Laboratories of the Mount Sinai Hospital, New York.
J Exp Med. 1928 Jul 31;48(2):247-68. doi: 10.1084/jem.48.2.247.
A phenomenon of local skin reactivity to B. typhosus culture filtrates is described in this report. The reactivity was induced by skin injections of the filtrate followed 24 hours later by an intravenous injection of the same filtrate. The local response consisted of severe hemorrhagic necrosis and was fully developed 4 to 5 hours after the second injection. About 78 to 79 per cent of the rabbits employed were susceptible to this phenomenon. Different areas of the skin of the abdomen, when similarly treated, responded with equal severity to the intravenous injection. There were variations in the size of different areas in the same animals. The intensity and size of the local hemorrhagic reactions were not related to the intensity of the erythema produced by the preparatory skin injections. Following intravenous injection very severe hemorrhagic reactions were obtained, in those areas which reacted negatively in this respect to the preparatory skin injections. Evidently, the local trauma produced by the preparatory skin injections was not responsible for the localization of the toxic factors introduced by the intravenous route. It was necessary to allow a short interval of time between the skin preparatory injections and the intravenous injection, for the reproduction of the phenomenon. An incubation period of 2 hours was insufficient. An interval of 24 hours was invariably sufficient. The ability to react disappeared in 48 hours after the preliminary skin injections. Repeated direct injections of the filtrate into the same areas of the skin, with an interval of 24 hours between the injections, did not result in reactions similar to the above described hemorrhagic necrosis. The second skin injection was followed by reddening, some swelling and a local accumulation of polymorphonuclear neutrophil leucocytes which showed no signs of necrobiosis. There was no rupture of blood vessels. Skin injections followed after a suitable interval by intravenous injection, were necessary for the reproduction of the severe local hemorrhagic response. Skin reactivity to B. typhosus culture filtrate injected intravenously was not induced by turpentine in various dilutions, sterile tryptic digest broth, culture filtrates of 4 strains of streptococci or by the Streptococcus erysipelatis toxin. It was possible to titrate the skin preparatory factors. Dilutions of the filtrate up to 1:64 were able to induce the local skin reactivity. But, whereas dilutions up to 1:4 invariably prepared the skin so that very severe hemorrhagic reactions followed the second injection in susceptible animals, dilutions from 1:8 to 1:64 were uncertain and their preparatory effect varied in different animals. The skin preparatory factors showed considerable heat resistance. The heat resistance varied with the strains employed. One strain produced factors totally resistant to heating in the autoclave for 1 hour. However, there was definite and unquestionable inactivation of these factors as derived from other strains when the filtrate was diluted 1:2 and heated in the autoclave. Various hydrogen ion concentrations in the range from 9.0 to 4.0 had no effect upon the skin preparatory factors. Heat resistance was not modified by the various pH within this range. The mechanism of the phenomenon described has not been fully studied as yet. An experimental comparison of it with the manifestations of bacterial allergy of the skin is necessary. There are certain features, however, which considered together, distinguish this phenomenon from the known phenomena of bacterial hypersusceptibility. These features are: local reactivity; the short incubation period necessary to induce the local reactivity; the short duration of the state of reactivity; the ability to induce local reactivity by a single skin injection; the severity of the reaction; and the necessity to make the second injection of the toxic agent by the intravenous route. Studies on the relation of specific antisera to the phenomenon described are under way.
本报告描述了 B. typhosus 培养滤液局部皮肤反应的现象。该反应是通过皮肤注射滤液 24 小时后,再静脉注射相同滤液引起的。局部反应为严重的出血性坏死,在第二次注射后 4 至 5 小时完全发展。约 78%至 79%的兔子对此现象敏感。腹部皮肤的不同区域,经类似处理,对静脉注射的反应相同严重。同一动物不同区域的大小有所不同。局部出血性反应的强度和大小与预备性皮肤注射引起的红斑强度无关。静脉注射后,在预备性皮肤注射对此方面反应阴性的区域,可获得非常严重的出血性反应。显然,预备性皮肤注射引起的局部创伤并不是通过静脉途径引入的毒性因子定位的原因。在重现该现象之前,必须在皮肤预备性注射和静脉注射之间留出短暂的间隔时间。2 小时的孵育期是不够的。24 小时的间隔时间总是足够的。在初步皮肤注射后 48 小时,反应能力消失。在 24 小时的间隔之间,将滤液直接重复注入同一皮肤区域,不会导致与上述描述的出血性坏死相似的反应。第二次皮肤注射后会出现发红、肿胀和局部积聚多形核中性粒细胞,这些细胞没有坏死的迹象。没有血管破裂。要重现严重的局部出血反应,需要在适当的间隔后进行皮肤注射和静脉注射。静脉注射 B. typhosus 培养滤液引起的皮肤反应不能被各种稀释度的松节油、无菌胰蛋白酶消化肉汤、4 株链球菌的培养液滤液或红斑丹毒丝菌毒素诱导。可以对皮肤预备因素进行滴定。滤液的稀释度高达 1:64 仍能诱导局部皮肤反应。但是,尽管 1:4 的稀释度始终能使皮肤准备好,以便在易感动物中第二次注射后出现非常严重的出血性反应,但 1:8 至 1:64 的稀释度不确定,其预备效果在不同动物中也有所不同。皮肤预备因素具有相当的耐热性。耐热性因所使用的菌株而异。有一个菌株产生的因子完全耐受高压灭菌器中 1 小时的加热。然而,当滤液稀释 1:2 并在高压灭菌器中加热时,来自其他菌株的这些因子确实被灭活了。氢离子浓度在 9.0 到 4.0 之间的各种变化对皮肤预备因素没有影响。在该范围内,耐热性不受各种 pH 值的影响。该现象的机制尚未完全研究。需要将其与皮肤细菌过敏的表现进行实验比较。然而,有一些特征,当它们一起考虑时,将该现象与已知的细菌超敏反应现象区分开来。这些特征是:局部反应;诱导局部反应所需的短孵育期;反应状态的短暂持续时间;单次皮肤注射即可诱导局部反应的能力;反应的严重程度;以及通过静脉途径注射有毒物质的第二次注射的必要性。正在进行关于该现象与描述的特异性抗血清关系的研究。