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Rate of absorption of horse serum after injection. Its relationship to serum desensitization and to serum therapy
SELECTED
AIiSTRAC’TS
95
serum, twenty-eight clays a,fter a prima,ry injection of 95 C.C. of serum and twifrty days after a mild serum sickness. Death occurred in spite of att,empts to desensitize by intramuscular injections immediately prior to the last intravenous reinjection. Commenting upon the case, the author concludes that when reinjections must be given under similar conditiocs, subcutaneous administrat,ioti is preferable.
Tuft, L.: Rate of Absor@hm of Horse Serum After Inje&on, 1PtiOaShip to Serum Desensitization and to Se= Therapy. A. 92: 167, 1929.
&J Rem J, A. M.
The article is written as an investigation into the possible causes of failure of a, protective preliminary desensitization in the treatment of certain types of eases demandin g intravenous injection of serum. It was considered possible that in attempted desensitization, insufficient time was allowed between the initial injection and the final one for enough absorption to occur to render desensitization effective. A study of the rate of absorption of horse serum was undertaken. After preliminary experiments upon guinea pigs, studies were carried out upon t,hrer patients who had received normal horse serum as a form of nonspecific protein therapy for certain skin lesions. Preliminary; skin tests were negative. Two patients received 50 cc. of sterile normal horse serum, intramuscularly into the thigh. The third patient received a like amount, subcuta.neously into the anterior abdominal wall. Blood samples were taken before the injection and at frequent intervals after the injection. Each serum was tested separat,ely against imControls were mune rabbit serum of known titer, for precipitation. used and the possibility of pseudoreaction by the presence in the rabbit serum of a natural precipitin for human serum was carefully ruled out. Results showed that after either subcutaneous or intramuscular injection, at least. from fifteen to twenty-four hours were required for absorption of the major portion of horse serum. This slow absorption rat? suggests tllat the usual methods of desensitization should be modifiecl allcl that gradually increasing closes be given over a period of tn.enty-four hours, so tllat enough of the antigen may be absorbed to It is further emphasized in the render desensitization more effective. course of the article, that desensitization should not be att~empted in skin test, all cases. Wit11 patients showing a, negative preliminary serum may be employed with safety. Those patients showing a positive &in reaction should be dividecl into tJvo groups : (1) those whose sel!sitivit>- to the serllm has been acquired 01‘ induced; (2) those to To those patients with a natural ~~llom the sensitivity is natural. sensitivity! the injection of horse serum in any form, even in t’he smallIn such pat,ients, therefore, attempts at est amount, may prove fatal. clesensitization are ineffective and may be fatal and SO should not be carried out. In those patients with an acquired sensitivity, however,
96
THE
JOURKAL
OF
ALLERGY
desensitization may be of value. The slow absorption rate for horse serum suggests a like occurrence with immune antibodies. Therefore, unless indications show it to be dangerous, intravenous injection is preferable for rapid clinical effect.
Horton, B. T., and Brown, J. E.: Systemic Histamine-Like in Allergy Due to Cold. A. J. M. SC. 178: 191, 1929.
Reactious
The authors report six cases which exhibited local and general symptoms of cold allergy. The local effects on the skin were (a) pallor during the period of exposure; (b) redness, swelling and increased heat of the hands after removal from the cold. Aft,er a latent period of from three to four minutes, a characterist,ic reaction, similar to that produced by histamine, appeared. There was a fall in blood pressure accompanied by a sharp rise in pulse rate. Flushing of the face and a tendency to syncope were noted. Within from twelve to twenty-four hours there was a complete recovery from the local reaction. Experimental work suggests the release of a histamine-like substance in the skin following exposure to cold. This substance when carried into the general circulation, produces a reaction chwractrrist~ic of histamine. Clinically, these cases yield to treatment.. Excellent, results may be obtained by immersing the hands daily in cold water, decreasing ill temperature, for increasing periods.
Urbach, E., and Steiner, M.: Barley Dust Idiosyncrasy. tion to Physical Allergy of the Skin. Arch. f. Dermat. 772. 1927.
A Contribuu. Syph. 153:
The authors describe at some length three cases of hypersensitivity of the skin to barley dust. In their estimation, the reaction is not duel to a direct chemical irritant, but rather to the fact that bhe tine ha,irs of the barley penetrate the skin and deliver the antigen to sensitive skin cells. With Doerr, they believe that not the substance released, as such, but the reaction of the allergic tissue with the antigen, must be considered as the pathogenic agent. In a further statistical study, thr fact is noted that men show a greater sensitivity to barley dust than do women, and brunettes react mnre st,rongly than do blondes,
Coventry, F. A. : Hypememitivemess to Helminth Proteins. II. Cutaneous and Precipitin Tests With Asmris Extracts in Infected and Immunized Animals. J. Prev. Med. 3: 43, 1929. Rabbits and guinea pigs infected with pig with ext,racts of these worms, were used in the animals to be infectecl, the dose was given by syringe to which a fine rubber tube 6 to H rm.
asearis: or immunized experimrnt,s. To those mouth. by means of a in length was at,tachrtl.
AIiSTRAC’TS
95
serum, twenty-eight clays a,fter a prima,ry injection of 95 C.C. of serum and twifrty days after a mild serum sickness. Death occurred in spite of att,empts to desensitize by intramuscular injections immediately prior to the last intravenous reinjection. Commenting upon the case, the author concludes that when reinjections must be given under similar conditiocs, subcutaneous administrat,ioti is preferable.
Tuft, L.: Rate of Absor@hm of Horse Serum After Inje&on, 1PtiOaShip to Serum Desensitization and to Se= Therapy. A. 92: 167, 1929.
&J Rem J, A. M.
The article is written as an investigation into the possible causes of failure of a, protective preliminary desensitization in the treatment of certain types of eases demandin g intravenous injection of serum. It was considered possible that in attempted desensitization, insufficient time was allowed between the initial injection and the final one for enough absorption to occur to render desensitization effective. A study of the rate of absorption of horse serum was undertaken. After preliminary experiments upon guinea pigs, studies were carried out upon t,hrer patients who had received normal horse serum as a form of nonspecific protein therapy for certain skin lesions. Preliminary; skin tests were negative. Two patients received 50 cc. of sterile normal horse serum, intramuscularly into the thigh. The third patient received a like amount, subcuta.neously into the anterior abdominal wall. Blood samples were taken before the injection and at frequent intervals after the injection. Each serum was tested separat,ely against imControls were mune rabbit serum of known titer, for precipitation. used and the possibility of pseudoreaction by the presence in the rabbit serum of a natural precipitin for human serum was carefully ruled out. Results showed that after either subcutaneous or intramuscular injection, at least. from fifteen to twenty-four hours were required for absorption of the major portion of horse serum. This slow absorption rat? suggests tllat the usual methods of desensitization should be modifiecl allcl that gradually increasing closes be given over a period of tn.enty-four hours, so tllat enough of the antigen may be absorbed to It is further emphasized in the render desensitization more effective. course of the article, that desensitization should not be att~empted in skin test, all cases. Wit11 patients showing a, negative preliminary serum may be employed with safety. Those patients showing a positive &in reaction should be dividecl into tJvo groups : (1) those whose sel!sitivit>- to the serllm has been acquired 01‘ induced; (2) those to To those patients with a natural ~~llom the sensitivity is natural. sensitivity! the injection of horse serum in any form, even in t’he smallIn such pat,ients, therefore, attempts at est amount, may prove fatal. clesensitization are ineffective and may be fatal and SO should not be carried out. In those patients with an acquired sensitivity, however,
96
THE
JOURKAL
OF
ALLERGY
desensitization may be of value. The slow absorption rate for horse serum suggests a like occurrence with immune antibodies. Therefore, unless indications show it to be dangerous, intravenous injection is preferable for rapid clinical effect.
Horton, B. T., and Brown, J. E.: Systemic Histamine-Like in Allergy Due to Cold. A. J. M. SC. 178: 191, 1929.
Reactious
The authors report six cases which exhibited local and general symptoms of cold allergy. The local effects on the skin were (a) pallor during the period of exposure; (b) redness, swelling and increased heat of the hands after removal from the cold. Aft,er a latent period of from three to four minutes, a characterist,ic reaction, similar to that produced by histamine, appeared. There was a fall in blood pressure accompanied by a sharp rise in pulse rate. Flushing of the face and a tendency to syncope were noted. Within from twelve to twenty-four hours there was a complete recovery from the local reaction. Experimental work suggests the release of a histamine-like substance in the skin following exposure to cold. This substance when carried into the general circulation, produces a reaction chwractrrist~ic of histamine. Clinically, these cases yield to treatment.. Excellent, results may be obtained by immersing the hands daily in cold water, decreasing ill temperature, for increasing periods.
Urbach, E., and Steiner, M.: Barley Dust Idiosyncrasy. tion to Physical Allergy of the Skin. Arch. f. Dermat. 772. 1927.
A Contribuu. Syph. 153:
The authors describe at some length three cases of hypersensitivity of the skin to barley dust. In their estimation, the reaction is not duel to a direct chemical irritant, but rather to the fact that bhe tine ha,irs of the barley penetrate the skin and deliver the antigen to sensitive skin cells. With Doerr, they believe that not the substance released, as such, but the reaction of the allergic tissue with the antigen, must be considered as the pathogenic agent. In a further statistical study, thr fact is noted that men show a greater sensitivity to barley dust than do women, and brunettes react mnre st,rongly than do blondes,
Coventry, F. A. : Hypememitivemess to Helminth Proteins. II. Cutaneous and Precipitin Tests With Asmris Extracts in Infected and Immunized Animals. J. Prev. Med. 3: 43, 1929. Rabbits and guinea pigs infected with pig with ext,racts of these worms, were used in the animals to be infectecl, the dose was given by syringe to which a fine rubber tube 6 to H rm.
asearis: or immunized experimrnt,s. To those mouth. by means of a in length was at,tachrtl.