Deficiency of Pneumococcal Serum Opsonizing Activity in Sickle-Cell Disease

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Abstract
Serum opsonizing activity for the pneumococcus was studied with a phagocytic test using normal peripheral leukocytes incubated in normal serum and in serum from patients with sickle-cell disease. Heat-labile serum opsonizing activity for the pneumococcus was markedly deficient in serum from the patients, with a mean phagocytosis of 6.5 per cent whereas control children with AA2 hemoglobin showed a mean value of 35.1 per cent. Serum opsonizing activity for salmonella was comparable in patients with sickle-cell disease and controls, although much of the activity was heat stable. Hemolytic complement activity was similar in both groups of children. Pathologic changes in the spleen in sickle-cell disease may result in functional autosplenectomy. Consequently, these observations may reflect the impairment of splenic clearance and heat-labile opsonin synthesis.