Control of tetanus neonatorum in rural communities--immunization effects of high-dose calcium phosphate-absorbed tetanus toxoid.
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The present study deals with the immunological response in man after passive immunization against tetanus toxoid. Treatment of man with equine antitetanus serum stimulates a rise of E rosette-forming T lymphocytes. The level of IgG also rises while the level of IgM falls. It is assumed that the foreign globulin acts as an antigen that evokes the T lymphocytes' co-operation for the humoral immune response with a switch from IgM to IgG synthesis.
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There is evidence that when plain tetanus toxoid is given at the same time as antitoxin, the response to the toxoid is inhibited. Good responses can be obtained when absorbed tetanus toxoid is used with non-human antitoxin, but there is evidence of an interval (10-15 days) between the end of passive immunization and the beginning of the active one. Using absorbed tetanus toxoid at the same time as human antitoxin there is complete absence of interference. Therefore simultaneous active and passive immunization (only using absorbed tetanus toxoid and human immunoglobulins) can be a practicable procedure in the treatment of persons liable to contract tetanus as a result of injury.
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McCOMB and Dwyer1 have recently presented data on the passive-active immunization of nonimmune persons against tetanus with the use of fluid toxoid and human tetanus immune globulin (TIG). This study pointed out that other investigators have recommended alum toxoid rather than fluid toxoid for this procedure,2 3 4 but that such preferences have not been adequately confirmed experimentally in man. One purpose of this paper is to present studies in human subjects that bring significant evidence to bear toward the resolution of the question of alum versus fluid tetanus toxoid in this context. A second purpose was to evaluate anxieties that immunologists . . .
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We have investigated the effects of nasal immunization with tetanus toxoid (TT) on the subsequent systemic IgA response. Healthy adult volunteers who had not had a TT boost for at least five years received either an intra-muscular (IM) TT immunization alone (n = 19) or first an intra-nasal and then two weeks later an IM immunization (n = 27). The serum and circulating B cell IgG and IgA1 antibody response to TT were measured. When compared to subjects who received only an IM immunization, those who were nasally primed had increased serum levels of dimeric IgA1 antibodies to TT and an increased number of B cells secreting IgA1 antibodies to TT. These data indicate that mucosal antigen exposure is one of the mechanisms involved in the induction of systemic serum IgA1 response.
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The Authors carried out a research work to study the dose-dependence of antibody response in BD2F, mice injected with tetanus toxoid. Experimental data show that it is possible to obtain an earlier resistance at least 14 days after immunization, increasing ten-fold the usual anatoxin dose administered in humans. The protection test toward 4 MLD i.v. injected of tetanus toxin proved a valuable tool for assessing the first appearance of acquired immunity.
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We have investigated the effects of nasal immunization with tetanus toxoid (TT) on the subsequent systemic IgA response. Healthy adult volunteers who had not had a TT boost for at least five years received either an intra-muscular (IM) TT immunization alone (n = 19) or first an intra-nasal and then two weeks later an IM immunization (n = 27). The serum and circulating B cell IgG and IgA1 antibody response to TT were measured. When compared to subjects who received only an IM immunization, those who were nasally primed had increased serum levels of dimeric IgA1 antibodies to TT and an increased number of B cells secreting IgA1 antibodies to TT. These data indicate that mucosal antigen exposure is one of the mechanisms involved in the induction of systemic serum IgA1 response.
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