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Disappearance of I¹³¹ Labeled Diphtheria Toxoid in Human Skin and its Relationship to Immediate Wheal Reactions¹

From the Department of Pathology, New York University School of Medicine, New York, New York

Abstract

The disappearance of I¹³¹ and I¹³¹ toxoid from injection sites was studied in the skin of normal Schick positive and Schick negative subjects. The curve of disappearance of I¹³¹ toxoid was in three phases; (1) equilibration, which occurred both in Schick positive and Schick negative persons immediately after injection; (2) exponential phase, which was observed in Schick positive persons subsequent to the equilibration phase; (3) immune elimination, which occurred in Schick negative subjects subsequent to the equilibration phase. Immune elimination appeared to be responsible for shortened survival of I¹³¹ toxoid in local sites as suggested by its relatively rapid removal from skin in the Schick negative person and in subjects who received preformed I¹³¹ toxoid antitoxin complexes. When delayed reaction occurred following I¹³¹ toxoid, there was seen an unexpected degree of retention of the isotope in Schick negative persons.

Apart from variable results associated with delayed reactions, the half-life of I¹³¹ toxoid in skin sites injected with toxoid was estimated at a) 3 to 5 days in Schick positive persons; b) <1 to 2 days in Schick negative persons. Preformed I¹³¹ toxoid-antitoxin complexes disappeared from intradermal sites with a half-life of < 1 day.

Immediate wheal reactions occurred commonly when I¹³¹ toxoid was present in a Schick-negative person with a high titer of circulating antitoxin. In this circumstance wheal reactions occurred in the phase of immune elimination of I¹³¹ toxoid. Two successive doses of I¹³¹ diphtheria toxoid given to each person caused wheal reactions in all instances. Delayed reactions after toxoid appeared to assist this process by slowing the release of antigen from the injection site. The data suggest that immediate wheal reactions occur in hyperimmune persons in association with the formation in skin of antigen-antibody complexes.

Footnotes

¹ This work was supported in part by U. S. Public Health Service Grants E3724 and E3766 and the American Heart Association Grant 60 G 174.

² The author is a Career Investigator of the Health Research Council of the City of New York under Contract 1-121.

Previous address, University of Pittsburgh, Department of Pathology.