Cutaneous Reactions and Antibody Response to Intracutaneous Injections of Pneumococcus Polysaccharides

Immediate cutaneous reactions, similar to those described by Tillett and Francis (15), were elicited in patients recovering from pneumonia. These reactions were, in general, type-specific and were associated with the homologous type antibody in the serum. Very similar reactions were elicited with preparations of soluble specific substances and cellular carbohydrates prepared from the same pneumococcus types by the methods of Heidelberger, Goebel and Avery (18) and those of Wadsworth and Brown (10), respectively. Characteristic delayed reactions were seen only with the cellular carbohydrates. These were not associated with type-specific antibodies. They were most frequently observed with the cellular carbohydrates of the atypical type I pneumococcus and with that obtained from the virulent type I strain. Delayed cutaneous reactions with the cellular carbohydrate of an atypical type I pneumococcus were obtained regularly during the febrile stage of a variety of infectious disease and could not be elicited soon after recovery in such cases. These findings are similar to those obtained by Francis and Abernethy (17) with the “C” substance of Tillett, Goebel and Avery (19). All of the type-specific polysaccharides were antigenically active in human subjects. They produced in almost every instance a strictly type-specific antibody response. Only minor differences were observed with the different preparations of types II and III polysaccharides. The type I cellular carbohydrate, however, was quantitatively more active than the corresponding SSS in this respect. Occasional subjects showed specific antibodies, particularly against type I pneumococci, following injections of the atypical cellular carbohydrate.