Three hundred seventy three asthmatic patients treating in the Taipei General Hospital have been asked for their hereditary histories regarding the atopic constitution, and they were tested intracutanceously by a series of various antigens. The incidence of rate asthmatic patients having same patients in their close relatives was 72% in the atopic patients and 11% in the infectious patients, and their rates became higher in case asking for whole relatives such as 78% in former and 14% in latter. There was no difference of the inheritance of asthmatic constitution between father and mother sides, but marked difference between one side and both sides inheritance from their parents. The incidence rate of asthmatic patients within all patients treated in the Taipei General Hospital tended to increase in recent ten years: i.e. 1.6% in 1954 and 3.4% in 1966. The positive rates of the skin tests were as follows: i.e. house dust 73%, ragweed pollen 26%, Japanese mat fiber 22%, red pine tree pollen 20%, cotton fiber 18% e.t.c.. The positive rate of house dust antigen was higher in the atopic or mixed typed patients than the infectious patients as well as normal subjects, especially low in the students of the nursing school (0%).

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1) Induction of skin-sensitizing antibody in human subjects was attempted with parenteral administration of a commercial ACTH preparation. Twenty units of depot porcine ACTH (ACTH-Zn, N.V. Organon, Holland) was injected to 33 asthmatic patients, 24 rheumatoid patients and 18 control subjects, once every week and repeated successively till 8 times, so far as the intradermal reaction to 2×10^<-3> u./ml ACTH solution remained negative. In the asthma group, especially in the inhalation-test-positive subjects, sensitization with immediate type reaction was achieved more easily. On the contrary, most of the rheumatoid patients were less easily sensitized. 2) Delayed type skin reaction appeared more frequently in rheumatoid group, however without statist tically significant difference. 3) Skin-sensitizing antibody producing capacity was also examined in several cases of hematopoietic diseases and dysgammaglobulinemias. Sensitization was achieved in 2 of 3 cases of acute myelocytic leukemia, 1 case fo γG type myeloma, 1 case of ataxia-telangiectasia associated with marked decreasein γA globulin and several other patients. No skin reactivity was evoked in 3 cases of malignant lymhpoma. 4) Anamnestic response was observed on skin-sensitizing antibody production. 5) Positive PK reactions were proved in 16 cases among 38 tested subjects. Antibody responsible for PK reaction was thermolabile and showed strong affinity to normal human skin, negative precipitation in agar gel, negative tanned hemagglutination and negative PCA reaction in guinea pig. 6) For the purpose of investigating possible difference between naturally produced reagin and artificially induced skin sensitizing antibody, the sera containing the both antibodies were fractionated with DEAE cellulose column chromatography and distribution of the above mentioned two skinsensitizing antibodies was compared, which were demonstrated by PK reactions to the corresponding antigens. No evidence was obtained suggesting difference between them. 7) Some evidence was presented suggesting that the antigenic substance responsible for immediate reaction in man is a contaminant in the ACTH preparation.

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In order to test for ability of antisera against various tissue homogenate to produce nephrotoxic serum nephritis (NSN), supernatant substance of trypsin digested tissue homogenate was used as antigen. Because we have already reported that active principle responsible for the production of NSN is present in the supernatant substance of trypsin digested kidney homogenate. Rat organs examined in this experiment were lung, aorta, heart, liver, muscle, brain, stomach, and spleen. Antisera were produced in rabbits by the alum method. One ml. of each antisera was injected intravenously into rats weighing 150 gm. and killed 10 days after injection. In rats recieving antisera against lung, aorta, heart, liver, and muscle, prominent proteinuria appeared and histological examination revealed typical NSN. Fluorescent staining of kidney frozen sections with antirabbit γ-globulin demonstrated exclusive uptake of fluorescence only in glomerular basement membrance. By injection of FITC labeled γ-fractions of these antisera, NSN was also induced. The existence of a common precipitin line was recognized between these five antisera and supernatant substance of trypsin digested kidney homogenate. When antisera against brain, stomach, or spleen was injected, no NSN occurred, although fluorescence in glomerular basement membrane was positive and a common precipitin line was noted in case of antibrain sera. Still further investigations should be necessary to conclude that these three antisera have no effect to produce NSN.

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Shelley and his colaborators reported that the blood basophil cell undergoes degranulation durnig the antigen-antibody reaction, and that this basophil degranulation may be used as a indicator of allergic sensitivity which parallels intensity with specific circulating antibody in any allergic state. The author attempted to confirm their observation by studying basophil degranulation induced by adding the antigens to the sera of the patients and guinea pigs known to be sensitive to "Maiko" and to the sera of the house dust sensitive subjects. The author employed the indirect tehcnique described by Shelley in 1962, in which basophils obtained from the buffy coat of rabbit blood are placed on slides prestained with neutral red, and sera from sensitive guinea pigs or human subjects are added to it, and then challenged with specific antigen. The criteria of the positive test was the same as described by Shelley. 1) Indirect basophil degranulation test, using as the antigen 40% and 60% saturated ammonium sulphate precipitated fraction from "Makio" extract, proved positive in the majority of the persons exposed to "Maiko", and proved negative in the majority of the persons without exposure to "Maiko". 2. When the author used house dust extract as antigen, this test proved positive in the most of the house dust sensitive patients, but negative in the house dust non-sensitive men. 3) On the guinea pigs actively sensitized with "Maiko" and not provocated, the test using "Maiko" antigen, proved positive in all cases, however after provocated inhalation with "Maiko", the most cases become negative, and the majority of the non-sensitized control animals proved negative. The author concluded that the test seems to be specific and useful means to detect the hypersensitive state.

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For the purpose of studying the antigenicity of the sea-squirts firmly adhering to the outside of the oyster's shells in the patients with oyster-shucker's asthma, skin test, Prausnitz-Kustner reaction, conjunctival test, leukocytolysis in vitro and sensitized hemagglutination reaction were performed both in the patients with oyster-shucker's asthma and in healthy oyster-shuckers, patients with ordinary bronchial asthma and healthy persons as control with antigens extracted from Ciona intestinalis, Styela plycata, Styela clava-sea-squirts adhering to the oyster's shells in Hiroshima Bay-and Halocynthia roretzi-a sea-squirt caught in Miyako Bay-and, moreover, the detection of blocking antibody as well as the observation in changes in the reactions above mentioned were attempted in the patients with oyster-shucker's asthma under the specific hyposensitization treatment. Results obtained were as follows: 1) The incidence of positive reaction in skin test or conjunctival test with sea-squirt antigens was remarkably high in the patients with oyster-shucker's asthma as compared with that of the control. In these patients the antibody of reagin type was revealed by Prausnitz-Kustner reaction and antibodies responded to leukocytolysis in vitro as well as to sensitized hemagglutination reaction were also found. A significant correlation was seen between skin test and Prausnitz-Kustner reaction or conjunctival test and also between leukocytolysis in vitro and sensitized hemagglutination reaction. 2) Among Ciona intstinalis. Styela plycata, Styela clava and Halocynthia roretzi, both antigen common to the species and antigens peculiar to the species were found. 3) In the patients with oyster-shucker's asthma received the specific hyposensitization treatment with sea-squirt antigens, the blocking antibody was detected. The blocking antibody was formed not only against the antigen used in the treatment, but also against the antigens which were not used in the treatment. 4) During the hyposensitization treatment with sea-squirt antigens, the limit of positive reaction of the skin test showed a tendency to increase. The reactions in the conjunctival test became negative or weak in the majority of the cases and the leukocytolysis in vitro showed a tendency to decline its decreasrate. No definite tendency was, however, observed in the sensitized hemagglutination reaction. From the results above mentioned, it was concluded that the patients with oyster-shucker's asthma had antibodies responded to the sea-squirt antigens and, therefore, oyster-shucker's asthma was an allergic asthma developed in the oyster-shuckers who were sensitized by sea-squirts.

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The mechanism of orthostatic albuminuria is not clear. On close observation, many cases are found to be accompanied by symptoms due to food allergy such as fatigability, dizziness, nausea, weakness, palpitation, headache, abdominal pain, mothion sickness and so on. In this study 16 cases of orthostatic albuminuria were studied from the standpoint of food allergy, and in all cases food allergens were confirmed clinically. Urinary albumin was checked and measured semirquantitatively with Albustix. In our study, the diagnosis of orthostatic albuminuria was made when the early morning specimen was negative for urinary protein, when albuminuria appeared on upright posture or erect-lordosis, and when complete disappearance of albumin was recognized on lying down. As the results, food allergens were determined in all the 16 cases, including 2 cases in which orthostatic albuminuria appeared exclusively was seen, 8 cases in which association of symptoms such as dizziness, fatigability, weakness, discomfort and pallor were found, and 6 cases in which food allergy conditions such as duodenal ulcer, gastric ulcer, migrain, urticaria, eczema, chronic gastritis were accompanied. Of the 16 cases, the allergen was determined to be milk in 5, egg in 2, soybean in 1, milk and egg in 5, milk and soybean in 1, and milk, egg and soybean in 2 cases. Thus, orthostatic albuminuria was related to milk in 13, and to egg in 9 of 16 cases, and these two were thought to be the important allergens for developing orthostatic albuminuria. Next, urinary excretion of milk or egg antigens were studied by PCA technique in 5 out of 16 cases. The PCA reatcion was negative for the early morning specimen before giving milk or egg. Upon the erects lordotic posture, however, urinary excretion of antigens were demonstrated in all the cases from titer of 1:10 to 1:1,000. Simultaneously, a large amount of protein appeared in the urine. It is quite interesting that the urinary excretion of the antigens is paralel to the appearance of protein on erect lordosis. In this presentation, it was shown by elimination and trial ingestion diets, that food allergy may play some role in the etiology of orthostatic albuminuria.

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