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墨西哥斑疹伤寒研究。I.

STUDIES ON MEXICAN TYPHUS FEVER. I.

机构信息

Department of Bacteriology and Immunology of the Harvard University Medical School, Boston.

出版信息

J Exp Med. 1930 May 31;51(6):847-58. doi: 10.1084/jem.51.6.847.

Abstract

The preceding studies on typhus fever, chiefly done with a Mexican strain obtained from Dr. Mooser, concern themselves largely with reinvestigations of some of the fundamental problems of this disease. Filtration experiments carried out with methods almost regularly successful with true filterable viruses, in regard to material, suspension fluid, reaction, nature of filters and pressure employed for filtration, indicate that the virus is not filterable in the ordinary sense in which this expression is employed. It is probably smaller than bacteria and the results of filtration experiments suggest that its magnitude is consistent with the tunica bodies observed by Mooser. Negative filtrates did not immunize, a result consistent with the previous work of Olitsky. The virus is present in blood plasma, hardly if at all in leucocytes, and becomes closely associated with the red blood cells, though we do not believe that it is contained in them. It becomes firmly associated with normal red blood cells when these are exposed to infectious plasma, a result similar to that obtained in Rocky Mountain spotted fever by Spencer and Parker. In tissue culture, tunica material with Mooser bodies remains alive and virulent for about 10 days, but so far we have not been able to determine that it can keep alive without the presence of living cells. These results do not carry this subject any further than it has been carried for European typhus in tissue cultures with the same method by Wolbach, Schlesinger and Pinkerton (12). Within glass capsules in the peritoneum of guinea pigs, the virus may remain alive for about the same length of time as in the tissue cultures. Rough comparative virulence estimations between blood plasma in which it would be hardly possible to find a limited number of Mooser bodies, even though they were present, showed the blood plasma to be less infectious than the tunica material, in which considerable numbers of Mooser bodies were visible. The testicular swelling characteristic of Mexican typhus and showing the above mentioned bodies-probably Rickettsia-may be absent in individual guinea pigs under ordinary conditions and in guinea pigs inoculated by other than the intraperitoneal route. On re-inoculation into the peritoneum after non-orchitic passages, the swelling reappears. Whenever it did not so reappear, we found that the strain had either degenerated in virulence or it had been contaminated by intercurrent infection. Though we can not prove it at the present time, we believe that the tunica lesion is an integral part of this disease in guinea pigs, and not an accidental accompaniment. Convalescent blood from Mexican typhus guinea pigs mixed in the test tube with virus affords protection if the blood is taken between the first to the tenth day after defervescence. After the third week, the blood no longer contains protective bodies although the guinea pigs may still be immune. In one case a serum was obtained which was both protective in such a test but at the same time seemed still to contain virus, a result which we cannot explain. No complement-fixing antibodies were found when virus serum was used as antigen and convalescent serum as antibody. The low concentration of the virus in the serum may account for this. In a limited number of observations guinea pigs which were negatively inoculated with virus-serum mixtures proved on re-inoculation to be immune. In one of these cases the protective serum mixture with the virus was taken 1 day, in the other 5 days after temperature had returned to normal and the re-inoculations were done 36 and 40 days after the primary injection. This recalls similar experiences of Nicolle and encourages further immunological study in this direction. In a number of experiments active immunization with formalinized tunica material containing large numbers of the Mooser bodies seems to have modified the course of subsequent inoculations in the direction of protection. A single accidental human infection seemed particularly associated with tunica material, although this cannot be positively asserted. All that part of our work which has bearing on the infectious agent is consistent with the assumption that the small, Giemsa-staining bodies observed by Mooser in the tunica of Mexican typhus guinea pigs represent the virus of the disease.

摘要

前文对斑疹伤寒的研究,主要是用从 Mooser 博士那里获得的墨西哥菌株进行的,主要关注的是对这种疾病的一些基本问题的重新研究。用几乎总是能成功过滤真正可过滤病毒的方法进行的过滤实验,就材料、悬浮液、反应、过滤器的性质和过滤时使用的压力而言,表明病毒在普通意义上是不可过滤的。它可能比细菌小,过滤实验的结果表明,它的大小与 Mooser 观察到的膜体一致。阴性滤液不能免疫,这一结果与 Olitsky 的先前工作一致。病毒存在于血浆中,几乎不存在于白细胞中,与红细胞密切相关,尽管我们不认为它存在于红细胞中。当正常的红细胞暴露于感染性血浆时,它们会与病毒紧密结合,这与 Spencer 和 Parker 在落矶山斑点热中获得的结果相似。在组织培养中,带有 Mooser 体的膜材料在大约 10 天内仍然保持活力和毒性,但到目前为止,我们还无法确定它在没有活细胞存在的情况下是否能够存活。这些结果并没有将这个主题进一步推进,除了 Wolbach、Schlesinger 和 Pinkerton(12)用相同的方法在组织培养中对欧洲斑疹伤寒进行的研究之外。在豚鼠的腹膜玻璃胶囊中,病毒的存活时间可能与组织培养中的存活时间相同。在几乎不可能在其中找到有限数量的 Mooser 体的血浆中进行粗略的比较毒力估计表明,与膜材料相比,血浆的传染性较低,膜材料中可以看到相当数量的 Mooser 体。墨西哥斑疹伤寒特有的睾丸肿胀,显示出上述的膜体-可能是立克次体-在普通条件下可能不存在于个别豚鼠中,也可能不存在于通过非腹腔途径接种的豚鼠中。在非睾丸炎的传代后再次接种到腹膜中,肿胀会再次出现。只要肿胀没有再次出现,我们就会发现该菌株的毒力已经退化或已经被并发感染污染。虽然我们目前无法证明这一点,但我们相信在豚鼠中,膜病变是这种疾病的一个组成部分,而不是偶然的伴随物。从墨西哥斑疹伤寒豚鼠的恢复期血液中,如果在退热后的第 1 天到第 10 天之间取血,与病毒混合在试管中可以提供保护。第三周后,尽管豚鼠仍可能具有免疫力,但血液中不再含有保护性体。在一个病例中,获得了一种血清,该血清在这种测试中既具有保护作用,但同时似乎仍含有病毒,我们无法解释这一结果。当使用病毒血清作为抗原和恢复期血清作为抗体时,没有发现补体结合抗体。病毒在血清中的浓度低可能是造成这种情况的原因。在有限的观察中,用病毒-血清混合物进行阴性接种的豚鼠在再次接种时被证明具有免疫力。在其中一个病例中,保护性血清混合物与病毒一起在体温恢复正常后 1 天,另一个病例在 5 天后使用,再次接种是在初次注射后 36 和 40 天进行的。这让人想起了 Nicolle 的类似经验,并鼓励在这一方向进一步进行免疫学研究。在一些实验中,用含有大量 Mooser 体的福尔马林化膜材料进行主动免疫似乎在保护方向上改变了随后接种的过程。一次偶然的人类感染似乎特别与膜材料有关,尽管这不能被肯定地断言。我们所有与传染性病原体有关的工作都与假设一致,即 Mooser 在墨西哥斑疹伤寒豚鼠的膜中观察到的小、吉姆萨染色体代表了这种疾病的病毒。

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