Immunochemical studies of antitoxin produced in normal and allergic individuals hyperimmunized with diphtheria toxoid. II. A comparison between the immunological properties of precipitating and non-precipitating (skin-sensitizing) antitoxins.

1. The immunological properties of two contrasting types of human antisera, each containing a high titer of diphtheria antitoxin, have been investigated. 2. Sera which contain only non-precipitating antitoxin exhibit most of the properties of atopic reagin-containing sera. This type of antitoxin is capable of sensitizing normal human skin to toxin or toxoid and remains for many weeks in the injected area. It exhibits no Danysz effect, does not fix complement unless very large amounts of serum are used, and can be specifically coprecipitated by addition of precipitating antitoxin and toxin. On the other hand, it is capable of sensitizing guinea pigs to fatal anaphylactic shock. Heating at 56 degrees C. for 4 hours destroys the skin-sensitizing properties and results in almost quantitative conversion to a modified antitoxin which is capable of blocking the wheal and erythema reaction caused by injection of toxoid into sensitized skin. Heating at 56 degrees C. does not result in an appreciable loss of neutralizing power as judged by tests in rabbit and human skin. The anaphylactogenic property of nonprecipitating antibody is likewise unaffected by heat at 56 degrees C. 3. Precipitating antitoxin is incapable of sensitizing normal skin to toxin or toxoid and disappears rapidly from the injected sites. It fixes complement to high titer and sensitizes guinea pigs to fatal anaphylactic shock. It was possible to demonstrate inhibition of the wheal and erythema reaction in sensitized skin by injecting certain mixtures of precipitating antitoxin and toxoid. 4. The two antitoxic sera studied in greatest detail represented extreme cases. Many persons immunized with toxoid developed both precipitating and nonprecipitating antitoxin simultaneously.