The participation of an endotoxin in the pathogenesis of brucellosis has received scant recognition although clinical observations have suggested that a Brucella toxin might be responsible for some of the manifestations in the acute phases of the disease. This has been especially obvious in patients whose illness has been due to Brucella melitensis. In general, brucellosis caused by Br. melitensis is a more severe disease than that resulting from Brucella abortus (1). It has also been observed in experimentally infected guinea pigs that Br. melitensis caused a more severe type of illness than did Br. abortus, although the abortus strains produced a larger number of demonstrable lesions in the tissues (2). Experience with aureomycin in the treatment of seriously ill patients with brucellosis has also suggested that an endotoxin might be responsible for some of the reactions observed after an initial dose of the antibiotic (3). Within eight to twelve hours after the first oral dose of aureomycin, an abrupt rise in temperature occurred, which was associated with a shock-like reaction, hypotension and tachycardia. Smaller initial doses of aureomycin eliminated the more severe reactions. A possible explanation for these clinical phenomena was that the antibrucella activity of the aureomycin resulted in the liberation of an agent or agents from the Brucella cells that provoked the undesired reactions. Further clinical observations that have promoted the present study were related to the dramatic improvement that occurred following the administration of adrenocorticotropin (4). No therapeutic agent available thus far for human brucellosis has resulted in a more rapid improvement in the condition of the acutely ill patient than that which has accompanied the use of either cortisone or adrenocorticotrophic hormone, even though the Brucella organisms have not been simultaneously eliminated from the tissues or blood stream. In view of the questions raised by these clinical observations, experiments were carried out to determine if the endotoxins of representative strains of the three species of Brucella differed in their toxicity for animals. The investigations were then extended to see if antibiotics or cortisone offered protection against the endotoxins. And finally, the acute lethal effect of the endotoxins was compared with that of living Brucella organisms.The concept that the endotoxin of Brucella organisms is related to the manifestations of the disease is in accord with many studies that have been carried out with the toxins of other gram-negative bacteria (5). It is now generally agreed that the endotoxins of gram-negative organisms are associated with somatic antigens located on or near the surface of smooth cultures of the cells (6). Little or none of the endotoxic substance is associated with the surface of rough colonies. These surface factors include the 0 and Vi antigens, and are composed of carbohydrate-lipoid-protein complexes, in which the carbohydrate is probably the major component (7).Miles and Pirie (...
A comparison was made of results obtained with a Brucella agar--gel immunodiffusion (AGID) test and the standard tube-agglutination test on 612 human sera. Agreement between the tests was 97% when the titer was 1:160 or higher. Of 448 sera that showed no agglutination titer, 447 were negative with the AGID test. Results of the AGID test were also compared to those obtained with the 2-mercaptoethanol (2-ME) agglutination test on 148 sera that demonstrated a standard tube-agglutination titer of 1:20 or higher. All sera with a 2-ME-agglutination titer of 1:40 or higher were positive with the AGID test. Of 123 sera that showed no 2-ME-agglutination titer, 21 were positive with the AGID test. Two of these 21 sera were obtained from patients with bacteriologically proven brucellosis, and eight were from abattoir employees with suspected but not bacteriologically proven brucellosis.
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