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Article1 February 1941THE BALANCE BETWEEN CAPSULAR POLYSACCHARIDE AND ANTIBODY IN RELATION TO THE PROGNOSIS AND THERAPY OF PNEUMOCOCCAL PNEUMONIAJESSE G. M. BULLOWA, M.D., SAMUEL C. BUKANTZ, M.D., PAUL F. DE GARA, M.D.JESSE G. M. BULLOWA, M.D.Search for more papers by this author, SAMUEL C. BUKANTZ, M.D.Search for more papers by this author, PAUL F. DE GARA, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-14-8-1348 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptINTRODUCTIONThe antigen-antibody balance in pneumococcal pneumonia was first reported by Blake,1who employed the methods of detection described by Dochez and Avery.2, 3Blake1studied 19 cases and demonstrated capsular polysaccharide in the blood of 11, 10 of whom died. Circulating antibody was not detected in these patients, nor in those who excreted large amounts of capsular polysaccharide in the urine. It has since been shown experimentally that capsular polysaccharide may interfere with defenses against the pneumococcus by enhancing the invasive power of pneumococci (Felton and Bailey4; A. W. Downie5), or by blocking the reaction between pneumococcal antigen and...Bibliography1. BLAKE FG: Antigen-antibody balance in lobar pneumonia, Arch. Int. Med., 1918, xxi, 779-790. CrossrefGoogle Scholar2. DOCHEZAVERY AROT: Proc. Soc. Exper. Biol. and Med., 1917, xiv, 126. CrossrefGoogle Scholar3. DOCHEZAVERY AROT: The elaboration of specific soluble substance by pneumococcus during growth, Jr. Exper. Med., 1917, xxvi, 477-493. CrossrefGoogle Scholar4. FELTONBAILEY LDGH: Biologic significance of the soluble specific substances of pneumococci, Jr. Infect. Dis., 1926, xxxviii, 131-144. CrossrefGoogle Scholar5. DOWNIE AW: Specific capsular polysaccharide of pneumococcus Type I and immunity which it induces in mice, Jr. Path. and Bact., 1937, xlv, 131-147. CrossrefGoogle Scholar6. SICKLES GM: Further observations on effect of Type I pneumococcus culture broth on phagocytic action of Type I pneumococcus serum, Jr. Immunol., 1927, xiv, 329-336. Google Scholar7. COLEDOCHEZ RAR: Reports of studies of pneumonia, Trans. Assoc. Am. Phys., 1913, xxviii, 606-616. Google Scholar8. PARKBULLOWAROSENBLÜTH WHJGMB: Treatment of lobar pneumonia with refined specific antibacterial serum, Jr. Am. Med. Assoc., 1928, xci, 1503-1508. CrossrefGoogle Scholar9. Medical Research Council, Lancet, 1934, i, 290. Google Scholar10. LORDHEFFRON FTR: Lobar pneumonia and serum therapy, 1936, The Commonwealth Fund, Oxford University Press. Google Scholar11. BULLOWA JG: The management of the pneumonias, 1937, Oxford University Press. Google Scholar12. HEFFRON R: Pneumonia, 1939, The Commonwealth Fund, Oxford University Press. Google Scholar13. BUKANTZBULLOWADE GARA SCJGPF: Detection of free polysaccharide in blood of pneumococcic pneumonia patients; prognosis and therapy, Proc. Soc. Exper. Biol. and Med., 1939, xli, 250-254. CrossrefGoogle Scholar14. DE GARABUKANTZBULLOWA PFSCJG: Pneumococcal capsular polysaccharide in urine; detection by precipitation and centrifugation, Jr. Immunol., 1939, xxxvii, 305-320. Google Scholar15. DE GARA PF: Influence of centrifugation on agglutination of pneumococci, Science, 1939, xc, 378. CrossrefGoogle Scholar16. FINLANDSPRINGLOWELL MWCFC: Jr. Clin. Invest., 1939, xviii, 483. Google Scholar17. ROBERTSONGRAESERCOGGESHALLHARRISON OHJBLTMA: Relation of circulating antipneumococcal immune substances to course of lobar pneumonia; acquired immune substances, Jr. Clin. Invest., 1934, xiii, 633-647. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: New York, N. Y.*Received for publication November 20, 1939.From the Littauer Pneumonia Research Fund, New York University College of Medicine, and the Medical Service of Harlem Hospital, Department of Hospitals, New York City, N. Y. These studies received financial support from the Littauer Pneumonia Research Fund of New York University College of Medicine, from the Metropolitan Life Insurance Company, and from Mr. Bernard M. Baruch, Mr. Bernard M. Baruch, Jr., Miss Belle N. Baruch and Mrs. H. Robert Samstag.†During the course of analysis of this series, an additional case of pneumococcus type III pneumonia, bacteremic, in whose blood capsular polysaccharide was detected, came under observation. This patient, treated with sulfapyridine alone, recovered after a stormy course, capsular polysaccharide continuing to be detectable in the blood for a period of 10 weeks, throughout which time the urine repeatedly contained capsular polysaccharide. During the greater part of her hospital stay, there was roentgenological evidence of a collection of air and fluid in the pleural space of the affected side. This effusion subsided spontaneously, the patient remaining afebrile during the last several weeks. The patient was discharged from the hospital 10 weeks ago, has been followed at regular intervals and is still clinically well. Her blood and urine have been negative for capsular polysaccharide for at least six weeks. This case will be included in the numerical analysis which follows. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byPneumococcal intracellular killing is abolished by polysaccharide despite serum complement activityEffects of pneumococcal mucopeptide and capsular polysaccharide on phagocytosisCorrelation of Circulating Capsular Polysaccharide with Bacteremia in Pneumococcal PneumoniaReactions to antipneumococcal rabbit serumReactions to antipneumococcal rabbit serumReactions to antipneumococcal rabbit serumReactions to antipneumococcal rabbit serum 1 February 1941Volume 14, Issue 8Page: 1348-1359KeywordsAntigensBloodCase seriesHospital medicineMedical servicesPneumococcusPneumoniaPolysaccharidesResearch fundingUrine ePublished: 1 December 2008 Issue Published: 1 February 1941 PDF downloadLoading ...

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