Toxoids diphtheria

Vaccines can be roughly categorized into killed vaccines and Hve vaccines. A killed vaccine can be (/) an inactivated, whole microorganism such as pertussis, (2) an inactivated toxin, called toxoid, such as diphtheria toxoid, or (J) one or more components of the microorganism commonly referred to as subunit vaccines. The examples are capsular polysaccharide of Streptococcus pneumoniae and the surface antigen protein for Hepatitis B vims vaccine. 

A human contraceptive vaccine based on lactide polymers is currently being developed. The antigen is a 37-amino-acid peptide of B-HCG conjugated to diphtheria toxoid. The antigen is administered wtih microencapsulated muramyl dipeptide as an adjuvant. Studies in rabbits have shown 9-12 months of elevated antibody liter following... 

Wahn U, Aalberse RC Down-regulation of IgE and IgG4 antibodies to tetanus toxoid and diphtheria toxoid by co-vaccination with cellular Bordetellapertussis vaccine. J Immunol 2001 15 167 2411-2417. dS... 

In the early 1900s, a balanced mixture of diphtheria toxin and antitoxin was found to produce active immunity in both animals and humans. This preparation gained widespread acceptance and protected approximately 85% of recipients. Several years later, diphtheria toxoid was developed by treating the toxin with small amounts of formalin. This process caused the toxin to lose its toxic properties while maintaining its immunogenic properties. In the mid-1920s, the addition of an alum precipitate enhanced the immunogenic properties of the toxoid. 

In the 1940s, diphtheria toxoid was combined with tetanus toxoid and whole cell pertussis vaccines, and later with the acellular pertussis vaccine. The diphtheria toxoid, tetanus toxoid, and acellular pertussis vaccine are part of the routine childhood immunization schedule. Diphtheria toxoid is also combined with tetanus toxoid and is commonly used as a booster vaccine. The pediatric product (DT) has a higher amount of diphtheria toxoid than does the adult product (Td). Diphtheria toxoid is not available as an individual vaccine. 

Recent outbreaks of diphtheria have demonstrated that immunity wanes in adulthood. Approximately 50% of all adults no longer have immunity to diphtheria. Regular boosters with tetanus and diphtheria toxoids every 10 years will provide adequate recall immunity to diphtheria provided the adult was previously immunized.2... 

Immunity to tetanus decreases with increasing age, therefore a regular booster every 10 years with tetanus toxoid is recommended. The preferred agent to use in adults is tetanus and diphtheria toxoid (Td) in order to give a booster for diphtheria. Tetanus immunization status should be assessed in the management of wounds in individuals seeking medical care. A tetanus booster should be administered if a tetanus-containing... 

The first pertussis whole cell vaccine was a mixture of killed organisms that was associated with frequent local and systemic reactions. In the late 1980s, an acellular pertussis vaccine was introduced that contains purified pertussis components that are immunogenic but associated with fewer adverse reactions. Acellular pertussis vaccine is available in combination with tetanus and diphtheria toxoids. Pertussis is not available as a separate vaccine component. In the spring of 2005, the Food and Drug Administration (FDA) approved tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccines for use in adolescents and adults. 

Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) is recommended as a single booster for the following groups in place of a tetanus booster. 

Tdap tetanus toxoid, reduced diphtheria toxoid, and acellular... 

Basmadjian G., Singh S., Sastrodjojo B. et al. Generation of polyclonal catalytic antibodies against cocaine using transition state analogs of cocaine conjugated to diphtheria toxoid. Chem. Pharm. Bull. 43 1902, 1995. 

The most common carrier proteins in use today are keyhole limpet hemocyanin (KLH MW 4.5 X 105 to 1.3 X 107), BSA (MW 67,000), aminoethylated (or cationized) BSA (cBSA), thyroglobulin (MW 660,000), ovalbumin (OVA MW 43,000), and various toxoid proteins, including tetanus toxoid and diphtheria toxoid. Other proteins occasionally used include myoglobin, rabbit serum albumin, immunoglobulin molecules (particularly IgG) from bovine or mouse sera, tuberculin purified protein derivative, and synthetic polypeptides such as poly-L-lysine and poly-L-glutamic acid. 

Diphtheria toxoid formed by treating diphtheria toxin with formaldehyde... 

If the immunization history of a patient with anything other than a clean minor wound is not known, tetanus/diphtheria toxoids should be administered. Both tetanus/diphtheria toxoids and tetanus immune globulin should be administered to patients who have never been immunized. 

Tetanus and diphtheria toxoids and acellular pertussis vaccine (Tdap). 

Administer at age 11-12 years for those who have completed the recommended childhood DTP/DTaP vaccination series and have not received a tetanus and diphtheria toxoids vaccine (Td) booster dose. 

Adults with uncertain histories of a complete primary vaccination series with tetanus and diphtheria toxoid-containing vaccines should begin or complete a primary vaccination series. A primary series for adults is 3 doses of tetanus and diphtheria toxoid-containing vaccines administerthe first2 doses at least 4 weeks apart and the third dose 6-12 months after the second. However, Tdap can substitute for any one of the doses of Td in the 3-dose primary series. The booster dose of tetanus and diphtheria toxoid-containing vaocine should be administered to adults who have completed a primary series and if the last vaccination was received >10 years previously. Tdap or Td vaccine may be used, as indicated. 

Two strengths of diphtheria toxoid are available (pediatric [D] and adult, which contains less antigen). Primary immunization with D is indicated for children younger than 6 weeks of age. Generally, D is given along with acellular pertussis and tetanus vaccines (DTaP) at 2, 4, and 6 months of age, and then at 15 to 18 months and 4 to 6 years of age. 

For nonimmunized adults, a complete three-dose series of diphtheria toxoid should be administered, with the first two doses given at least 4 weeks apart and the third dose given 6 to 12 months after the second. The combined preparation, tetanus-diphtheria, is recommended in adults because it contains less diphtheria toxoid than DTaP, with fewer reactions seen from the diphtheria preparation. Booster doses are given every 10 years. 

Adverse effects to diphtheria toxoid include mild to moderate tenderness, erythema, and induration at the injection site. 

Singh, M., A. Singh, G.P. Talwar, Controlled Delivery of Diphtheria Toxoid Using Biodegradable Poly(D, L-Lactide) Microcapsules, Pharmaceutical Research. 8, 958, 1991. 

Td = Tetanus and diphtheria toxoids, adsorbed (for adult use), which is a combined preparation containing <2 flocculation units of diphtheria toxoid... 

Haemophilus b conjugate vaccine contains 25 micrograms of a purified capsular polysaccharide and 18 micrograms of diphtheria toxoid protein in a single dose of 0.5 mL. How many micrograms of diphtheria toxoid proteins are there in a vial containing 2.5 mL of the vaccine ... 

Diphtheria toxoid adsorbed on to aluminum hydroxide is available in strength of 30 Lf units per mL. Its usual dose is 2 injections of 0.5 mL 6 to 8 weeks apart, and a third reinforcing dose approximately one year later. From the available dosage form containing 5 milliliters how many complete courses can be provided ... 

The tri-immunal preparation from Wyeth-Ayerst contains 6.7 Lf units of diphtheria toxoid, 5 Lf units of tetanus toxoid, and 4 protective units of pertussis vaccine in each dose of 0.5 mL. In a 7.5-mL dosage form of the tri-immunal preparation, how many Lf units of diphtheria toxoid are present ... 

J. Singh, S. Pandit, V. W. Bramwell, and H. O. Alpar. Diphtheria toxoid loaded poly-(e-caprolactone) nanoparticles as mucosal vaccine delivery systems. Methods 38 96-105 (2006). 

The presence of multiple FnBPs could possibly explain how S. pyogenes is able to colonize different host tissue and confer various tissue tropisms. The identification of fhe Sfbl adhesin has contributed to the recent development of vaccines composed of Sfbl-derived peptides conjugated to either the diphtheria toxoid or used with the Lipid Core Peptide (TCP) delivery system. These vaccines have been shovm to confer protective immunity to BALC/c mice when challenged intranasally with lethal doses of S. pyogenes (Olive et ah, 2007 Schulze et ah, 2006). 

Schulze, K., Olive, C., Ebensen, T., and Guzman, C. A. (2006). Intranasal vaccination with Sfbl or M protein-derived peptides conjugated to diphtheria toxoid confers protective immunity against a lethal challenge with Streptococcus pyogenes. Vaccine 24, 6088-6095. 

Fig. 16.3 Literature network of 26 genes shared in mice, which were immunized with diphtheria toxoid or tetanus toxoid and different adjuvants (5). The 26 shared genes were submitted to the PubGene software (version 2.6) together with the key word immune response. The gene names were translated into primary symbols by the software. These primary symbols formed a literature network with a functional relationship to immune response, confirming their role in immune response after vaccination. The number of cocitations ranged from 1 to 5198...

Patients with protein-calorie malnutrition, especially children with marasmus and chest infections, had very high levels of serum IgD (R7). Antigen binding activity of IgD to diphtheria-toxoid and to bovine y-globulins in some human sera have been reported (G4, H3). 

Uses Immunization against pneumococcal Infxns in infants children Action Active immunization Dose 0.5 mL IM/dose series of 3 doses 1st dose age 2 mo then doses q2mo, 4th dose at age 12-15 mo Caution [C, +] Thrombocytopenia Contra Diphtheria toxoid sensitivity, febrile illness Disp Inj SE Local Rxns, arthralgia, fever, myalgia EMS None OD Unlikely... 

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