肺結核症の血清諸反応の比較

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The authors reviewed a series of serological studies carried out by their cowerkers employing somatic substances of the tubercle bacillus as antigens. These studies were performed on some technical basis elaborated by them. Firstly, proteins isolated from mechanically disintegrated bacillary cells with minimum denaturation were proved to be highly active serologically and were used for the titration of corresponding humoral reactivities, in addition to well-recognized bacilary antigens-phosphatides and poly-saccharides which were also obtained mechanically more effectively than from intact cells. Secondly, titration of precipitins against the three bacillary antigens were performed by the agglutination reactions of antigen-coated collodion particles established by them. The techniques are delicate enough to estimate relative concentration of these precipitins in tberculous sera. From the data of comparative titrations of precipitins and complement fixing properties in sera from patients with pulmonary tuberculosis, it was indicated that humoral reactivities ageinst the proteins were more plentiful and of more significance than those against other bacillary antigens. Therefore, data obtained by the use of proteins were chiefly described in this paper. Complement fixation titer as titrated against the proteins or phosphatides kept a certain parallelism with severity of the pulmonary disease. In fact, complement fixation using the proteins was useful in making differential diagnosis of chest shadows resembling tuberculosis and in speculating prognosis of tuberculosis. On the contrary, precipitins to combine with the proteins or phosphatides as measured not only by the agglutination, above mentioned, but also by less sensitive flocculation gave quite inconsistent results with complement fixing properties against these bacillary antigens. It was noteworthy that antiproteins were distinctly of low titer (1/10 or so) in relapsing or severe cases of pulmonary tuberculosis, whereas the same precipitins were plentiful (1/80-1/160) in cases fighting successfully in the face of advanced disease. It was known, therefore, that high concentration of the antiproteins could be taken as a serological sign of powerful operation of resistance of the host against the invader. It was noticed, however, that clinical value could not be attached directly to the antiprotein titer, because it was commonly low in severe and almost recovered cases as well as in healthy positive reactors to tuberculin. On this, some attempt was undertaken in order to attach clinical value to the titer. It was demonstrated that the antiprotein titer would provide a valuable index of the balance of activities between the host and the invader, when it was sutdied incombination with complement fixation titer or erythrocyte sedimentation rate. For example, ration of antiprotein strength to E.S.R. (reciprocals of antiprotein titer/E.S.R.) was large reaching 6.0 or more not only with improving and almost recovered cases but also with healthy positive reactors, contrary to severe cases with which the same ration was inevitably small (0.2 or so). Likewise, ration of antiproteins to complement fexing properties was found to bear analogous clinical significance. It may be of utomost interest that the antiproteins are scant in severe patients, while the well-known Middlebrook-Dubos antibodies (precipitins) are not so. It was suggested that on some experimental evidences that production of precipitins against toxic bacillary substances as proteins would be paralyzed in severe clinical condition, whereas production of precipitins against non-toxic substances such as lipo-polysaccharides active in the Middlebrook-Dubos hemagglugination, would not be inhibited even in the mostly hopeless condition.
日本アレルギー学会の論文
1966-04-30

肺結核症の血清諸反応の比較

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