Immunisation passive

There are two types of immunisation passive and active. Passive immunisation involves transfer of antibodies formed in response to an antigen in one individual to another. Such antibodies were first produced in animals but now most antibodies used for passive immunisation are of human origin, which minimises allergic reactions. This form of immunisation gives immediate protection but it does not last very long, since the antibodies are soon degraded in the body. It is used, for example, to protect against tetanus, rabies and the toxins in snake venom. 

It is used for passive immunisation in suspected cases of diphtheria and should be given without waiting for bacteriological confirmation of the infection and antibacterial agent is usually given concomitantly. A test dose of diphtheria antitoxin should always be given to test hypersensitivity. 

Davidson, G.P., Daniels, E., Nunan, H., Moore, A.G., Whyte, P.B.D., Franklin, K., McCloud, P.I., and Moore, D.J. 1989. Passive immunisation of children with bovine colostrum containing antibodies to human rotavirus. Lancet 2, 709 -712. 

Anti-tetanus immunoglobulin is an example of passive immunisation (refer to Immunoglobulins in BNF for other examples). It is designed to give immediate, short-term protection. It does not confer long-term immunity to tetanus and Ms.AR should be advised that her son should be immunised with the tetanus vaccine at an appropriate time. A full course of the tetanus vaccine should ensure protection for several years. 

Seamer JH, Boulter EA, Zlotnik I. Delayed onset of encephalitis in mice passively immunised against Semliki Forest virus. Br J Exp Path. 1971 52 408-414. 

The most interesting developments involve catalysis of simple aldol reactions. The key to reactive immunisation is the use of a hapten that is chemically reactive, rather than a passive template. This means that (i) relevant chemistry is going on during the course of antibody induction, which thus happens in the presence of intermediates involved in the reaction, and so may be modified to favor the formation of antibodies which bind these intermediates (and perhaps transition states leading to them). Furthermore (ii) it becomes possible to select for antibodies that react with, rather than just bind, to the hapten. The system used for the development of aldolase antibodies is outlined in Scheme 2... 

Early work (796) on T. taeniaeformis and T. pisiformis showed that the high degree of immunity developed against larvae of these species could be transmitted by passive transfer of immune serum. Results with other species, such as E. granulosus and T. solium have not been so successful and not as promising as procedures involving active immunisation (see below). 

Passive immunity can be obtained by i.m. injection of globulin containing antibody to the virus normal immunoglobulin prepared from pooled plasma from known immune donors) which confers temporary protection for travellers visiting areas where the virus is endemic. Active immunisation with Hepatitis A vaccine is now preferable protective antibody takes about two weeks to develop. 

Szmuness W, Stevens CE, Oleszko WR, Goodman A. Passive-active immunisation against hepatitis B immuno-genicity studies in adult Americans. Lancet 1981 1(8220 Pt l) 575-7. 

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