RESUMEN
Two hundred twenty-one healthy children, from 6 months to 7 years of age, were tested for delayed-type hypersensitivity (DTH) by the Multitest CMI (cell-mediated immunity) (Merieux Institute, Miami). This device permits the simultaneous application of seven standardized recall antigens and a glycerol diluent control. Younger children were tested on the back and older children on the volar surface of the forearm. Only 6.8% of the children were anergic, and most of them (11/15) were female. The DTH responses were present for one or more antigens in 93% of the infants. The DTH responses increased tremendously during the second year of life and increased slowly thereafter. A relatively high incidence of positive reactions was found for three of the tested antigens--diphtheria toxoid (79%), tetanus toxoid (62%), and Proteus (57%), in children in the preschool years, and accounted for three fourths of all positive reactions. Much lower levels were found for Streptococcus (25%), Candida (16%), Trichophyton (5%), and tuberculin (4%). Measurement of DTH by the standardized Multitest CMI system seems to be a convenient and reliable tool for assessing CMI function in infants and small children. The tool permitted us to measure patterns of DTH responses from infancy onward in a healthy population and to develop index values in a normal reference population with which any tested preschool child can be compared.
Asunto(s)
Hipersensibilidad Tardía/diagnóstico , Inmunización , Pruebas Cutáneas/instrumentación , Factores de Edad , Niño , Preescolar , Femenino , Humanos , Inmunidad Celular , Inmunocompetencia , Lactante , Masculino , Valores de Referencia , Factores Sexuales , Factores de TiempoRESUMEN
The Multitest CMI system was used to measure cutaneous delayed type hypersensitivity (DTH) to a standardized battery of seven recall antigens in 448 healthy school children in relation to sex, age, race, and socioeconomic groups. Blacks demonstrated highest overall DTH, hispanics were intermediate, and whites were lowest. There was a trend for males to be more reactive than females at certain ages in each race. Incidence of reduced DTH scores (relative to adult values) was somewhat increased in the youngest school children, chiefly whites. Incidence and size of DTH responses to certain antigens were consistently higher in the blacks and/or hispanics as compared with whites. Blacks lived almost exclusively in the "poorer" school district, hispanics were evenly divided in both districts, while whites were mostly from the "affluent" district. Level of DTH appeared to be greatest in children from relatively poor homes possibly reflecting more intense and frequent exposure to ubiquitous microorganisms.
Asunto(s)
Hipersensibilidad Tardía/epidemiología , Inmunidad Celular , Pruebas Cutáneas/métodos , Adolescente , Niño , Femenino , Humanos , Hipersensibilidad Tardía/diagnóstico , Hipersensibilidad Tardía/inmunología , MasculinoRESUMEN
Measurement of cutaneous delayed-type hypersensitivity (DTH) to a battery of ubiquitous antigens is an accepted means of assessing cell-mediated immunity (CMI). The recently introduced Multitest CMI system consists of a plastic multiple puncture device that simultaneously applies seven standardized recall antigens in a reproducible manner. A representative population of 448 healthy US schoolchildren was tested to determine incidence and size of DTH responses to each of the seven antigens. All responded to one or more antigens, the number and size of reactions generally increasing with age. Incidence of positive DTH tests was highest for tetanus and diphtheria toxoids, intermediate for streptococcal, Candida, and Proteus antigens, and lowest for tuberculin and Trichophyton antigens. These normal values, related to age and sex, can be a foundation for immunologic evaluation and are the basis of a proposed scoring system that distinguishes between normal DTH reactivity and diminished responsiveness.