Abstract
The pathogenic activity of microörganisms may be due to toxic substances of either cellular or extracellular nature or both. These substances are usually designated endotoxin and exotoxin, although it is likely that no sharp division line exists.
An ideal antigen for active immunization in the case of invasive microörganisms, which produce both endo- and exotoxin, should contain both endo- and exotoxic principles. Likewise, an ideal antibody-solution when administered therapeutically should be able to neutralize both the endo- and exotoxin of the homologous organism.
Staphylococcus pyogenes produces a soluble exotoxin 1 which is readily converted into formol-toxoid, and is used for active immunization of laboratory animals and human beings. The staphylococcus contains endotoxin, 2 and vaccines have been used for a long time in the prophylaxis and treatment of localized staphylococcal infections. Bacteriophage-solution is also used therapeutically, both on account of its lytic activity towards the organisms and because bacteriophagic solution of the lysed staphylococcus is antigenic. 3 The toxoid, the vaccine, and the bacteriophagic solution may be considered as representing different antigenic groups.
If an antigen embodied all these antigenic principles, the immunity would presumably be more effective than specific antitoxic immunity or a strict antibacterial immunity, and the administration of an antitoxin which in addition contained antibacterial antibodies would better match the toxin-producing and invading characteristics of S. pyogenes. Prompted by these considerations we prepared a multivalent staphylococcal toxoid which contains endotoxic as well as exotoxic principles of staphylococci.
Lysis by bacteriophage was preferred to other methods in order to avoid denaturation and because the antigenic activity of bacteriophage solution is well established. 3
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