Zusammenfassung
Mit Hilfe isologer 4-Aminophenazonserum- bzw. -leukocytenkonjugate wurden Kaninchen sensibilisiert. Die gewonnenen Hyperimmunseren ergaben eine serologische Spezifität für das Hapten (4-Aminophenazon); spezifisch gegen die entsprechenden Trägerproteine, vor allem gegen leukocytäre Antigene, gerichtete Antikörper lie\en sich in diesen Seren nicht nachweisen. Die unkonjugierten Haptene (4-Aminophenazon, Aminopyrin) zeigten weder in vitro noch in vivo eine sicher objektivierbare, direkte immunologische Aktivität. Immunhämatologische Untersuchungen auf zellspezifische Leukocytolysine bzw. Leukocytenagglutinine in den gewonnenen Hyperimmunseren verliefen negativ. Im Leukocytenagglutinationstest konnten aber Spenderzellen zur Agglutination gebracht werden, wenn im Versuchsansatz neben den Hyperimmunseren das Konjugatantigen bzw. ein in vitro hergestellter Antigen-Antikörperkomplex vorhanden war. An Hand von Belastungsversuchen lie\ sich experimentell ein vom Sensibilisierungsgrad der Tiere und der Menge des verabfolgten Vollantigens abhängiger Granulocytensturz herbeiführen, der in der Regel rasch reversibel war. Hämatologisch der menschlichen Agranulocytose vergleichbare Zustandsbilder traten dagegen nicht auf. Lösliche Immunkomplexe aus 4-Aminophenazonkonjugat und hochtitrigen Hyperimmunseren lie\en sich quantitativ an angereicherte Blutleukocyten bzw. Knochenmarkzellen absorbieren. Auf Grund der gewonnenen Versuchsergebnisse wird die Hypothese entwickelt, da\ für den granulocytopenischen Effekt am Versuchstier cytotrop aktive Immunkomplexe verantwortlich sind. Entsprechende Vorstellungen zur Immunpathogenese des Morbus Schultz sowie die daraus resultierenden Konsequenzen für eine sinnvolle Anwendung der Serodiagnostik bei dieser Erkrankung werden abschlie\end diskutiert.
Summary
Aminopyrin (ap), its metabolite 4-aminophenazone (4aph) and conjugates, produced by binding 4aph to isologous serum or homogenates of leukocytes were used as antigens in immunization experiments in rabbits. The hyperimmunsera exhibited a high grade specificity towards the haptenic group of the antigens. There was no evidence of any specificity to the protein carriers, especially to leukocytic antigens, as could be shown by precipitin tests, complement fixation, passive hemagglutination technic or passive cutaneous anaphylaxis. Immunohematological tests for agglutinins and cytolysins specific to leukocytes failed to give positive results. Leukocytes did agglutinate, however, when conjugate was added to the reaction system or when antigen-antibodycomplexes, formed in vitro in slight antigen excess, were used in the LAT. There was complete absorption of antigen-antibody-complexes in vitro by rabbit leukocytes, washed free of plasma. No comparable effect took place with thrombocytes or erythrocytes. When sensitized rabbits were challenged with 4aph or ap no granulocytopenia was observed. But a marked fall of the granulocyte count did occur, when highly sensitized animals were challenged with the homologous, conjugated antigens. Sometimes “granulocytoclasia” simulated agranulocytosis, but was compensated as a rule within one hour. Even after a treatment of several days a hematological state comparable to agranulocytosis-Schultz could not be elicited immunologically in animals sensitized to ap.
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Meinem Lehrer, Herrn Professor Dr. H. E.Bock, in Verehrung und Dankbarkeit gewidmet.
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Hartl, W. Tierexperimentelle Untersuchungen zur medikamentös-allergischen Agranulocytose Schultz. Z. Gesamte Exp. Med. 142, 297–333 (1967). https://doi.org/10.1007/BF02044811
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DOI: https://doi.org/10.1007/BF02044811