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Measurement of Immunological Function in Clinical Medicine
Author(s) -
Forbes I. J.
Publication year - 1971
Publication title -
australian and new zealand journal of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0004-8291
DOI - 10.1111/j.1445-5994.1971.tb02284.x
Subject(s) - medicine , toxoid , delayed hypersensitivity , immunology , phytohaemagglutinin , tetanus , immune system , antibody , antigen , immunization , cellular immunity , vaccination
Summary: A comprehensive routine for assessment of immunological function in clinical medicine is presented. It is safe and acceptable to patients. The bracket of tests gives information on cellular and humoral immune functions. One or more delayed hypersensitivity reactions were positive in 41 of 42 control subjects. The best antigens of the bracket used to demonstrate the capacity to manifest delayed hypersensitivity were preparations of Streptococcus, Candida and mumps (killed virus). Phytohaemagglutinin (PHA)‐induced blastic transformation of circulating lymphocytes was impaired only in cases in which delayed hypersensitivity was lost. However, transformation was satisfactory in the lymphocytes of many cases in which delayed hypersensitivity was lost. Loss of the capacity to transform with PHA is an indication of a severe deficiency of cellular immune function. The cutaneous reaction to intra‐dermally injected soluble Tetanus toxoid occurred only in subjects who had circulating antibody at the time of testing. The reaction commonly reached a peak at 24–36 hours. It was not elicited in subjects in whom the capacity to manifest delayed hypersensitivity responses could not be demonstrated. For these reasons thecutaneousreaction to Tetanus was considered to be complex and was not used to elicit delayed hypersensitivity. All control subjects made antibody in response to immunisation with S. Typhi. This response has the characteristics of a primary immune response, at least in most subjects. Forty‐one of the 42 control subjects made antibody to Tetanus toxoid. In 39 subjects antibody was present before immunisation. This response has the characteristics of a secondary immune response. Isohaemaggiutinin litres are apparently lost only in states of severe immunological insufficiency. The range of titres was wide in the control group, and in other groups of subjects studied. Only one subject was found whose serum lacked isohaemagglutinins, an infant with severe immunological failure. A high proportion of subjects investigated because of susceptibility to infection had an immunological deficiency. A number of these failed to make one or other antibody after immunisation, even though the serum immunoglobulin levels were normal. The profile does not yield information on the ability to acquire new cellular immunological capacities, on the secretion of IgA antibodies at mucosal surfaces, or on the IgD and IgE systems. Information on immunological function is frequently needed. This report describes a comprehensive screening system designed for routine use.