Diphtheria toxoid antibody response

A six-year-old child had anaphylaxis 30 minutes after a fifth dose of DT vaccine (22). Skin tests, in vitro determination of specific IgE antibodies, and immunoblotting assays showed that the IgE response was directed against tetanus and diphtheria toxoids. Cross-reactivity between the two toxoids was not demonstrated, indicating the presence of co-existing but non-cross-reacting IgE and IgG antibodies. 

The only positive findings have been severe serum IgG deficiency and subnormal levels of antibodies to tetanus toxoid and diphtheria toxoid following adequate challenge. Serum and salivary IgA and the response to oral poliomyelitis vaccine (presumably mainly in the IgA class) have usually been normal, as have serum IgM and isohemagglutinins. Neutro-phile function, lymphocyte transformation, and the responses to vaccinia and childhood virus infections were all normal. This seems a milder disease than Bruton s and does well on y-globulin prophylaxis or even only with prompt treatment of infections. 

Although a single dose of tetanus toxoid in a nonimmunized individual does not produce sufficient antibody response, a series of three 0.5-mL doses results in protection for 90% of vaccinees. Primary vaccination provides protection for at least 10 years. Additional doses of tetanus toxoid (combined with diphtheria toxoid, i.e., Td) are recommended as part of traumatic wound management if a patient has not received a dose of tetanus toxoid within the preceding... 

Acellular pertussis antibody response ELISA assays [13] were run in the study of the acellular pertussis vaccine component of the Diphtheria and Tetanus Toxoids and acellular Pertussis Vaccine Adsorbed (DTaP) to assess vaccine potency before and after irradiation of DTaP Vaccine Lots A, B, and C. 

Table 5 Acellular Pertussis Vaccine Antibody Response (ELISA OD at 405 nm 45min at 25°C) of Gamma Irradiated and Nonirradiated Samples of Lot A of Diphtheria and Tetanus Toxoids and Pertussis (DTaP) Vaccine, Adsorbed Liquid... 

The following experiments were conducted in order to ascertain the effects of a pantothenic acid deficiency upon the various phases of the anamnestic response to diphtheria toxoid (Pruzansky and Axelrod, 1954). Pantothenic acid-deficient rats and their respective controls were immunized as described above. Three weeks later the antibody response to this primary injection was determined, and the rats were given a secondary injection of the toxoid. A week later, the anamnestic response to this secondary injection was determined. As previously noted, the antibody response to the primary injection of toxoid was very poor in the deficient rats in contrast with the good responses of the controls. No anamnestic response to the secondary injection was observed in the deficient rats, whereas the controls displayed a very marked anamnesis. An anamnestic response in the deficient rats could not be elicited despite the simultaneous administration of large amounts of pantothenic acid immediately following the secondary injection of toxoid. In contrast, the growth effect of the vitamin was immediate and profound. Thus, the deleterious... 

In order to investigate further the specificity of these vitamin effects, these studies were extended to include purified diphtheria toxoid as the antigen. Again, the marked impairment of antibody response in various vitamin deficiency states was evident (Pruzansky and Axelrod, 1955). With the exception of the deleterious action of a vitamin D deficiency, the trends observed with diphtheria toxoid were similar to those noted when red blood cells served as the antigen. Later studies clearly demonstrated the inhibitory effects of the nutritional deficiency states upon the anamnestic process, with impairment of the secondary response being most pronounced (Figure 1.) (Axelrod, 1958). The conclusion was drawn that the successful attainment and maintenance of a satisfactory anamnestic response to diphtheria toxoid in the albino rat requires a state of adequate nutriture during both the primary and secondary phases of this process. 

Figure 1. Effect of Repeated Antigenic Stimuli upon Antibody Response in Pyridoxine-deficient and Control Rats. Injections of Diphtheria Toxoid Given at Times Indicated by the Arrows. Animals were Fed the Pyridoxine-deficient or the Control Diet during the Entire Course of the Study, and were on Experiment for Four Weeks Prior to the First Toxoid Injection, Figures on the Ordinate Represent Reciprocal Titers. Used by Permission, from Axelrod (1958), Copyright by the American Society for Clinical Nutrition, Inc,...

Effect of Pyridoxine-deficiency upon Circulating Antibody Response to Alum-precipated Diphtheria Toxoid ... 

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