The Nature of the Bacterial-Specific Intradermal Antiserum Reaction

• Published in: The Journal of infectious diseases 1936-11, Vol.59 (3), p.330-339
• Main Author: Foshay, Lee
• Format: Article
• Language: English
• Subjects: Agglutinins; Antibodies; Antigens; Antiserum; Infections; Inoculation; Intradermal tests; Polysaccharides; Tularemia; Viruses
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/59.3.330

In tularemia the bacterial-specific intradermal antiserum reaction is due to an antigen-antibody reaction involving only the species-specific polysaccharide. Indirect evidence indicates that the same, or similar, mechanism is responsible for the identical type of bacterial-specific reaction in certain other infectious diseases. Since the production of positive reactions in patients is dependent upon the existence in their skins of that part of the antigenic complex which determines the species-specificity of the invading parasite the reaction serves as a confirmatory diagnostic test of great precision and accuracy. Differentiation of the type or strain of the infecting species is possible in certain diseases. In some diseases which confer prolonged immunity after recovery diagnoses can be made in retrospect many years after complete convalescence. In such diseases the tests alone can not be expected to distinguish between past and existing infections. On the other hand it is possible in this group of diseases to select, by this method, the immunes from a given population sample. For infections which do not confer lasting protection it seems probable that the test may be useful as a measure of the duration of immunity. Early experience suggests that it may serve the same purpose in relation to artifically acquired immunity. Because of the high degree of specificity involved the test would appear to be a valuable method for testing relations between alleged microbic causes of disease and these diseases in their classical clinical forms. Even with the present limited experience the test seems to be the most accurate means available to determine which polyvalent antistreptococcus serum is most suitable for a given patient. Serums for test purposes should be strictly species-specific. They are best made by using only recently isolated, virulent strains. In general the available commercially produced serums are unreliable for test purposes. In performing these tests it is imperative that strictly normal serums should be injected simultaneously as controls.