The influence of epinephrine upon antigen and antibody action

Abstract

I N ORDER to avoid possible untoward reaction from the administration of certain antigenie agents or immune antibody mixtures, the use of epinephrine either prior to or coincident with the injection has been advocated and is frequently employed with apparent success. Thus, for example, in the method of so-called desensitization prior to the administration of immune horse serum, it has been suggested1 that epinephrine be given in small doses along with each fraction of serum. There is little question that this procedure is of value in the prevention of serious serum reaction. Likewise, in the administration of such substances as diphtheria toxoid or scarlet fever streptococcus toxin, it has been our practice as well as that of other physicians to administer 0.1 or 0.2 cc. of epinephrine with every dose in order to prevent or minimize the possibility of unusual local or general reaction. In immunizing medical students or older children against diphtheria or scarlet fever, we have found that this procedure has often prevented subsequent constitutional reactions and minimized the severity of the local reactions which are more frequent in these individuals than in younger children. The question has arisen at times as to whether the inclusion of the epinephrine along with either the antigen or the antibody would act in any way to inhibit its immunologic action. This seemed very unlikely, at least from a theoretical standpoint, and also when one considers the pharmacologic action of this drug. Review of the available literature failed to supply a satisfactory answer to this question. It seemed worth while, therefore, to attempt to settle it more definitely by means of the following experiments :‘f