Oxidase and Tuberculosis Physiopathologic Meaning and Possibilities for the Diagnosis of Infections by Acid-Fast Bacilli

(Preliminary Report)

¹ Fellow, National Academy of Medicine, Rio de Janeiro, Brazil.

The author observed that in tuberculosis leucocytic oxidase increases proportionally to the advance of the disease, which is contrary to what happens with serolipase. This might be due to the fact that the surrounding membrane of the granulations of the neutrophil be composed similarly to the acid-fast capsule of the Koch bacillus, whose membrane, being lipidic, is destroyed by lipase. This hypothesis was confirmed by the Ziehl method after its special adaption to the case. The substance surrounding the granulations of the neutrophil is, therefore, acid-fast.

The author then recalls the prevailing conception as exposed by Middlebrook: in tuberculosis, the lipase decreases because the Koch bacillus, if virulent, produces a neutralizing substance, formerly called " antilecithinase" by Calmette and now known as "factor P".

Since the capsule of the oxidasic granulations gets stronger in tuberculosis, the normal oxidasic effusion from the neutrophil toward the red corpuscles gets reduced to hypoeffusion.

It has been possible to demonstrate this fact, thanks to the creation of an electro-photometric method for the evaluation of erythrocytic oxidase which, indeed, appears to be reduced in the pathologic conditions due to acid-fast bacilli (tuberculosis and leprosy).