THE FACTS OF IMMUNITY 



of interest is the finding that the same process of feeding 

 prevented the production of circulating antibody against 

 a picryl chloride-protein complex given intraperitoneally. 



5. Congenital agammaglobulinaemia 



As an incidental result of the effectiveness of antibiotics, an 

 increasing number of children are being recognized and kept 

 alive who have no circulating gamma globulin and who are 

 unable to manufacture circulating antibody. Such children 

 provide what are essentially natural experiments of the 

 greatest importance for the understanding of the immune 

 process. 



The essential features of the disease from the immuno- 

 logical angle may be summarized as follows: 



(i) It is a sex-linked genetic anomaly seen only in males. 

 (ii) There is an absence of demonstrable gamma globulin 

 and circulating antibody; the /^^agglutinins to be 

 expected from the blood group of the individual are 

 also absent, 

 (iii) There is no response to the ordinary immunizing inocu- 

 lations either by the appearance of circulating antibody 

 or in the case of diphtheria antigens by the change 

 from Schick-positive to Schick-negative. 

 (iv) There is an absence of plasma cells in bone marrow 



and lymph nodes even after antigenic stimulation. 

 (v) Agammaglobulinaemic patients may be actively sensi- 

 tized to tuberculin by BCG vaccination and to 2-4- 

 dinitrofluorobenzene by skin sensitization. Sensitivity 

 to the latter is transferable by blood cells to normal 

 individuals. 



The important clinical features that have been recorded 

 are as follows: 

 (vi) There is a great susceptibility to pyogenic bacterial 

 infections, especially pneumonia, but these can 

 generally be cured by administration of antibiotics and 

 normal human gamma globulin. 



42 



