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              <text>RESUMO E CONCLUSÕES&#13;
1) Realizamos um teste de potência imunogênica e um teste de potência antigênica de uma vacina contra a gripe "asiática" de produção nacional. A análise dos dados obtidos foi feito conjuntamente com revisão dos conhecimentos atuais sôbre o vírus da gripe, a epidemiologia desta infecção e os princípios gerais da vacinação e teste de vacinas. As experiências em sêres humanos e trabalhos de laboratório de que consistiram os testes referidos, serviram de exemplo para a aplicação e discussão de conhecimentos gerais sôbre a matéria.&#13;
2) A 4 de setembro de 1957 vacinávamos 131 voluntários, adultos, de profissão relacionada com a saúde pública, com vacina monovalente contendo 200 unidades hemaglutinantes ("CCA unit") por mililitro de amostra "asiática" do vírus da gripe. Injetamos 1 ml por via subcutânea e momentos antes da vacinação foram sangrados todos os voluntários para ter um contrôle da produção de anticorpos. Três semanas depois, apenas 101 daqueles voluntários foram sangrados de novo e 19 dêstes, revacinados com a mesma dose e pela mesma via. Três semanas mais tarde, êstes 19 indivíduos revacinados eram de novo sangrados.&#13;
3) Na última semana de setembro e nas duas primeiras semanas de outubro de 1957, ocorria o acme da epidemia de gripe "asiática" na cidade de São Paulo. Posteriormente, realizamos um inquérito epidemiológico para determinar a incidência de gripe nos vacinados e nos seus controles. Êstes últimos eram os conviventes dos vacinados nos aglomerados familiares a que êstes últimos pertenciam.&#13;
4) Realizamos o cálculo da incidência da gripe no grupo dos vacinados e nos contrôles, mediante diversos tipos de agrupamento de dados, visando evidenciar possíveis influências de certas características dos indivíduos sôbre a incidência da gripe. Assim, consideramos como contrôles, os adultos conviventes dos vacinados, enquanto que em outras análises, considerávamos tanto adultos como crianças não vacinados. Foram eliminados dos cálculos os indivíduos que apresentavam títulos significativos de anticorpos antes da vacinação.&#13;
5) Nos soros colhidos, nas diversas sangrias, realizamos as reações de fixação de complemento e de inibição da hemaglutinação, usando como antígeno tanto a amostra "A//Formosa/313/57" como a "A/Japan/305/57".&#13;
6) A análise estatística da diferença de incidência de gripe entre os vacinados e os não vacinados mostrou não ser significante ao nível de 5%.&#13;
7) A análise estatística dos resultados das reações sorológicas mostrou diferença significante, ao nível de 5%, entre a percentagem de indivíduos que apresentaram resultados positivos antes e depois da vacinação, tanto em ambas as reações sorológicas, como em ambas as amostras usadas como antígeno.&#13;
8) A comparação dos nossos resultados com achados realizados em estudos similares feitos nos E. U. A., nos levam às seguintes conclusões:&#13;
a - A vacina testada não manifestou poder protetor.&#13;
b - A vacina testada mostrou muito pouco poder antigênico.&#13;
9) As conclusões e achados anteriores são analisadas apresentando diversos argumentos favoráveis, assim como suas possíveis limitações.</text>
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              <text>RESUMO GERAL E CONCLUSÕES&#13;
1 - A reação de fixação do complemento em sôro de lepra com antígenos preparados de bacilos da tuberculose se deve à atividade haptênica dos fosfatídeos ácidos complexos ligados à carboidratos e solúveis em piridina.&#13;
2 - O efeito anticomplementar dos antígenos solúveis em piridina é corrigido pela lecitina; efeito semelhante se observa nos antígenos aquosos do bacilo da tuberculose.&#13;
3 - As reações entre antígeno, anticorpo e complemento, podem ser melhor estudadas por meio das "curvas de isofixação" obtidas por projeção de antígeno contra sôro, o complemento sendo mantido constante.&#13;
4 - A curva de isofixação em seu ramo vertical permite determinar as condições necessárias para a titulagem de antígenos e também a influência da quantidade de sôro presente na reação sôbre os parâmetros da linha de regressão: antígeno-complemento.&#13;
5 - O ramo horizontal da curva de isofixação indica as condições nas quais se deve processar a titulagem do sôro. A influência da dose de antígeno empregada sobre os parâmetros da linha de regressão sôro-complemento poude ser apreciada e dada uma correta interpretação.&#13;
6 - A dose de antígeno a ser usada numa titulagem de sôro é aquela que não afeta o relativo paralelismo das curvas de isofixação. Então, complemento fixado será função linear da quantidade de sôro presente.&#13;
7 - A parte da curva de isofixação que liga os dois ramos assintóticos, traduz a suplência observada entre sôro e antígeno e indica as condições em que a fixação do complemento depende tanto da quantidade de sôro presente, como da quantidade de antígeno usado. Nesse caso a titulagem de qualquer um desses elementos não poderá ser feita. '&#13;
8 - Para a titulagem de soros, por método simplificado, fatores de conversão são utilizados. Esses fatores foram determinados para o sistema lepra onde os valores de h sofrem marcada influência da quantidade de complemento necessário para 50% de hemó1ise, pois há estreita dependência entre a percentagem de complemento fixado e a inclinação da linha de regressão logaritmo de complemento contra logitos de hemólise.&#13;
9 - A padronização da reação de fixação do complemento exige a reprodutibilidade das partidas de antígenos. Métodos de análise sequêncial foram então adotados' para o sistema lepra e tabelas construidas para maior facilidade de uso e precisão de resultados, com o menor número possível de observações.&#13;
10 - A reprodutibilidade dos antígenos solúveis em piridina é maior que a observada com os antígenos aquosos; sua estabilidade é também superior e não se observou, em um ano, qualquer alteração de suas propriedades.&#13;
11 - O estudo da reação entre sôro de lepra e antígenos solúveis em piridina sugere a aplicação da reação de fixação do complemento quantitativa para contrôle sorológico da leprose, não só como meio diagnóstico auxiliar, como também para avaliar sorológicamente o efeito das drogas modernamente utilizadas para seu tratamento.</text>
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