[Studies on the intradermal reactions with the fractions of Ascaris lumbricoides]
INTRODUCTION : The studies on allergic reaction with the substances of Ascaris lumbricoides have long been studied by various worers; Conventry(1929), Campbell(1936), Sakei(1949), Miyakawa(1950), Ikeda(1952), Matsumoto and Imawari(1952), Morishita and Kobayashi(1953, 1954), Komiyayama(1954) and Yammoto(1956). Campbell(1936) and some other workers reported that the polysaccharides from ascaris produced the stronger intrademal reactions than protein fraction, though Yamamoto(1954) and others found the reverse results. On the other hand, Hosotani(1954) reported that the crude antigen or mixed antigen with polysaccharide and protein fraction of the ascaris produced the strongest skin reaction than with the other single fraction. As are shown in above reports, the intensity of the allergic reaction with the substances from ascaris is still remained under dipute. The reason might be due to the difference of the method of preparation, technique and evaluation. The aim of the present study is to elucidate the intensity of allergic reactivity fo protein and polysaccharide fration and mixed substance of two fractions and crude antigen of Ascaris lumbricoides. MATERIALS AND METHODS : A Intrdermal Test 1. Human Experiment. The intradermal test was performed on several groups of people. A: Ascaris lumbricoides egg positive cases among adult ages. B: Ascaris lumbricoides egg negative cases but who bad doubtful symptom. C: Ascaris lumbricoides egg negative cases but who had past history of ascaris infection. D: Ascaris lumbricoides egg negative cases and aged 3-8 months old. 2. Animal Experiment: Same breeds of 6 dogs were raised i cages of laboratory for 6 months, During the period, special attention was paid to keep them in parasite free conditon. The body weight was 10kg in average. B. Antigens. The adults worms of Ascaris lumbricoides, which were obtained during laparotomy, were first washed with sterilized saline solution. Each ascaris was placed in 50ml of saline solution and kept in 30 degrees C incubator for 24 hours. Among of them, the active one was seleted and put to sudden freeze at -70 degrees C for 20 hours. the whole body was powdered in a dried condition and kept it in ampoule at -4 degrees C. a) Crude antigen: The ether extract of powdered Ascaris lumbrucoides were motared by adding veronal buffer solution (1:100) and kept in icebox for 48 hours. The suspension was diluted with veronal buffer solution in the ratio of 1:10,000. b) Protein antigen : This antigen was prepared by Chaffee's modified methods and ammonium sulfate extraction mehtod. c) Polysaccharide antigen: Chaffee's modified method and ethanol extration method were applied. d) Mixed antigen : The same amount of preparation of protein and polysaccharide antigen were mixed. C. Intrdermal test 1. The intradermal test : 0.02ml of natigen was injected on the anterior surface of the frearm in human and on the back in aninmal, with tuberculin syringe. The criteria of the skin reaction were determined as follows; wheal: -; 0-4mm, +/-; 5-7mm, +;8-9mm, +; 21-32mm, ++; 33-44mm, +++; 45-56mm, ++++; over 57mm, in diameter. D. Stool examination : All the stool examination was done by formalin-ether concectration(M.G.L) method. E.P.G (egg per gram) was also determined by Stoll's egg counting method. RESULT : The intradermal reaction after the injection of each antigen was observed at 15, 30, 60 minutes and 3, 24 hours. In 58 ascariasis cases, the peak of wheal was appeared at 30 minute; 93.0% with the crude antigen, 15.5% with the mixed antigen, 10.3% with the Protein antigen, but all were negative in the polysaccharide antigen. The erythema reaction paralledled, in general, to the wheal; 75.8% at 15 minutes, 72.5% at 30 minutes and 48.3% at 60 mintues, with the crude antigen. Only 3.4% showed erythema at 15,30, and 60 minutes int the case of mixed antigen, and 1.7% fo positive was appeared at 30 minutes in the case of protein antigen, but none was observed in the polysaccharide antigen. The wheal and erythema revealed correlationship each other. Both of them showed 65.5% positive boundary in the case of crude antigen. Generally, the crude antigen resulted the highest and strongest reaction than the other fractions; the mixed, protein and polysaccharide in decreasing order. In adult age group, who showed egg negative at the time of injection, 81.5% were positive in skin reaction with the crude antigen, and 88.6% in the group who complained doubtful symptom but egg negative. In the group who had past history of ascaris infection showed 66.6% positive and the egg negative infant group with the same crude antigen. The sheal size was not always paralleled with the worm burden. The cross reaction with the antigen from Ascaris lumbricoides and Toxocara canis was examined by the intradermal test. There was no cross reaction between the two antigen. The infected dog with Toxocara canis showed positive reaction by the crude antigen of same species, but mot by the human species. Experimentally, the positive skin reaction was appeared only by the crude antigen at four weeks after the infection of Toxocara canis. CONCLUSION: The intradermal studies with the fraction of Ascaris lumbricoides and Toxocara canis were performed to human and dog, and the following results were observed. 1) Wheal and erythema were appeared in the cases of ascaris infection or who had past history, but not in the ascaris free before. 2) The size of wheal reached to peak 30 minutes after the injection. 3) The crude antigen had specificity and showed no cross reaction. 4) The crude antigen cause the strongest and largest reaction than the other substances; protein, polysaccharide and the mixed antigen. No cutaneous reaction was observed with the fraction of polysaccharides. 5) The size of wheal did not parallel with the worm burden. 6) The skin reaction was appeared four weeks after the infection.
Lee
Chan Wook
CW
Department of Parasitology, Yonsei University College of Medicine, Korea.