Specific Antipneumococcal Immunity in Relation to the Chemotherapy of Pneumonia 12

Abstract

The findings recorded in this report are concerned with the effect of chemotherapy on the occurrence of type specific pneumococcal antibodies in patients suffering from pneumonia. The incidence of the development of demonstrable specific immunity has been determined with samples of serum obtained at frequent intervals from patients with pneumonia, who were treated with either sulfapyridine or sulfathiazole. In addition to the quantitative aspects of the immunological information derived from the observations, the serological results have also formed the basis for an analysis of the significance of the presence or absence of measurable specific antibodies, in relation to the outcome of the infection in patients treated with either one drug or the other.The patients available for the immunological study presented varied clinical courses and suffered from pneumonia of varying degrees of severity. Approximately one-third of the group had bacteremia. Although the majority of them recovered promptly from the infection, some had complicating febrile episodes, with and without bacteremia, and still others died. By correlating the different kinds of clinical courses with the results of the serological tests for specific antibodies, the attempt has been made to reconstruct the course of the disease on the basis of the immunological findings. In elaborating the second phase of the problem, the study has also included clinical and postmortem findings of other patients with pneumonia who were not used for serological study, but who were serviceable in the assay of factors that appeared either to promote or retard recovery, or were associated with fatal termination.

Immunological Studies of Pneumococcal Pneumonia in Patients Treated With Penicillin 1

“…The inferior response of the type 3 and 8 cases conforms with previous observations (1,6,18). The results are likewise in accord with those of Heidelberger and Anderson (8).…”

“…The data presented in this paper indicate that the antibody response (agglutinins and mouse protective antibodies) of patients with pneumococcal pneumonia treated with penicillin is comparable to that of similar patients treated without specific therapy (17)(18)(19)(20) or treated with sulfonamides (1)(2)(3)(4)(5)(6)(7)(8). The inferior response of the type 3 and 8 cases conforms with previous observations (1,6,18).…”

“…of pneumococcal infections in both man (1)(2)(3)(4)(5)(6)(7)(8) and animals (9)(10)(11)(12)(13) have shown that the development of specific antibodies is not affected by early therapy with sulfonamide drugs. In contrast, early penicillin therapy of rabbits and mice (14) and of rats (15) infected with pneumococci has been observed to suppress or decrease the antibody response of these animals.…”

Studies on the Mechanism of Recovery in Pneumococcal Pneumonia

“…There is clinical evidence, however that patients recovering from pneumonia, either spontaneously or after sulfonamide chemotherapy, not infrequently experience a crisis in the disease several days before immune bodies appear in the serum (21)(22)(23)(24)(25). This evidence alone is inconclusive, for it is conceivable that the crisis might occur before appreciable phagocytosis took place in the lungs.…”

Sulfonamide-Fast Pneumococci. A Clinical Report of Two Cases of Pneumonia Together With Experimental Studies on the Effectiveness of Penicillin and Tyrothricin Against Sulfonamide-Resistant Strains

“…In a recent report, Tillett (10) (12) to material which contains both gramicidin and tyrocidin. Although more toxic than gramicidin, the curative action of tyrothricin for experimental pneumococcal infections has been established (12).…”