Agglutination Phenomena in Lobar Pneumonia

Abstract

Numerous investigators (I to I I) have noted that when pneumococci are grown in immune serum the organisms exhibit unusual characterisC~ics, Certain observers have also shown that the sera of animals immunized to pneumococci are able to cause agglutination of these organisms when the ordinary agglutination technique is employed.In 19oo Besan~on and Griffon (12) noted the presence of agglutinins in the blood of patients ill of and convalescent from lobar pneumonia. They found that often the homologous strain (,the strain derived from the patient) was agglutinated when a heterologous strain was not. This fact suggested that the various strains of pneumococci might possess biological differences which could not be detected by ordinary cultural methods. Eyre and Washbourn (I3) and Garg~.no and Fattori (14) also noted such differences, bu~ Neufeld and H~indel (I5) were the first to study thoroughly immunological variations in pneumococci. They worked, however, with relatively few strains of pneumococci. Dochez (i6) and Dochez and Gillespie (I7), working with a large number of strains of pneumococci, isolated from patients suffering from lobar pneumonia, were able to differentiate pneu,mococci into four groups on the basis of cultural and immunological reactions. The three main groups were distinguishable by agglutination and animal protection experiments with a fourth group which includes all strains of pneumococci which cannot be otherwise classified.More recently Lister (I8) in South Africa, approaching the problem from another standpoint, has differentiated into four groups eighteen of twenty strains of pneumococci isolated by puncture of the lungs of patients having lobar pneumonia. This he was able to do by cross agglutination tests with cultures of these strains of pneumococci and the sera derived from these patients at about the time of crisis. Two strains he found to be non-agglutinable.The present study has been carried out with the purpose of determining the time of appearance and disappearance of agglutinins in the blood of patients suffering from pneumonia, and of learning more concerning the specific character of these agglutinins, especially their specific relation to the various groups of pneumococci.

Cutaneous Reactions in Pneumonia. The Development of Antibodies Following the Intradermal Injection of Type-Specific Polysaccharide

“…Many investigators have noted the presence of specific antibodies for the homologous strain or type of Pneumococcus in the blood of pneumonia patients at the time of crisis. Bacteriotropins (5,6,7), agglutinins (5,7,8,9,10,11,12) and protective antibodies (13,14,15,6,12) have all been demonstrated but so far as can be discovered, in no instance has the development of antibodies for a heterologous type been described. Chickering (11) in 1914 followed the course of agglutinin production to all types throughout convalescence in 40 cases but found only antibodies for the homologous type.…”

Changes in Humoral Immunity Occurring During the Early Stages of Experimental Pneumococcus Infection

“…However, these workers used avirulent strains of pneumococci in their tests; whereas the organisms isolated from pneumonia patients were almost invariably virulent and found to be resistant to the opsonic action of the serum. Other workers (5), (6), (7), studying the humoral changes in lobar pneumonia, were unable to demonstrate opsonins, agglutinins, or mouse protective substances, in the blood stream until about the time of crisis. Bull (8), on the other hand, studying the natural resistance of the dog to pneumococcns infection, was able to demonstrate clearing power of normal dogs blood for highly virulent pneumococci.…”

Antibody Formation in Cases of Lobar Pneumonia Treated With Sulfapyridine

“…(Received for publication October 19, 1939) For many years it has been known (1,2,3,4) that at the time of the crisis in lobar pneumonia, or immediately thereafter, an excess of typespecific antibody can be demonstrated in the blood serum of the patient. While this phenomenon is not absolutely invariable, most observers have agreed that it occurs in the great majority of instances.…”