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Delayed hypersensitivity at the injection sites of a low-molecular-weight heparin.

We report a case of delayed hypersensitivity to a low-molecular-weight heparin. The patient presented with eczema at the site of subcutaneous injections and allergy tests confirmed the clinical diagnosis. There were positive tests with 3 low-molecular-weight heparins and unfractionated subcutaneous calcium heparin but negative with intravenous sodium heparin. Although delayed hypersensitivity to low-molecular-weight heparins is rare, the possibility of cross-allergy to unfractionated heparin could be a therapeutic problem for some patients.

Eczema↗

Delayed hypersensitivity skin testing does not influence the management of surgical patients.

Delayed hypersensitivity skin testing was performed at weekly intervals on 95 patients with major surgical illness. Patients with abnormal reactions on initial skin testing had a higher mortality than those who were normal initially (p less than 0.01), but this was not due to a greater rate of major septic complications. Significantly higher rates of sepsis (p less than 0.001) and mortality (p less than 0.001) were found in patients with abnormal reactions at any stage of their illness compared with patients who remained normal throughout. However, careful study of the temporal relationship between skin reactions and clinical events in individual patients suggested that these differences were not of value in clinical practice. Abnormal reactions usually followed obvious complications, such as sepsis or secondary hemorrhage, rather than predicted them. Deterioration of skin reactions from normal to abnormal was observed on 32 occasions in 25 patients but preceded the development of sepsis in only four patients.

Abdomen↗

Suppression of delayed hypersensitivity to the hapten by induction of tolerance to the carrier.

Delayed hypersensitivity reactions (DHR) and anaphylactic reactions to carrier and hapten determinants were studied in guinea pigs immunized with DNP-mycobacterium and rendered partially tolerant to the carrier by a single intravenous injection of mycobacterium prior to immunization. The results clearly show that the induction of depressed DHR to mycobacterium leads to a suppression of DHR to the hapten while no depression of anaphylaxis to the hapten is observed. It is proposed that the tolerogenic treatment acts at the macrophage level rather than at the T cell level.

Animals↗

Delayed hypersensitivity reactions in patients with Mycobacterium chelonei and Mycobacterium fortuitum infections.

Delayed hypersensitivity reactions to skin test antigens prepared from rapidly growing mycobacteria were measured in patients with postoperative wound infections due to Mycobacterium chelonei and M. fortuitum. Sixteen of 19 patients with M. chelonei infection had more than 10 mm of induration to the M. chelonei purified protein derivative antigen (PPD-CG) and were significantly more likely to react to PPD-CG than patients or hospital personnel who had no evidence of infection. All but one patient had more induration with PPD-CG than with the antigen prepared from M. fortuitum (PPD-F). Three of 4 patients with M. fortuitum infection had greater than or equal to 9mm of induration with PPD-F and were significantly more likely than noninfected patients to react to PPD-F. Three of the 4 patients also had at least as much induration with PPD-F as with PPD-CG. In an outbreak of infections due to M. chelonei, testing with PPD-CG may be useful epidemiologically. Although the data are less clearly defined for PPD-F, testing with this antigen may be of value in an outbreak caused by M. fortuitum.

Adult↗

[Delayed hypersensitivity to Candida albicans].

Conditions and factors influencing the formation of delayed hypersensitivity (DH) to yeast-like fungi of the species C. albicans under experimental conditions have been studied. The intensity of this reaction has been found to depend on the dose and method used for infecting mice, the time of the test and the qualitative state of fungal cells. As the result of this study, the infectious model of DH to C. albicans has been proposed. This model may be used for the study of the influence of different exogenous and endogenous factors of cell-mediated immune response to candidiasis.

Animals↗

[The activating effect of ceruloplasmin on the development of delayed hypersensitivity in mice].

The influence of ceruloplasmin on the development of delayed hypersensitivity (DHS) and activity of T-suppressors were studied in experiments on intact Balb/c mice. Ceruloplasmin introduced in a dose of 5 mg per 1 kg of weight a day before immunization of animals is shown to have a stimulating effect. The amount of the introduced drug being raised to 200 mg per 1 kg of weight suppressed the ability of organism to form DHS effect rather than increased it. Ceruloplasmin is stated to inhibit induction of DHS suppressors and to exert no effect on the expression of functional activity of the formed suppressors.

Adjuvants, Immunologic↗

Induction and specificity of delayed hypersensitivity to Staphylococcus aureus in mice.

The induction and specificity of delayed hypersensitivity (DH) to Staphylococcus aureus in mice was evaluated in vivo by the footpad (FP) assay and in vitro by spleen cell stimulation. Repeated infections result in a biphasic DH response. The first DH response, observed following three subcutaneous injections, was route and antigen specific, required viable organisms, and could not be enhanced by the incorporation of bacteria in adjuvants. Footpad reactivity was transferred to non-injected recipients by spleen cells but not serum and was inhibited by anti-thymocyte serum but not by cyclophosphamide. Spleen cell stimulation was maximal with homologous antigen, but, some cross reactivity was observed when cells were stimulated with hererologous gram-positive antigens. No cross reactivity was observed when antigens from gram-negative bacteria were used to stimulate spleen cells. The FP reactivity to homologous antigen following 7 injections, the second DH response, is of longer duration than that following 3 injections. Mice given seven injections exhibit a greater degree of cross reactivity to heterologous gram-positive but not gram-negative bacterial antigens. Similar results were observed when spleen cells from mice receiving 7 injections were simulated with gram-positive antigens. Furthermore, the degree of spleen cell stimulation following three of seven injections could be increased by elicitation prior to the vitro experiments.

Adjuvants, Immunologic↗