肺吸虫症の免疫学的研究 : 肺吸虫症に於ける寒天ゲル内沈降反応
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In recent years, the method of gel diffusion in agar has been widely applied for the demonstration of specific antigens and antibodies. The purpose of this study is to analyse the immun systems in paragonimus infection and to discern the diagnostic value of agar gel diffusion tests. Using crude extracts of the whole adult worm, metacercaria and ES preparations (excretions and secretions) of Paragonimus westermanii, agar gel double diffusion and immunoelectrophoresis were carried out against sera obtained from 27 experimentally infected animals as well as 415 individuals positive for skin test including typical paragonimiasis patients. The reactions to crude extracts of adult worm were positive in 38.5 per cent of 52 sera from human cases showing intense skin reaction over 10mm of increase of wheal diameter, and there was no positive reaction among ten skin test-negative cases. There seems to be a good correlation between the intensity of the skin reaction and the Ouchterlony tests. Of 65 sera from both of infected animals and patients discharging eggs of the parasite in their stool, 55 revealed strong reactions producing the multiple distinct precipitine bands against the crude and ES antigens. On the other hand, some strong reactions were demonstrated in 19 among 325 sera from individuals who lacked any manifestation such as egg discharge or abnormal X-ray findings except positive skin reaction. These test-positive human cases, whether eggs were proved or not, were treated with Bithionol. The Ochterlony tests were carried out during and monthly after treatment. In most of them, such precipitine bands decreased gradually in the number and disappeared within 5 months after treatment. It is, therefore, considered that agar gel precipitine reaction is a significant proof of presence of the living worms in the body and valuable in evaluation of chemotherapeutic effect on the worms. Compared with the crude somatic antigen from adult worm, precipitine bands appeared in larger number more frequently in agar gel diffusion slides by ES antigen. The results indicate the advantage of ES antigen in sensitivity. This is probably due to antigenic substances other than worm extracts. Antigen extracted from metacercaria produced 1 to 4 precipitine lines against all sera from cats taken at 6th month after infection, but it produced less or no reactions against the sera from human paragonimiasis. A marked variations in the pattern were demonstrated between antigens prepared from adult worm and from metacercaria in agar gel diffusion with the animal sera, occasionally partial fusions or crossing of the lines. From the results, it may be considered that these variations are due to the antigenic differences between adult worm and metacercaria, and also they are influenced by the stage of infection.著者は肺吸虫寄生による免疫現象を解析するため,寒天ゲル内二重拡散法及び免疫電気泳動法を手段として観察を行い次の結果を得た.1)肺吸虫感染者血清を用いてのゲル内沈降反応は特異的に陽性反応を呈し,その反応の出方は皮内反応の強さに概ね比例する.2)虫卵陽性者は胸部レ線所見の有無に関係なく高率に陽性反応を呈し,一方皮内反応のみ陽性のものにも低率ながら特異的沈降線の出現を認めた.3)ゲル内反応陽性者のレ線陰影の種類をみると輪状影が最も高率で,次で肋膜病変,浸潤影,結節影の順であった.古い病巣を示すと思われる石灰沈着,索状影は極めて低率であった.4)肺吸虫症患者をBithionolにより治療を行なうと,ゲル内沈降反応に於て投薬終了后,概ね3～5ケ月目に沈降帯の消失が観察された.猶,虫卵陰性でゲル内反心陽性を示した2例に於ても同様の現象がみられた.5) 4例の患者血清に於て治療后沈降帯が消失する迄の間に治療前には認められなかった新しい沈降帯の出現が免疫電気泳動により観察された.6)感染血清に対する虫体抽出抗原,飼育液及びメカセルカリア抽山液のゲル内沈降反応では飼育液抗原が最も優れた反応源性を示した.尚メタセルカリア抗原には他の2種抗原とは異なる極めて特異的な抗原抗体反応系の存在を確認した.本論文の要旨は昭和42年3月29日,第36回日本寄生虫学会総会において発表した.
- 1968-03-30
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