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Diphtheria and tetanus antitoxin levels in Thai children.

Determination of diphtheria and tetanus antitoxin levels by an indirect haemagglutination method were conducted in 101 nonimmunized schoolchildren, 155 pediatric patients and 102 blood donors. Diphtheria and tetanus antitoxin levels were found mostly adequate among immunized children. Diphtheria antitoxin levels were found adequate in 68.3% of the non-immunized schoolchildren. Tetanus antitoxin levels were found inadequate for protection in the non-immunized children and adults. Immunization of children and adults with diphtheria and tetanus toxoid are highly recommended.

Adult

[Several properties of low-molecular weight tetanus antitoxin].

Following intravenous injection of tetanus antitoxin, obtained by tryptic digestion of the horse immunoglobulin "Diaferm-3", purification and concentration of active fragments, the antitoxin was eliminated from the rabbit organism three times more rapidly than after the injection of the original "Diaferm-3" antitoxin. After injection of the split antitoxin its urinary excretion lasted up to 6 days, whereas following injection of the "Diaferm-3" antitoxin it was excreted for up to 19 days; in the first case considerably less antitoxin was excreted than in the second one (2 and 3.5%, respectively). In both cases in the antitoxin excreted with urine represented monovalent. Fab'-fragments, producing a delay in precipitation in the cross reaction in agar gel between the tetanus toxoid and the tetanus antiserum. Fab'-fragment obtained by the mentioned method possessed anaphylactogenic properties.

Animals

[Tetanus antitoxin in serum and cerebral spinal fluid in viral meningitis in children (author's transl)].

Tetanus antitoxins were measured in serum and cerebro spinal fluid from 58 children--35 boys and 23 girls--with viral meningitis. The concentrations of IgG, IgA and IgM were also determined. The appearance of tetanus antitoxins in cerebral spinal fluid depends on absolute antitoxin levels in serum as well as on the antitoxin/IgG ratio. Antitoxin/IgG ratios in serum and cerebro spinal fluid were in the same order of magnitude. Detection of tetanus antitoxins in the cerebral spinal fluid of children with viral meningitis shows clearly that antibody found in cerebral spinal fluid is not an absolute proof of a certain disease. The results further indicate that local production of IgG antibody cannot be postulated by detecting certain antibodies in the CSF. It is also necessary to prove that antibody/globulin ratios are of significantly different magnitude in serum and CFS.

Adolescent

Quantification of tetanus antitoxin in human sera. I. Counter-immunoelectrophoresis.

An extensive sero-epidemiological survey of immunity to tetanus is to be performed in Norway during 1978 and 1979 and thus a simple and reliable method for screening sera for content of tetanus antitoxin is needed. An improved counter-immunoelectrophoretic method for quantification of tetanus antitoxin is described. The toxin neutralization test in mice is considered to correlate well with protection in humans. Counter-immunoelectrophoresis has the advantage of using tetanus toxoid instead of toxin as well as being more rapid and less expensive. Specific antibodies of the IgG, IgM, and IgA classes could be read simultaneously for many sera. This may be of importance, since it is reported in the literature that only antibody of the IgG class is capable of neutralizing tetanus toxin in mice. Counter-immunoelectrophoresis is limited by being less sensitive than the toxin neutralization test in mice.

Chromatography, Gel

Titration of tetanus antitoxin by passive hemagglutination. I. Titration of guinea-pig antitoxins at various periods of immunization.

An improved technique for passive hemagglutination (HA) for titration of tetanus antitoxin was described. The use of highly purified tetanus toxoid and of improved diluent increased the specificity and reproducibility of the test. Several hundreds of specimens of guinea-pig serum taken at various stages of immunization were titrated by HA and toxin neutralization (NT) in mice. The ratio of HA to NT titers varied significantly depending on the immunization stage; higher at early stages and lower at later stages. The high HA/NT ratio was not due to the IgM antitoxin, which is very rare in guinea pigs. The variation in discrepancy between HA and NT titers decreased considerably by grouping the serum specimens with respect to the stage of immunization. Thus, it is possible to predict the in vivo titer of a tetanus antitoxin accurately enough for clinical study. The HA test may be useful as an alternative method for titrating tetanus antitoxin in the field trials. Moreover, it can be used for the study of characteristics of antitoxins.

Animals

Quantification of tetanus antitoxin in human sera. II. Comparison of counter-immunoelectrophoresis and passive haemagglutination with toxin neutralization in mice.

We described recently an improved counter-immunoelectrophoretic method for quantification of tetanus antitoxin. The toxin neutralization test in mice is considered to correlate well with protection in humans. In the present study, the correlation coefficient between the two methods was 0.89. Sera containing more than 7.0 I.U./ml could be quantified directly by counter-immunoelectrophoresis, while sera containing less tetanus antitoxin had to be concentrated prior to quantification. The passive haemagglutination test was also compared with the toxin neutralization test in mice. The correlation coefficient between the two methods was 0.76.

Antibodies, Bacterial

Treatment of tetanus in the horse by injections of tetanus antitoxin into the subarachnoid space.

In 40 horses with tetanus, large doses of tetanus antitoxin (TAT) were injected into the subarachnoid space. In all the horses that recovered, the disease stabilized immediately after the injection. The results (77.5% recovery) were much better than in a previous series of horses with tetanus (50% recovery), in which TAT was injected either intravenously, intramuscularly, or in the epidural space.

Animals

[Preliminary studies on the immune response to tetanus antitoxin: use of dried blood on filter paper].

The tetanus antitoxin titers of blood obtained by venepuncture and those of finger-blood absorbed on filter paper are compared when the titration techniques use fresh or formalinized erythrocytes sensitized by the bis-diazotized benzidine (BDB) method. The results show that the antitoxin titers are closely similar with the two methods of sampling and storage.

Antibody Formation

Titration of tetanus antitoxin by passive hemagglutination. II. Serological characteristics of antitoxin production in rabbits and monkeys.

1) Production of tetanus antitoxin in rabbits and monkeys was followed by passive hemagglutination (HA) and toxin-neutralization (TN) tests. The HA activity was observed in both IgM and IgG in both animal species. 2) In rabbits, IgM antitoxin was detected as early as in 7 days, reached the maximum titer in 10--14 days, and disappeared in 3 weeks after the primary immunization. Antitoxin of IgG class was detected in 10 days, and increased gradually. The ratio of HA/TN titers ("serum ratio") was high at an early stage of primary immunization and approached the unity in 3--4 weeks. Unlike the case of guinea pigs, IgM was found to contribute greatly to this high level of ratio. Besides, most rabbits produced IgG antitoxin of high ratios at early stages of immunization. 3) The immune response of monkeys showed a pattern very similar to that of rabbits except a few days' delay in the time course of antitoxin titers. No IgG antitoxin with a high serum ratio was demonstrated. Therefore, the high serum ratio of early sera could be accounted for mainly by IgM. 4) In response to the secondary immunization, no IgM antitoxin was detected in either animal species. 5) No definite correlation between serum ratio and avidity in terms of "dilution ratio" was demonstrated. However, both the dilution ratio and serum ratio were high at an early stage of immunization and gradually decreased, though the magnitudes of the ratios were variable depending on individual animals.

Animals

Detection and quantitation of tetanus antitoxin in blood donations.

Passive haemagglutination and IEOP have been used both to detect and to measure tetanus antitoxin in human donor sera. Forty percent of blood donors had detectable antitoxin but only 9% had levels suitable for production of human antitetanus immuoglobulin (larger than or equal to 2 IU/ml). The incidence of high titre antitoxin was significantly greater in men and was unrelated to the ABO blood group system. The prevalence of antitoxin in selected donor groups and immunized staff is shown.

ABO Blood-Group System

[Measurement of human tetanus antitoxin using as enzyme-linked immunosorbent assay].

An enzyme-linked immunosorbent assay (ELISA) has been developed for the detection and measurement of human tetanus antitoxin. This simple test has proved to be a simple and sensitive as the radio immunosorbent test (RIST) described earlier by the authors and needs no special equipment. The technique which is based on the pioneer work done by Eva Engvall, is described. The antitoxin titers obtained with ELISA and RIST are comparable.

Antibody Formation