The Journal of Experimental Medicine, Vol 33, 791-813,
Copyright, 1921, by The Rockefeller Institute for Medical Research New York
STUDIES ON DECREASING THE REACTION OF NORMAL SKIN TO DESTRUCTIVE DOSES OF X-RAYS BY PHARMACOLOGICAL MEANS AND ON THE MECHANISM INVOLVED
John Auer M.D.1 and
William D. Witherbee M.D., Roentgenologist1
1 From the Laboratories of The Rockefeller Institute for Medical Research.
When a fixed area of the ears of rabbits is subjected to the action of a standard destructive dose of x-rays (30 skin units) the type of reaction resulting depends upon the previous treatment of the rabbit. (1) In normal rabbits a mild acute inflammation develops in the x-rayed area which leads at once to a perforating gangrene within an average of 15 days. (2) If rabbits are x-rayed and about 2 weeks later injected with horse serum for the first time, a mild acute inflammation appears which heals for a time; then a second, subacute inflammation sets in which leads to a perforating gangrene. The average time of the process from the first inflammation to gangrene is 32 days. (3) If rabbits are sensitized with horse serum and 10 days later are exposed locally to the standard dose of x-rays, the ensuing ear reaction is either similar to the second reaction described above, except that it may last up to 110 days, or the first inflammation leads to a healing which may be apparently permanent (340 + days). (4) If rabbits are first sensitized with horse serum, exposed locally to the standard dose of x-rays 10 days later, and 13 days after the x-ray treatment reinjected with horse serum, the reaction of the x-rayed area of the ears is in general similar to the second reaction described above (inflammation—healing—inflammation—gangrene). The average time of the whole process is about 42 days.
On the basis of the general hypothesis that an anaphylactic reaction is initiated in the body when the specific antibody meets its antigen, and that both antibody and antigen are rendered more or less functionally inert by their interaction, the following inferences may be drawn from our experimental results. (1) The protection from the effects of a standard destructive dose of x-rays which a previous sensitization confers, is referable to the presence of anaphylactic antibodies in the x-rayed area. (2) This protection is largely due to the anaphylactic antibodies which are anchored in the x-rayed area, and not to those which are free in the circulation. (3) An anaphylactic reaction renders the anchored anaphylactic antibodies largely impotent as protective factors against the standard destructive x-ray dose, even though sensitization preceded exposure to the x-rays. (4) An area treated with the standard destructive dose of x-rays is unable to produce or to anchor a sufficient amount of anaphylactic antibodies for protection from necrosis, when the x-ray treatment precedes the sensitization, or when the locally anchored anaphylactic antibodies are rendered functionally inactive by a general anaphylactic reaction.
It is possible that the procedure of increasing the resistance of the skin to a destructive dose of x-rays by means of a previous sensitization with protein may be applicable in the treatment of certain types of inoperable disease, when it is important to use massive doses of x-rays.
Animals which have been sensitized, or sensitized and reinjected with any undenatured alien protein, should not be reemployed as normal controls in any investigation unless trial has shown that these proteinized animals react quantitatively and qualitatively like normal animals.
The presence of an abnormal reactor in a group of supposedly normal animals may be an indication of a previous proteinization.
Submitted on March 17, 1921
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