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Studies on the "Toxins" of Hemolytic Streptococci

V. The Dick Test and Allergic Skin Reactions to Streptococcus Nucleoproteins

From the Bacteriological Department (Khoji Ando), Hygienic Institute (Director Shoji Kanai) of the S. M. R. Co., Dairen

Abstract

1. Skin reactions to the nucleoprotein of streptococcus seem to indicate a somewhat nonspecific allergic state of the individuals tested with this substance which seems to be common at least to various streptococci, and are not an indication of a specific relationship with certain streptococci. The fact that the allergy to the N.P. runs parallel to the immunity to the essential toxin is due to the structure of Streptococcus scarlatinae of which the N.P. and the essential toxin are the two components. But that both are not necessarily parallel to each other seems to depend upon the fact that nucloproteins are widely common to various sorts of streptococci while only a limited variety of streptococci can produce essential toxin and that the rapidity of development of immunity to the essential toxin and of allergy to the N.P. does not run parallel to each other.

2. An explanation of many data reported by various authors on the Dick test contrary to the Dicks' theory may be found in the fact that the ordinary Dick toxin (culture filtrate) in addition to the essential toxin contains N.P. which is also capable of evoking allergic reactions on human skins. The culture filtrate which contains a considerable amount of N.P. seems to have given results inconsistent with the toxin-antitoxin theory.

3. For the standardization of the Dick toxin for the Dick test it is not sufficient to determine its skin units, but the nucleoprotein content of it must be considered. In this respect, the Washington standard toxin was very satisfactory, but the use of the purified toxin free fron N.P. is most reasonable.

4. In order to determine skin units of ordinary culture filtrate very young children with strongly positive reaction to the scarlatinal toxin are preferred, as they scarcely have a positive reaction to the nucleoproteins. If we utilize weak positive reactors and place the importance on the percentage of positive reactors, this will likely lead us into error, owing to the positive reactions to the N.P.

5. The divergence of the results reported by many authors on the age distribution of positive reactors seems to depend upon the different content of nucleoproteins in the filtrate used.