IMMUNITY IN MUMPS : V. THE CORRELATION OF THE PRESENCE OF DERMAL HYPERSENSITIVITY AND RESISTANCE TO MUMPS

Portrait of an autologous cancer vaccine: Then and now

Active immunotherapy of cancer with therapeutic vaccines has been the subject of experimental and clinical studies for at least 50 years. Our approach has employed 1) autologous, human cancer cells because of extensive evidence that tumor rejection antigens may differ between multiple tumors of the same histology; 2) the immunopotentiating drug, cyclophosphamide; and 3) haptens, particularly dinitrophenyl. Multiple clinical trials in 455 patients with melanoma and ovarian cancer have shown that administration of haptenized vaccines at the proper dosage-schedule regularly induces T cell-mediated immunity to autologous tumor cells as measured by delayed-type hypersensitivity. Moreover, the vaccine causes changes in the tumor site suggestive of an immune reaction, including inflammation and infiltration with CD8+ T lymphocytes that are activated and produce cytokines. The T cell response is oligoclonal, and dominant Vβ families differ between patients. Studies of measurable metastases show clinically important tumor regression. Commercial development of this technology is clearly feasible.

The reactivity of various human sera with mumps complement fixation antigens

Human sera taken at various stages of mumps have been analyzed in regard to their reactivity with two serologically distinct complement fixation antigens which were derived from the infected chick embryo. Antibodies to the soluble or S antigen appear earlier in the disease and, as a rule, reach high levels before antibodies against the virus-bound or V antigen commence to rise. In early convalescence, both antibodies reach high levels. Subsequently antibodies against the S antigen decrease usually at a faster rate than those against V, so that after a period of several years, frequently only anti-V may be left. These findings were found helpful in diagnostic procedures. The use of both the V and S antigens has permitted the early diagnosis of manifestations of mumps in the absence of parotitis, such as meningoencephalitis, since the finding of high levels of anti-S and of low titers of, or no, anti-V is considered diagnostically significant for the first few days of illness. For the determination of resistance the use of the V antigen appears more useful. Following vaccination or skin testing, antibodies against both antigens may develop; those against V increase more regularly and to higher titers than those against S.

Studies on the agent of infectious hepatitis. III. The effect of skin tests for infectious hepatitis on the incidence of the disease in a closed institution

At the onset of an epidemic in a closed institution about one-fourth of the inmates were skin-tested. During the year following the skin test, 5 cases of hepatitis with jaundice were recorded among 320 skin-tested individuals with unknown histories, one in the 144 skin test-positive, and 4 in the 176 skin test-negative subjects. In contrast 112 cases occurred among the 825 non-skin-tested individuals. Thus, the incidence of jaundice in the skin-tested group was 1.6 per cent as against 13.6 per cent in the non-skin-tested individuals. Possible explanations for this observation have been discussed.

Delayed hypersensitivity to mumps antigen in humans

Sixty-one subjects, preselected for mumps sensitivity, were entered into a double-blind protocol to standardize Mumps Skin Test Antigen. Four lots of mumps antigen selected on the basis of in vitro potency tests were used. Four other antigens, Histoplasmin, Dermatophytin-O, Dermatophytin, and fluid tetanus toxoid were also tested; positive reactions for these four antigens occurred in 48, 68, 25, and 43% of individuals, respectively. The mumps lots exhibited delayed hypersensitivity with positivity ranging from 63 to 67% at 20 CFU/ml and 77 to 84% at 80 CFU/ml in the acceptable lots. Side effects were primarily local and minor in nature. Mumps Skin Test Antigen is a useful measure of the integrity of the immune system, but lacks complete specificity because of local dermal factors.

Immunological skin testing and interpretation: a plea for uniformity

Immunological skin tests are one of the major methods used for the assessment of one's immune status. A review of the literature clearly reveals that there is no uniform methods for the administration and interpretation of skin tests. Without uniformity, it is obvious that data are not comparable. Contradictory conclusions may be reached from the same skin test data, depending upon the method of interpretation used. Precedent, rather than rationale, has often determined the method of interpretation. There are studies which suggest that slight induration or erythema, often considered negative, are significant immunologic events. The various methods of skin test administration and interpretation are reviewed. Recommendations for application and interpretation are presented so that uniformity may exist.

Controversies in current immunization policy and practices: one physician's viewpoint

Immunization offers the best available method preventing diseases which exact huge tolls in terms of comfort, life and economic stability of humans. However, immunization is a mixed blessing because of unavoidable risks to recipients of almost any biologic product. Only by careful attention to the balance of risks between an immunization procedure and its corresponding disease will we achieve a rational, sound and appropriate policy and practice. This report details the author's analysis and opinion concerning some current controversies in immunization policy and practice. The reader is cautioned that the report represents one viewpoint; others report differing or even contradictory interpretations of the data presented, leading to different or even opposing views. The purpose of this report will be ably served if the reader considers the data himself (herself) and reaches an independent, informed opinion.

Studies of delayed hypersensitivity in vitro. II. Delayed hypersensitivity in experimental mumps virus infections

Guinea pigs experimentally infected with mumps virus develop a delayed, hypersensitive skin reaction following the intradermal injection of heat-inactivated mumps virus. This in vivo hypersensitivity is accompanied by a state of cellular hypersensitivity which can be demonstrated in vitro by the addition of mumps viral antigen to cultures of splenic macrophages, following which they become less motile and undergo lysis. These observations support the hypothesis that the state of hypersensitivity which develops early in mumps virus infections may have a role in the pathogenesis of the disease.