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Dinitrochlorobenzene responsivity in disseminated coccidioidomycosis: an inverse correlation with complement-fixing
Abstract:
The immunologic status of 25 patients with disseminated coccidiodomycosis was evaluated by serum anticoccidioidin complement-fixing antibody levels, coccidiodin skin tests, and dinitrochlorobenzene (DNCB) sensitization. In the 10 patients who had disseminated disease and a complement-fixing titer of 1:32 or less, responses to DNCB were similar to those of 20 controls. In the 15 patients with disseminated disease and a complement-fixing titer of 1:64 or more, responses to DNCB were statistically significantly diminished compared to controls (p = 0.002). Since the complement-fixing titer is associated with extent of dissemination, these results signify a relationship between diminished DNCB responses and extensive dissemination. Of the several hypotheses which might explain this relationship, we find the most attractive is that of a nonspecific deficiency of cell-mediated immunity developing secondarily to extensive disseminated disease.
Insights
Patients with severe disseminated coccidioidomycosis show weakened cell-mediated immunity. This immunologic deficiency, measured by dinitrochlorobenzene (DNCB) sensitization, correlates with higher antibody titers, suggesting a link to disease severity.
Area of Science:
- Mycology
- Immunology
- Infectious Diseases
Background:
- Coccidioidomycosis is a fungal infection endemic to the southwestern United States.
- Disseminated coccidioidomycosis can lead to severe illness and immune system compromise.
- Assessing immunologic status is crucial for understanding disease progression and patient outcomes.
Purpose of the Study:
- To evaluate the immunologic status of patients with disseminated coccidioidomycosis.
- To investigate the relationship between antibody levels, skin test reactivity, and cell-mediated immunity.
- To explore potential immune deficiencies associated with extensive disease.
Main Methods:
- Serum anticoccidioidin complement-fixing antibody levels were measured.
- Coccidioidin skin tests were performed.
- Dinitrochlorobenzene (DNCB) sensitization was assessed to evaluate cell-mediated immunity.
Main Results:
- Patients with disseminated coccidioidomycosis and complement-fixing titers of 1:64 or higher exhibited significantly diminished DNCB responses compared to controls (p = 0.002).
- Lower antibody titers (1:32 or less) were associated with DNCB responses similar to controls.
- A correlation was observed between higher complement-fixing titers, indicating more extensive dissemination, and reduced DNCB reactivity.
Conclusions:
- Diminished dinitrochlorobenzene (DNCB) responses are linked to extensive disseminated coccidioidomycosis.
- These findings suggest a secondary, nonspecific deficiency in cell-mediated immunity in patients with severe disease.
- This immunodeficiency may develop as a consequence of extensive coccidioidal dissemination.