Paper
GROUP A HEMOLYTIC STREPTOCOCCUS ANTIBODIES. II. GRIFFITH TYPE AGGLUTININ AND ANTISTREPTOLYSIN TITERS IN CARRIERS AND NON-CARRIERS.
Published May 1, 1943 · W. M. Kirby, A. Jacobs, L. Rantz
The Journal of clinical investigation
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Abstract
In the previous paper, hemolytic streptococcus antibacterial and antitoxic antibodies were studied by the determination of agglutinins for various Griffith types and antistreptolysin, in the sera of normal individuals who were not shown to be nasopharyngeal carriers of Group A streptococci. It is the purpose of this report to describe a more extensive study of these antibodies in carriers and non-carriers of hemolytic streptococci of Group A. This program was prompted by two previous observations. First, and most important, were the carefully controlled studies of Bloomfield and Felty (1) who, in 1926, pointed out that individuals harboring hemolytic streptococci in the tonsils were immune to infection by these organisms until the carrier state had terminated. It therefore seemed possible that high titers of circulating antibody might be demonstrable in the sera of Group A carriers. A further incentive to this work arose from the study of circulating antibodies in individuals suffering acute attacks of hemolytic streptococcus pharyngitis (2, 3), in whom it was observed that very great variations existed from patient to patient in the level of antistreptolysin at the onset of the infection and in the rate of fall after recovery. The high titers demonstrated in some of these individuals might have been maintained by a prolongation of the carrier state after previous infection. The study of hemolytic streptococcus carriers is, however, greatly complicated by the fact, previously emphasized (4), that ordinary throat swabs will recover the organism in a relatively small number of cases, since it inhabits the crypts and not the surface of the tonsil. This is particularly true if no recent episode of acute infection has occurred. In the present study, sera for antibody determinations were obtained from children who were about to undergo tonsillectomy and the entire excised tonsil was then examined by cultural methods suitable for the isolation of Group A streptococci. This procedure has permitted the precise separation of these individuals into carriers and non-carriers. The results of the determination of the levels of circulating antibodies in this group will now be presented.
High titers of circulating antibodies against Group A hemolytic streptococci were found in individuals harboring the bacteria in their tonsils, suggesting a potential immune response to infection.
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