Summary and Conclusions A soluble antigen, obtained by sonic vibration of washed yeast-phase cells of Blastomyces dermatitidis, was used to test for complement-fixing antibodies in 165 sera, including 69 samples from patients with proved cases of blastomycosis and 15 from patients with a clinical diagnosis or suspected diagnosis of other fungus infections. The antigen, although failing to give positive results in 29% of cases of proved blastomycosis, proved to be as satisfactory as the yeast-phase antigens previously employed, and had the distinct advantages of solubility and ease of storage. The soluble materials from sonic-treated washed yeast-phase cells of Histoplasma capsulatum also gave positive complement fixation tests with sera from patients with proved blastomycosis. The supernatant fluid from the protein-free saline suspensions of untreated yeast-phase cells was shown to contain an antigen which fixed guinea pig complement with sera from immunized rabbits but not with sera from patients with blastomycosis. This supernatant fluid, and a polysaccharide precipitated from it, were capable of sensitizing sheep's cells, rendering them agglutinable by sera from patients with blastomycosis. There was no correlation between the titers obtained by the hemagglutination technique and those obtained by the complement fixation tests in sera of patients with blastomycosis, but there was a definite relationship between the titers obtained in both tests and the prognoses of the patients. The data obtained on a limited number of mice suggested that the injection of small amounts of carbohydrate material, precipitated from the saline extract of the untreated cells, stimulates the development of a limited degree of resistance to heavy challenge doses of living B. dermatitidis. Skin tests on guinea pigs infected with B. dermatitidis and Histoplasma capsulatum using extracts of untreated cells and treated cells of both fungi indicated that the former substances produced more specific reactions and that the latter antigens were less specific. The above findings and their implications in the interpretation of the immunologic reactions obtained in blastomycosis and other systemic fungus infections are discussed.
Read full abstract