The Use of Diphtheria and Tetanus Toxoids to Assess Cell-Mediated Immunity (Cmi)

Abstract

Ihrinn a measles immunjzation camoai~n hlood sam?les were collected from 203 children before vaccination. Follow un specimens were collected from 125 children 3 ~rlcs. later and from 98 chtldren 10 mos. later. Of the 125 children with follow up study, 88 had been previously vnccinated. 10 had a I~istory of measles and 27 denied vacctnntion or illness. !kanles llAT antibody geometric nesn titers (C!ms) were 13. (day 01, 33 (3 wks.), and 23 (111 mos.). Twenty-six of the 125 llsd !!.\I titers of -5 prior to vaccination and sho!red a 24-fold antitiodv titer rise. Ig:: measles ontibodv was detected in 12 of these children after protein-A and 2-!E treatmentSwith a C'PT at 3 weeks and 10 months of El and 40 respectively. There was no history of measles exposure or vaccination in this group. Tn the remaining 14 children vith initial ttters < 5 no Kx!! antibody response was detected. and despite n &-fold increase in IlAI titer at 3 wks. (C'IT 28). the 10 aonth titer had dropped considerably (C\V 9). Ten of these 14 children had a history of previous measles vaccination. The remaining 99 children had detectable initial titers between 5 and 320. After grouping these according to their pre-booster titers, no significant cllange in Q R s was ol~served when dsv 0. 3 wk. and 10 mo. results were compared. Our study suggests that IIAT antihodv titers in children previously imnunologically stimulated against measlen are not altered significantly bv revaccination, even when the prebooster titers are low or not detectable. Monocytea from two unrelated C3 deficient patients, one of whom has keen described (J. Clin. Invest. 56, 703, 1975). were examined in culture. Serum from each of the patients contained less than It of the normal C3 concentration (not due to hypercatabolim) but monocytes from each produced C3 at approximately 25% of the nonnal rate when studied after two weeks ~JL yLtyp. The C3 produced in vitro by monocytes from one of the patients was shown to have thy m i i o ular weight of normal serum C3 and to dissociate appropriately under reducing conditions. Monocytes from C3 deficient patients could not be distinguished from normals on the basis of morphology, roaetting with C3 coated erythrocytes, or rates of C2 and total protein synthesis. The ability of monocytes from C3 deficient patients to produce C3 in vitro is in contrast to studies of monocytes from C2 deficient humans and macrophages from C4 deficient guinea pigs in which specific biosynthetic defects for C2 and C4, respectively, persisted in vitro. Monocyte chemotactic defects have previously been described in several conditions. We have noted marked defects (>2 S.D.) in one patient with chronic mucocutaneoua candidiasis and 4/29 atients with atopic dermatitis. In 8 patients on salicylate tRerspy, a mean decrease of monocyte chemotaxis of 25% was seen with salicylate levels >15 mgsX compared to a mean increase of 8% when neutrophil chemotaxia was concurrently measured. We also noted decreased monocyte chemotaxis in several seemingly normal subjects with absen...