For the demonstration of circulating antibody in Ascaris-infected animals, precipitation, complement fixation tests and passive cutaneous anaphylaxis have been carried out. All of these, however, cannot clinically be utilized in ascaris-infection or ascariasis in man. In view of this, kuroume of this department, in 1956, demonstrated the human ascaris antibody with Boyden's tanned cell hemagglutination test. The results show that the hemagglutinin titer both in the infected and noninfected, was different in each age group, being lower in infants, rising with age, and attaining the level of the adult in middle school children. It was also found that the titer was remarkably higher in the infected than in the non-infected through all age groups. The author studied, the change in the hemagglutinin titer in patients with intestinal ascariasis, with his method and obtained the following results: 1) The titers at the attack: One out of five preschool children, showed the titer of 1:10, two was 1:80, one 1:160, and one 1:320. Out of four elementary school children, one was 1:320, and the other three 1:160. One middle school child was 1:160. In two adults, the titer was 1:160. Compared with the hemagglutinin titer in ascaris carriers in each age group, eight showed the higher, titer and four were the same level. 2) The titers in the reconvalescence: One out of three preschool children showed the titer of 1:20 and two 1:80; two elementary school children was 1:40 and one 1:80; one middle school child showed the titer of 1:80; and two adults were 1:40 and one 1:80. Compared with hemagglutinin titer in ascaris carriers in each age group, two were the higher level, five were the same level and one was the lower level. Compared with the hemagglutinin titer at the attack, the titer in the reconvalescence was found lower than at the attack in seven out of eight cases. 3) The titers after anthelmintic treatment: one preschool child was 1:20; two elementary school children was 1:20 and 1:40: one middle school child was 1:40; and one adult was 1:20. Comparison with the ascaris-noninfected in corresponding age groups revealed that two showed the higher and another three almost the same titer. Compared with the hemagglutinin titer in the reconvalescence, in four the titer was found to be lower after the anthelmintic treatment than in the reconvalescence. To summarize, the hemagglutinin titer in intestinal ascariasis was in general, higher at the attack, fell to the level of ascaris carriers in the reconvalescence, and fell further to the level of the noninfected after anthelmintic treatment. In this way, the titer showed a definite change from onset through the course of the disease, giving another evidence to support the assumption that ascariasis is principally based on allergic reaction due to ascaris infection.

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In the previous paper the results of tanned cell hemagglutination test with ascaris body fluids in human intestinal ascariasis are reported. The present paper shows the results of the same experiment preformed on patients with gastro-duodenal ascariasis to trace the change in the hemagglutinin titer. At the attack, the hemaggltutinin titers in different age groups were as follows: Two preschool children showed the titer of 1:320 and 1:1,280; two elementary shool children showed the titer of 1:128 and 1:1,024; and one adult gave the titer of 1:640. Compared with the hemagglutinin titer of ascaris carriers in each age group, all the cases showed higher levels. Further, four showed the higher levels than patients with intestinal ascariasis, and the remaining one showed the same level with them. In the reconvalescence, the hemagglutinin titers in different age groups were as follows: Two preschool children showed the titer of 1:160, and one elementary school child 1:256. The hemagglutinin titer was lower than at the attack in all the three cases. Comparison in corresponding age groups revealed that all the cases were on higher level than both ascaris carriers and patients with intestinal ascariasis in reconvalescence. These patients were subjected to anthelmintic treatment, and the hemagglutinin titer was determined. The titers after anthelmintic treatment; two infants showed the titers 1:80 and 1:160, one elementary school child 1:256 and one adult 1:160. In one of the three cases, the titer was lowered, and in the other two, it remained unchanged. Comparison in corresponding age groups revealed that three out of the four showed the higher level than ascaris carriers, and one showed the same level with them; and further that all the cases showed the higher levels than patients with intestinal ascariasis after anthelmintic treatment. In this way, the hemagglutinin titer was higher at the attack of gastro-duodenal ascariasis, lowered in reconvalescence, and unchanged or lowered after anthelmintic treatment. And even after the treatment, the titer maintained at the level of about 1:160; evidently higher than intestinal ascariasis after treatment (1:20〜1:40). The hemagglutinin titer thus followed a definite course of change from the onset through succeeding stages of gastro-duodenal ascariasis, giving one more strong evidence to susport the assumption that ascariasis is principally based on an allergic reaction due to ascaris infection. Fur ther, the titer in gastro-duodenal ascariasis was higher than in intestinal ascariasis at the attack, in reconvalescence, or after anthelmintic treatment. Especially, the evidently high titer in the noninfected state after the treatment seemed to suggest that gastro-duodenal ascariasis was based on stronger sensitization and higher allergic state than the intestinal ascariasis.

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It has been well known that the trachea and the bronchus have not only analogous histologic structures, but also similar responses to bronchospastic and bronchodilator drugs. On this ground, we attempted to clarify with isolated trachea from sensitized guinea pig whether bronchial contraction is caused by allergic reaction in the experimental asthma. Three methods, tracheal chain and tracheal spiral, both of which have already been reported, and our new method, were used in this study. Our method was so designed that the surface of solution in a fine glass tube, connected to isolated trachea, might be moved by tracheal contraction and dilatation, in order to be recorded. From result of comparative study on these three methods, we found that tracheal responses to several drugs were more sensitive in tracheal spiral and our method than in tracheal chain. By use of these better two methods, we could demonstrate that trachea was contracted specifically by addition of antigen in the same way as the ileum in the Schulz-Dale method. Since the contraction elicited by the antigen in the sensitized trachea is initiated by reaction of antibody with antigen, this fact proves that specific tissue antibody exists also on the trachea as on the ileum removed from sensitized guinea pig, suggesting that bronchial contraction based on allergic reaction plays a role in the experimental allergic asthma.

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In view of the fact that quinoline derivatives are potential therapeutic agents of collagen diseases, the authors have been using them in the management of bronchial asthma since 1959. Favorable effects of their long-term use upon bronchial asthma were in part reported in the previous papers. The present paper deals with results of observation in which many of the asthmatic patients have taken these drugs for as long as two years. For the past over two years, 405 out of 605 asthmatic patients were given either chloroquine diphosphate 200-300 mg. (354 cases) or chloroquine diorotate 300 mg (51 cases) daily in one to three divided doses. The drugs proved to be effective in 90 per cent of the treated patients and asthmatic attacks were no longer observable in 40 per cent of them. In contrast, the side effects of the drugs were rare and included slight, transient ophthalmic, gastrointestinal and neurologic complaints. In the course of the treatment no signs of liver impairment were noted. In patients whose peripheral blood showed leukocytosis prior to the therapy, the white cell count tended to decrease. There was no significant change in the percentage of circulating eosinophils but it, likewise, tended to decline with the treatment. In vitro tissue culture experiments in which these drugs were added to the medium demonstrated suppression of fibroblastic growth. This experimental evidence suggests some of the mechanisms of in vivo drug action in bronchial asthma.

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