IMMUNOLOGICAL STUDIES IN PNEUMOCOCCAL DISEASE

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  • 1 January 1977
    • journal article
    • research article
    • Vol. 89  (6) , 1198-1207
Abstract
Many patients die from pneumococcal [streptococcus pneumoniae] disease despite the availability of effective antimicrobial agents. Immunologic studies including detection, typing and quantitation of serum pneumococcal capsular polysaccharide (PCP) antigen by counterimmunoelectrophoresis (CIE), quantitation of PCP antibody by radioimmunoassay (RIA), and quantitation of serum complement [C] components C3, C4, and C3PA [C3 proactivator] and serum Ig[immunoglobulin]G, IgM and IgA by the radial immunodiffusion technique of Mancini were performed with the sera of 18 patients. Five patients died (group I) and 13 survived (group II) pneumococcal infection. Both groups were comparable in age, underlying disease and leukopenia on admission. All patients of group I and 10 of 13 (77%) of group II patients were bacteremic. Two patients in each group had an extrapulmonary focus of infection. PCP antigen was detected in the sera of all group I and nine of 13 group II patients. PCP antigen levels were .gtoreq. 15 .mu.g/ml in 4 of 5 group I and 2 of 13 group II patients (P = 0.022). Levels of antibody of PCP exceeded 100 ng/ml of antibody N (AbN) in 10 of 12 group II and 1 of 5 group I patients (P = 0.027) during the course of illness. All group I patients and 3 of 12 group II patients had decreased levels of 1 or more C components on admission (P < 0.01). One or more C components remained decreased until death in 4 group I patients but returned to normal or elevated levels in all group II patients. No difference in serum Ig concentrations were found.

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