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Immunological investigations of meningococcal disease. II. Some characteristics of group C antigen of Neisseria meningitidis in the sera of patients with fulminant meningococcemia.

The prognosis of patients with septicemia due to group C Neisseria meningitidis, who had high levels of soluble meningococcal antigen in their sera, was poor. The polysaccharide nature of this antigen was suggested by its immunologic similarity to group C purified polysaccharide as shown by counterimmunoelectrophoresis and immunodiffusion tests. The antigen eluted from Sephadex G-200 along with IgM and Blue Dextran 2000. Several properties of the antigen suggested an endotoxin component, i.e., pyrogenicity in rabbits, induction of a "pyrogenic refractory state" to Escherichia coli lipopolysaccharide, and epinephrineinduced dermal necrosis in rabbits. It is postulated that the circulating antigen may represent a bacterial cell-wall complex containing polysaccharide and lipopolysaccharide, and may be responsible for the vascular and coagulation abnormalities so characteristic of fulminant meningococcemia. Observations that serum from patients with group C fulminant meningococcemia had high levels of a soluble group-specific antigen of Neisseria meningitidis suggested a temporal relationship between the level of this antigen and prognosis [1, 2]. No attempt was made to identify other immunochemical properties of this antigen. This report is an extension of our earlier obser