Quantitative Antibody Studies in Man. I. The Effect of Adrenal Insufficiency and of Cortisone on the Level of Circulating Antibodies 1

Abstract

Investigators have for many years been interested in the relation of the adrenal gland to antibody formation. Observations made in animals have frequently led to conflicting results. The effect of adrenalectomy on antibody titres has been studied and has been shown to be associated with an elevation (1-3), a depression (4), and no change (5-8). The effect of ACTH or cortisone on antibody levels in the acute experiment has resulted in an elevation (1, 5, 9-11), no change (8,12), and a depression (13). The effect of ACTH or cortisone on antibody levels in the chronic experiment has resulted in an elevation (9), a depression (14, 15) and no change (16,17 Individuals used in this study were from the hospital and clinic population of the Presbyterian Hospital. The patients used as controls were diagnosed as having peptic ulcer or arteriosclerotic heart disease. The five patients with adrenal insufficiency had the characteristic clinical and laboratory findings of Addison's disease. Desoxycorticosterone acetate was administered to four of the five patients during the test period. Although there is little evidence available in the literature, it has been shown that in animals DCA does not appear to influence antibody titres (10). The cortisone treated group were patients with rheumatoid arthritis receiving 200 milligrams of the drug by mouth three times each week. Cortisone treatment was started at least two weeks before immunization and was continued throughout the test period. No other medications were given. As an additional control group, eight patients with untreated rheumatoid arthritis were included in this study.8 Following a preliminary bleeding, each of the subjects was given 0.08 milligrams each of types I and II pneumococcus polysaccharides subcutaneously. Post-immunization bleedings were obtained at two and four weeks. RESULTSAs can be seen from Table I, the 12 normal individuals exhibited responses similar to those observed by Heidelberger and associates (25, 26).C-antibody was present in all sera tested and there was no rise in the titres of C-antibody in spite of sizeable changes in antibody to the type-specific capsular polysaccharides. Pre-immunization antipolysaccharide titres were low or not detectable. Maximum antibody titres were usually achieved by two weeks after immunization. A good response to one antigen was not necessarily accompanied by a similar response to the other antigen.

Quantitative Antibody Studies in Man. Iii. Antibody Response in Leukemia and Other Malignant Lymphomata 1

“…There was no apparent relation between the total white blood cell count in the peripheral blood and the amount of antibody produced. The data do raise the possibility that, in man, the immature white blood cell may play a role in the formation (16). In the present studies, cortisone administration to patients with acute leukemia was associated with the production of smaller amounts of antibody than was observed in the group of patients with acute leukemia who Antibody formation to pneumococcus capsular polysaccharides I and II has been studied in a group of human subjects with leukemia and other lymphomatous disease, using quantitative immunochemical techniques.…”

“…The purpose of this communication is to report observations on antibody formation in human leukemia, lymphosarcoma and Hodgkin's disease, using the quantitative precipitin technique developed by Heidelberger and his associates (15 usually little change in the levels of C-antibody during. the test period ( 15,16). Nine of 11 patients with untreated acute leukemia produced unusually large amounts of antibody to at least one of the antigens (Table II).…”

Decreased 19S antibody response to bacterial antigens in systemic lupus erythematosus

“…It is of interest that a study of the effect of Prednisone on Brucella antibody formation in the rat has actually shown an enhancement of antibody formation (23). In man, dosages equivalent to or greater than those used in the present study did not affect antibody production (24,25).…”

Inhibition of Red Cell Sequestration by Cortisone

“…These reports have led to the conclusion that, in acquired hemolytic anemia, adrenal steroids must act primarily to suppress antibody synthesis. Certain objections to this conclusion may be raised: (a) Steroid-induced remissions in acquired hemolytic anemias may occur so rapidly (within a few days) that it is difficult to accept suppression of antibody synthesis as the primary effect of such therapy; (b) in man, suppression of antibody synthesis by cortisone has not yet been conclusively demonstrated (41)(42)(43)(44)(45)(46), and (c) often no appreciable diminution in red cell sensitization (as measured by the antiglobulin titer) occurs early in cortisone-induced remission (47). On the other hand, these objections are not necessarily insurmountable.…”