The Immunopurification of Tetanus Toxoid

S ummary . The isolation of tetanus toxoid by immunosorption chromatography is described. The immunosorbent, a polymerized horse antitoxin, was used repeatedly with little loss in capacity and recoveries of toxoid of > 90% were achieved. In terms of specific antigenic activity, immunopurified tetanus toxoid is purer than that purified by conventional procedures and is at least as immunogenic.     

聚合破伤风类毒素抗原特性的研究

由戊二醛脱毒的聚合破伤风类毒素,经高压液相层析及聚丙烯酰胺凝胶电泳分析,类毒素中多聚体含量占８１．９％以上,多聚体分子量为８００ｋＤ,常规破类多聚体仅占有２．２４％。聚合破类免疫豚鼠后,平均心血抗体单位达２ＩＵ／ｍｌ,常规破类仅为０．７５ＩＵ／ｍｌ（Ｔ＝１３．１５,Ｐ＜０．００１）,聚合破类免疫马匹后所诱发的抗体水平较常规抗原的高。     

Determination of Tetanus Toxin and Toxoid by ELISA Using Monoclonal Antibodies

The procedure for obtaining monoclonal antibodies TT-1, TT-2, and TT-3 against tetanus toxin/toxoid is described. It is shown that the commercial DTP vaccine and tetanus toxoid conjugated with a low-molecular-weight hapten can both be used as immunogens. Monoclonal antibodies TT-1 and TT-2 neutralized tetanus toxin in vivo. The monoclonal antibodies obtained were used to design and compare several schemes of quantitative determination of tetanus toxoid and toxin by ELISA. A more sensitive competitive ELISA allowed the detection of as much as 0.01 EC/ml toxoid and 50 LD₅₀/ml toxin.     

Histopathological Studies of Reactions in Mice Injected with Aluminum-Adsorbed Tetanus Toxoid

Histopathological observations of changes at the injection site in mice were made for 20 weeks after a single intramuscular (im) injection of aluminum hydroxide-adsorbed tetanus toxoid (Alum-TT), plain tetanus toxoid (TT), or aluminum adjuvant (Alum alone). Marked injury to muscle fibers and infiltration of neutrophils around the aluminum remnants were observed, and some microabscesses were occasionally formed, after im injection of Alum-TT. Some mature alum-granulomas were seen in the Alum-TT group, while the Alum alone group had only a few immature alum-granulomas. The TT group showed only slight injury to muscle fibers and acute inflammation at an early stage. In the Alum-TT group, well-developed lymphoid tissues and granulomatous lesions were still observable even 20 weeks after the injection; however, these changes had already diminished in the Alum alone group by that time. These findings could serve as good models for undesirable local reactions to aluminum-adjuvanted vaccines.     

Maternal Tetanus Toxoid Vaccination and Neonatal Mortality in Rural North India

Objectives

Preventable neonatal mortality due to tetanus infection remains common. We aimed to examine antenatal vaccination impact in a context of continuing high neonatal mortality in rural northern India.

Methods and Findings

Using the third round of the Indian National Family Health Survey (NFHS) 2005–06, mortality of most recent singleton births was analysed in discrete-time logistic model with maternal tetanus vaccination, together with antenatal care utilisation and supplementation with iron and folic acid. 59% of mothers reported receiving antenatal care, 48% reported receiving iron and folic acid supplementation and 68% reported receiving two or more doses of tetanus toxoid (TT) vaccination. The odds of all-cause neonatal death were reduced following one or more antenatal dose of TT with odds ratios (OR) of 0.46 (95% CI 0.26 to 0.78) after one dose and 0.45 (95% CI 0.31 to 0.66) after two or more doses. Reported utilisation of antenatal care and iron-folic acid supplementation did not influence neonatal mortality. In the statistical model, 16% (95% CI 5% to 27%) of neonatal deaths could be attributed to a lack of at least two doses of TT vaccination during pregnancy, representing an estimated 78,632 neonatal deaths in absolute terms.

Conclusions

Substantial gains in newborn survival could be achieved in rural North India through increased coverage of antenatal TT vaccination. The apparent substantial protective effect of a single antenatal dose of TT requires further study. It may reflect greater population vaccination coverage and indicates that health programming should prioritise universal antenatal coverage with at least one dose.     

Collaborative study for the calibration of a replacement International Standard for Tetanus Toxoid Adsorbed

We present the results of a collaborative study for the establishment of a replacement International Standard (IS) for Tetanus Toxoid Adsorbed. Two candidate preparations were included in the study, one of which was established as the 4th IS for Tetanus Toxoid Adsorbed at the WHO Expert Committee on Biological Standardization meeting in October 2010. This preparation was found to have a unitage of 490 IU/ampoule, based on calibration in guinea pig challenge assays. Results from mouse challenge assays suggest that the relative performance of two candidate preparations may differ significantly between guinea pigs and mice. The authors note that the number of laboratories that performed guinea pig challenge assays, which are used to calibrate and assign IU, is much lower than in previous collaborative studies and this may have implications for calibration of replacement standards in the future. The issue of assigning separate units to the IS for guinea pig and mouse assays is discussed. The study also assessed performance of the replacement standard in serological assays which are used as alternative procedures to challenge assays for tetanus potency testing. Results suggest that the replacement standard is suitable for use as the reference vaccine in serological assays.     

Influence of Mouse Strain on the Assayed Potency (Unitage) of Tetanus Toxoid

The assayed potency of an adsorbed tetanus toxoid C(2), relative to the international standard for tetanus toxoid (adsorbed), varied significantly with the use of different strains of mice. The unitage was highest with NIH mice, and it was not significantly different from that with CFW mice. With CDF(1) and BALB/c mice, however, the assayed potency was significantly lower than with NIH mice. C3H mice failed to respond to the dose range of the toxoids employed with the other four strains. The significance of the influence of the mouse strain on the designation of a prescribed unit requirement for tetanus toxoid, adsorbed, relative to human efficacy is discussed.