Immunological Studies in Human Parasitic Infestation

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Abstract
Summary: Intradermal tests with saline extracts of Ascaris and Dibothriocephalus were made upon 277 individuals of from one to sixty-five years of age, and with extracts of Taenia solium upon 20 persons. Reactions similar to those elicited in conditions of atopic hypersensitiveness (hay fever and asthma) were obtained. Of 110 moderate and slight reactions 6 (or about 6 per cent) showed infestation in the excreta, as corroborated by findings. Of 53 individuals presenting marked reactions, 21 (or 40 per cent) revealed positive findings in the stools. Of 309 cases giving negative reactions 1 was found to harbor Dibothriocephalus. The absence of a positive reaction is not an absolute criterion of the absence of infestation with Dibothriocephalus, for one person infested with Dibothriocephalus remained negative to repeated tests. Among those reacting to the Ascaris antigen were some individuals that were infested not with Ascaris lumbricoides, but with other members of the nematode family,—namely Uncinaria (hookworm), Trichiuris trichiuria, Oxyuris vermicularis, and Trichinella spiralis. This indicates a group reaction. Testing with the extract of Ascaris lumbricoides is sufficient therefore for the diagnosis of any nematode infestation. The specificity of Dibothriocephalus latus and Taenia solium reactions was demonstrated. In every case which gave a marked positive reaction, where the transfer of sensitivity passively to the normal human skin was undertaken, the transfer was successful even in individuals in whom active infestation could not be demonstrated, suggesting similarity to the same phenomenon observed in some atopic cases. Constitutional reactions elicited in 3 asthmatic individuals as the result of intradermal tests with the Ascaris extract, indicates that extreme caution is necessary for routine testing, especially in atopic persons, with this type of extract. A marked reaction was interpreted to indicate either the presence of parasites or recent infestation.

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