Agglutination reactions in rheumatoid arthritis I Agglutination reactions with Streptococcus hemolyticus II The nature and significance of agglutination reactions with Streptococcus hemolyticus

Boots, R.H.

Jour Immunol: 187-204, 205-228


Accession: 029940519

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I. Sera from 206 cases of rheumatoid (chronic infectious) arthritis were tested against 1 or more strains of Strep. hemolyticus. 27 strains, including 4 of the so-called "typical strains" of Cecil, Nicholls and Stainsby (recovered from blood cultures of rheumatoid arthritis cases), were used as agglutinogens. 67% of the sera from typical cases agglutinated Strep. hemolyticus to titers of 1:160-1:10,240. Strains obtained from cases of scarlatina, erysipelas, and rheumatic fever were agglutinated to as high a titer as were the "typical strains" of Cecil, Nicholls and Stainsby. Of 41 other Gram-positive cocci tested, only R pneumococci were agglutinated to a significant titer. Control tests were performed with 256 sera from other pathological conditions, and from normals. With the exception of specimens from several cases of lupus erythematosus and psoriasis, control sera did not agglutinate strains of Strep. hemolyticus at 55° C, in a titer comparable with that in rheumatoid arthritis.-II. The property of rheumatoid-arthritis serum responsible for agglutination of Strep, hemolyticus was related to type of case, duration of disease and age of patient; it was unrelated to sedimentation rate of erythrocytes. The agglutinating power of rheumatoid arthritis serum was progressively weakened by heating at 55-60°, and destroyed by heating at 60-65°. The agglutinogen with which rheumatoid-arthritis sera reacted was thermostable, withstanding 90°. Living cultures of Strep. hemolyticus were agglutinated by most control sera at 37°, but only slightly at 55°. It was therefore necessary to incubate tests at 55° for demonstration of the rheumatoid-arthritis reaction. Agglutination tests with rheumatoid-arthritis sera and suspensions of Strep. hemolyticus heated for 1 hr. at 55° appeared to be equally satisfactory at 37° and at 55°. Control sera showed little tendency to agglutinate heated suspensions at either 37° or 55°. A possible relationship between the rheumatoid-arthritis reaction and natural antibodies is indicated.