Intracutaneous Reactions in Lobar Pneumonia

Bigelow, George H.

doi:10.1001/archinte.1922.00110020080003

Cited by 6 publications

(3 citation statements)

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“…Experimental observations in man bearing on this problem consist almost entirely of studies on the cutaneous reactions of man to a variety of pneumococcus antigens, both during health and during the active and convalescent stages of pneumococcus pneumonia. A resum6 of these observations (1,2,3,4,5,6) shows, in general, that 30 to 85 per cent of normal persons have been found to react locally to an intracutaneous injection of pneumococcus antigen with the "delayed" type of skin reaction, that during the acute stage of pneumococcus pneumonia the skin is not reactive to these same antigens, and that during convalescence from the disease a large proportion of patients sooner or later develop cutaneous sensitiveness. In addition Tillett and Francis (7) have recently shown that the reactions of convalescents may be separated into two types--(a) an immediate wheal and erythema type of reaction in response to intradermal injections of the type-specific carbohydrate of the pneumococcus, first appearing at or about the time of crisis and (b) a delayed type of reaction in response to injections of pneumococcus nucleoprotein, usually appearing somewhat later in convalescence.…”

Section: Discussionmentioning

confidence: 99%

“…The existence of allergy in man to pneumococcus is suggested by the local reactions obtained in many human beings when various fractions or products of the pnetunococcus are injected intradermally (1,2,3,4,5,6,7), and by the rapid development of the pathological lesion of pneumococcus pneumonia with its characteristic diffuse exudate. Lauehe (8), in fact, largely on clinical and theoretical grounds, has strongly advocated the view that hypersensitiveness plays an important r61e in the pathogenesis of lobar pneumonia, though presenting no direct experimental observations in support of this conception.…”

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confidence: 99%

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Host Factors in the Pathogenesis of Pneumococcus Pneumonia

Sharp

Blake

1930

Journal of Experimental Medicine

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The present study was undertaken in order to determine whether animals exhibiting cutaneous hypersensitiveness to pneumococcus would show an acute inflammatory reaction in the lungs when pneumococcus autolysate was brought into contact with the pulmonary tissues and, if so, whether the pulmonary reaction might be shown to be due to the allergic state of the animal, rather than to intrinsic properties of the autolysate. Twenty young rabbits were sensitized to pneumococcus by various procedures and their degree of hypersensitiveness determined at frequent intervals over varying periods of time by means of intracutaneous injections of pneumococcus autolysate standardized on the basis of nitrogen content and so treated as to be devoid of the known toxic principles. Twenty-four hours after the last skin test each rabbit was injected intratracheally with the same pneumococcus autolysate. Seven non-sensitive controls were similarly injected intratracheally. Twenty-four hours after intratracheal injection the rabbits were killed. The lungs were removed, a portion was cultured, and the rest was examined histologically. Of the twenty sensitized rabbits, three that showed no cutaneous sensitivity and three that were only slightly skin-sensitive at the time of intratracheal injection exhibited no detectable pulmonary reaction to the autolysate; eleven of fourteen that showed moderate to extreme cutaneous hypersensitiveness were found to have an acute exudative inflammation of the lungs. The exudate consisted largely of polymorphonuclear leukocytes and serum. It varied in extent from a slight focal exudate lining the bronchioles and adjacent alveoli to a very marked diffuse involvement of considerable portions of the lung. In all but one of the eleven the cultures of the lungs were sterile. The single animal showing a positive culture (B. lepisepticum) has been excluded. None of the seven non-sensitive controls showed any pulmonary reaction to the autolysate. From these results it may be concluded that there is in rabbits a fairly close parallelism between cutaneous and pulmonary hypersensitiveness to pneumococcus autolysate and that the inflammatory response of the pulmonary tissue resulting from contact with the autolysate depends upon the allergic state of the animal rather than upon inherently injurious substances in the autolysate. The observations are in harmony with the theory that allergy may play a part in the pathogenesis of pneumococcus pneumonia in man.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Host Factors in the Pathogenesis of Pneumococcus Pneumonia

Sharp

Blake

1930

Journal of Experimental Medicine

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“…Later Weiss and Kolmer (17) showed that patients with pneumonia gave skin reactions to pneumotoxin (a sodium choleate solution of the cell) from the fifth to the thirteenth day of the disease. Bigelow (18) also obtained skin reactions in pneumonia patients with heat-killed pneumococci and several soluble derivatives. Herrold and Traut (19) found that 73 per cent of pneumonia patients failed to react to injections into the skin of a filtrate of a 5-day culture of Pneumococcus, while only 15 per cent of normal persons failed to react.…”

Section: Discussionmentioning

confidence: 99%

Reactions of Rabbits to Intracutaneous Injections of Pneumococci and Their Products

Julianelle

1930

Journal of Experimental Medicine

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1. A skin reaction elicited by the injection of the Pneumococcus "nucleoprotein," or of a solution of the cells from which the acid and heat-coagulable proteins have been removed is described in rabbits which have previously received repeated intracutaneous injections of heat-killed pneumococci. 2. In terms of bacterial specificity, the skin reaction is considered to be not type-specific, but species-specific. 3. A similar skin reaction to the proteins of Pneumococcus occurs in rabbits following the repeated administration by the intravenous or intracutaneous route of the heat-killed organisms or their protein derivatives. 4. The skin reaction may occur independently of resistance to infection. 5. The skin reaction appears to be related to the presence of circulating species-specific antibodies.

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