Streptococcus scarlatinae of which the N.P. and the essential toxin are the two components. But that both are not necessarily parallel to each other seems to depend upon the fact that nucloproteins are widely common to various sorts of streptococci while only a limited variety of streptococci can produce essential toxin and that the rapidity of development of immunity to the essential toxin and of allergy to the N.P. does not run parallel to each other. 2. An explanation of many data reported by various authors on the Dick test contrary to the Dicks' theory may be found in the fact that the ordinary Dick toxin (culture filtrate) in addition to the essential toxin contains N.P. which is also capable of evoking allergic reactions on human skins. The culture filtrate which contains a considerable amount of N.P. seems to have given results inconsistent with the toxin-antitoxin theory. 3. For the standardization of the Dick toxin for the Dick test it is not sufficient to determine its skin units, but the nucleoprotein content of it must be considered. In this respect, the Washington standard toxin was very satisfactory, but the use of the purified toxin free fron N.P. is most reasonable. 4. In order to determine skin units of ordinary culture filtrate very young children with strongly positive reaction to the scarlatinal toxin are preferred, as they scarcely have a positive reaction to the nucleoproteins. If we utilize weak positive reactors and place the importance on the percentage of positive reactors, this will likely lead us into error, owing to the positive reactions to the N.P. 5. The divergence of the results reported by many authors on the age distribution of positive reactors seems to depend upon the different content of nucleoproteins in the filtrate used.
Article
There are those who believe that the specific poison of Streptococcus scarlatinae, though thermostable, is a soluble toxin comparable to that of diphtheria, and there are others who hold that it is endotoxic in nature (especially Duval and Hibbard); correspondingly, there is a conflict of opinion as to the nature of Dick reaction. According to the prevalent opinion, the Dick test indicates the presence or absence of antitoxin to the scarlatinal toxin, but there are also a few who still believe in the allergic nature of Dick reaction (v. Gröer, Dochez, Cooke, Bristol etc.). In examining the purification and concentration of the Dick toxin, we have recently succeeded in isolating two substances with which skin reactions can be elicited in human beings. The first seems to be bacterial protein, which may be considered as the so-called nucleoprotein and the second as the essential specific toxin which is heat-labile and exotoxic in nature.
The subject of bacterial allergy in its relation to certain phenomena of infectious diseases has assumed increasing importance in recent years. In our studies of rheumatic fever the view that such an allergy has an important bearing in the pathogenesis of the disease has become more and more prominent. Several years ago one of us1 called attention to the similarity between many of the manifestations of rheumatic fever and those of syphilis and tuberculosis. The anatomic features of these last two diseases have been thoroughly established as allergic in their pathogenesis. If, therefore, one had a conception of rheumatic fever as an analogous disease, it seemed only logical to determine whether the micro-organisms suspected of playing an etiologic rôle could be brought into relationship with any allergic state. In this connection we2 have been able to show that by suitable inoculation with nonhemolytic streptococci it is possible to
Article
1. The immunological behavior of two cell constituents of nonhemolytic streptococci has been studied, (a) One, the so called nucleoprotein, is relatively non-specific and gives rise to an antibody which shows group reactions with nucleoproteins of related species. (b) The other is non-protein by qualitative chemical tests. Preliminary chemical examination has indicated that it may be a carbohydrate. Although this substance is highly reactive with the specific antibodies produced by the intact bacterial cell, yet in its chemically purified condition it is probably non-antigenic. Specific serological reactions with this substance are dosely related to specific agglutination of the microorganism. 2. The study of sera prepared by immunization with the chemically extracted protein has shown the presence of antibodies for nudeoproteins alone. No antibodies against the specific soluble substance have been found in these sera. The protein antibodies are little, if at all, concerned in causing agglutination. Precipitin tests, complement fixation reactions, and absorption experiments have been used to analyze the group relationships with the nucleoproteins of other species. The proteins of each species of Gram-positive cocci studied were immunologically similar within the species and showed definite relationships to the proteins from related species. Proteins from bacteria of unrelated species did not react with antisera against streptococcus protein. 3. Two distinct antibodies have been demonstrated in antisera prepared against living bacteria. By prolonged immunization it was found possible to produce sera with a high content of protein as well as specific antibodies. With ordinary methods, however, the immune sera had a low content of relatively non-specific protein antibodies but a high titer for specific antibodies. The specific antibodies were not reactive with proteins but were active with high dilutions of the soluble specific substance and were responsible for the parallel specific agglutination. Absorption experiments showed that the two antibodies in antibacterial sera were immunologically distinct.
Article
1. Accompanying and following the evolution of a secondary reaction in the skin of rabbits after inoculation with suitable doses of certain non-hemolytic streptococci there quickly develops a general state of hypersensitiveness or allergy towards these streptococci. 2. This state is made evident by ophthalmic reactions following corneal inoculations, by much increased reactivity of the skin following intracutaneous reinoculations, and by lethal reactions, resembling tuberculin shock, following intravenous inoculations. 3. In a given hypersensitive rabbit there is a rough parallelism in the intensities of these different kinds of reactions. 4. This type of hypersensitiveness or bacterial allergy does not follow primary intravenous inoculation of rabbits with comparable doses of the streptococci employed. 5. As the development of this type of hypersensitiveness or bacterial allergy seems to accompany the production of focal lesions of a certain intensity, it is probable that in these foci are produced the substances or conditions which lead to this type of bacterial allergy.
Article
Scintigraphic images of the cardiac blood pool were displayed in color, with red indicating tracer distribution during diastole and green indicating systole. This display permits easy identification of vascular structures.
Skin Reactions of Patients with Rheumatic Fever to Toxic Filtrates of Streptococcus
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