Studies on the Immune Response of the Rheumatic

Preceding papers have shown (1, 2, 3, 4, 5) that in the rheumatic subject one factor essential for the development of acute rheumatism is the magnitude of the immune response to hemolytic streptococcus infection. The mechanism involved in the rheumatic process is unknown. The present paper deals with an attempt to diminish the. patient's antibody production for the purpose of modifying the rheumatic process, and with observations on the relation of the spleen to rheumatic activity. A number of investigators (6, 7, 8) interested in the mechanism of immune reactions are agreed that the spleen plays a role in the fixation of antigen and in the production of antibody, and that splenectomy may inhibit antibody formation under certain conditions. Clinical observers have established the effectiveness of splenectomy in certain hemorrhagic disorders. Since the tendency to hemorrhage is a common characteristic of rheumatic activity, which occurs at the time that the immune response is evoked, it seemed possible that splenectomy might modify the responses of the rheumatic subject to infection. Splenectomy was performed on a selected group of children who have subsequently been kept under close observations. The findings are discussed in this paper.