Abstract
Previous studies from this laboratory demonstrated that patients with inactive rheumatic valvular disease generally maintain elevated levels of antibody to Group A streptococcal carbohydrate (A-antibody) following acute rheumatic fever, while A-antibody levels fall to normal in other post-streptococcal states. Immunization of rabbits with killed Group A streptococci was performed to define the conditions necessary to produce sustained A-antibody. A-antibody was assayed by the Farr technique utilizing 14C-A-carbohydrate. Rabbits immunized by Lancefield's schedule of thrice-weekly IV injections for 4 weeks produced very high A-antibody levels which promptly fell; boosting with a similar schedule induced the same response. Transient low A-antibody levels followed a single IV immunization, peaking at 6-8 days and falling by 14-20 days. Single IV boosts consistently recalled transient A-antibody responses. In contrast, a single subcutaneous (SC) dose of vaccine in complete Freund's adjuvant (CFA) led to sustained high A-antibody levels. Peak levels were reached by 35-45 days and remained elevated for at least 120-185 days. SC vaccine without CFA induced low level A-antibody which declined promptly and disappeared by 50 days. Because adjuvant effect appears to correlate with slow antigenic release from the depot, these data support the possibility that the sustained serum A-antibody levels in rheumatic heart disease represent chronic anti-genic stimulation by streptococcal A-carbohydrate or by cross-reactive tissue antigens.
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Shulman, S., Ayoub, E. SIMULATION OF RHEUMATIC RESPONSE TO STREPTOCOCCAL CARBOHYDRATE IN RABBITS BY USE OF ADJUVANT. Pediatr Res 11, 505 (1977). https://doi.org/10.1203/00006450-197704000-00813
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DOI: https://doi.org/10.1203/00006450-197704000-00813