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PubMed1998

Quantitation of tetanus and diphtheria antitoxins in mouse sera by indirect haemagglutination.

Serum samples obtained from 75 groups of mice immunized with various doses of adsorbed tetanus vaccine, adsorbed diphtheria-tetanus vaccine and adsorbed diphtheria-tetanus-pertussis vaccine were titrated for tetanus antitoxin content by an in-vitro indirect haemagglutination (IHA) and by toxin neutralization test (TN) in mice. From these serum samples of 49 groups of mice which were immunized with combined vaccine containing diphtheria toxoid were titrated for their diphtheria antitoxin content by IHA and by i.d. toxin neutralization test (TN) in guinea pigs. Good correlations were found between the estimates obtained by in-vitro IHA and in vivo TN tests in both tetanus and diphtheria antitoxin titrations. The minimum level of tetanus or diphtheria antitoxin detectable by IHA was 0.00039 IU/ml. It is concluded that IHA is a simple, sensitive and reproducible alternative test which can replace the animal TN tests for the estimation of tetanus and diphtheria antitoxins and could reliably be used in the potency assay of tetanus and diphtheria toxoids of combined vaccines based on antibody induction in mice.

Animals↗
PubMed1986

Effects of carbon dioxide and tetanus duration on relaxation of frog skeletal muscle.

Sartorius and semitendinosus muscles of the frog Rana temporaria (0 degrees C) were stimulated under isometric (fixed-end) conditions and force during stimulation and relaxation was recorded. Relaxation time was assessed by measuring the time from the last stimulus until force declined to 90% or 50% of its value at that time. The relaxation time increased linearly with concentration of CO2 in the Ringer's solution (pH 7.2), whereas, at constant CO2, relaxation was hardly affected by changes in extracellular HCO3- and pH. This is consistent with the view that CO2 enters the cells, but H+ and HCO3- do not, and that entry of CO2 causes intracellular acidification and slows relaxation. For tetani lasting between 0.5 and 5s, relaxation is slower the longer the tetanus; further increase in tetanus duration to 10 s has little additional effect. The presence of 3.3 mmol 1(-1) CO2 in the Ringer's solution has a small effect on relaxation after a brief tetanus, but greatly slows relaxation as tetanus duration increases. Experiments with paired tetani (conditioning and test) showed that relaxation from a test tetanus was slower if a conditioning tetanus was given. However, the size of this effect was independent of muscle length during the conditioning tetanus. After a conditioning tetanus, an interval of many minutes is required for the muscle to recover its ability to relax quickly from a test tetanus. The results indicate that changes in metabolite levels caused by contraction itself are not responsible for the slowing of relaxation. Possible mechanisms of the effects of CO2 on relaxation are discussed.

Animals↗
PubMed1997

Interaction between tetanus long-term potentiation and hypoxia-induced potentiation in the rat hippocampus.

Interaction between tetanus long-term potentiation and hypoxia-induced potentiation in the rat hippocampus. J. Neurophysiol. 78: 2475-2482, 1997. The interaction between tetanus-induced long-term potentiation (LTP) and hypoxia-induced potentiation was investigated by performing extracellular recordings in the CA1 region of rat hippocampus using a two-pathway design. Hippocampal slices were placed in an interface chamber containing artificial cerebrospinal fluid (ACSF) solution with high magnesium concentration. Hypoxia was induced by replacing the 5% CO2-95% O2 gas mixture with 5% CO2-95% N2 for 2 min. Tetanus-LTP was induced with 1-s, 100-Hz current pulses. Significant hypoxia-induced potentiation of the slope of the dendritic excitatory postsynaptic potential (EPSP) was found in ACSF containing 2 mM of magnesium 2, 27 +/- 10% (mean +/- SE; n = 16; P < 0.01) with no change in the mean amplitude of the presynaptic volley. All experiments in which a stable control baseline was obtained were used for data analysis. The data show that short episodes (2 min) of hypoxia can induce LTP of the alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid-mediated synaptic transmission. The present study demonstrated that after tetanus-LTP, 33 +/- 3% (n = 10; P < 0.01), hypoxia further potentiated the field EPSP slopes by a mean value of 16 +/- 5% (n = 10; P < 0.05). Moreover, using a two-pathway design, we showed that hypoxia produced similar potentiation in both the control [19 +/- 5%; n = 10; P < 0.01) and tetanus-induced LTP pathway, and the total potentiation produced by a combination of tetanus then hypoxia, 63 +/- 13% (n = 10; p < 0.01), was significantly larger (P < 0.01) than hypoxia alone. These data suggest that hypoxia-induced potentiation is additive with tetanus-LTP. Occlusion experiments were performed to verify whether the mechanisms responsible for hypoxia-induced potentiation are independent of preexisting synaptic levels induced by high-frequency stimulation. Hypoxia produced significant potentiation (23 +/- 7%; n = 7; P < 0.05) after successful occlusion of the LTP pathway. Therefore, because the magnitude of hypoxia-induced potentiation is both independent of preexisting synaptic levels and also additive, synaptic specificity associated with LTP is preserved. The magnitude of tetanus-LTP induced 20 min after hypoxia (15 +/- 4%; n = 10) was significantly smaller (P < 0.01) relative to LTP after normoxic conditions (33 +/- 3%; n = 10). Additionally, hypoxia blocked the transient, robust potentiation occurring during the early phase of LTP induction. This study suggests that although hypoxia modifies neuronal processing by general excitation, synaptic specificity associated with tetanus-LTP still is preserved. However, hypoxia can disrupt neuronal processing by inhibiting new modification of synaptic transmission.

Animals↗
PubMed2004

Adjuvant activity of Mycobacterium bovis BCG expressing CRM197 on the immune response induced by BCG expressing tetanus toxin fragment C.

In order to develop a combined recombinant Mycobacterium bovis BCG (rBCG) vaccine against diphtheria, pertussis and tetanus (DPT), we have constructed different strains of rBCG expressing tetanus toxin fragment C (FC), driven by the up-regulated M. fortuitum beta-lactamase promoter, pBlaF*. Tetanus toxin FC was expressed in comparable levels in native form or in fusion with the beta-lactamase exportation signal sequence; however, in both constructs it was localized to the cytosol. Immunization of mice with rBCG-FC or its combination with rBCG expressing CRM197, induced anti-tetanus toxin antibodies with a Th2 immunoglobulin profile. Administration of a subimmunizing dose of the diphtheria-tetanus toxoid vaccine showed that rBCG-FC primed mice for production of an intense humoral response. Interestingly, the combination of rBCG-FC and rBCG-CRM197 reduced the time required for maturation of the immune response and increased anti-tetanus toxin antibody levels, suggesting adjuvant properties for rBCG-CRM197; this combination induced 75% protection in mice challenged with 100 minimum lethal doses (MLD) of tetanus toxin. Antisera from guinea pigs immunized with this combination were shown to neutralize tetanus toxin and diphtheria toxin. Our results suggest reciprocal adjuvant effects of rBCG-FC and rBCG-CRM197, which may contribute to induction of a more effective immune response against both diseases.

Adjuvants, Immunologic↗
PubMed2003

Tetanus complicating snakebite in northern Nigeria: clinical presentation and public health implications.

BACKGROUND: There is inequality in vaccination coverage, and adult farmers in tropical rural communities could have missed tetanus toxoid as campaigns target children. Snakebite is not uncommon and partly because of lack of effective antivenom, management in inaccessible areas could be complicated with tetanus in unimmunized victims. PATIENTS AND RESULTS: Four snakebite victims who developed tetanus were seen in northern Nigeria. Three were bitten while farming and patients took 10-25 days before presenting to hospital. All patients had incised bite sites and applied local medicinal herbs and in one case, a black 'snake' stone. Bites were by the cobra (Naja nigricollis) and carpet viper (Echis ocellatus) in the extremities and victims had swollen limbs and bleeding with incoagulable blood. Three of the patients were given anti-tetanus serum (ATS) after development of tetanus symptoms in a primary facility and only one recalled receipt of one dose of tetanus toxoid prior to bite. Patients had trismus, rigidity, backache, spasms and one had autonomic dysfunction and was managed with antispasmodics, ATS, wound care, antibiotics and supportive measures. Two patients with envenoming and severe tetanus received antivenom, but died. One of the two surviving patients developed osteomyelitis with prolonged hospital stay, while the other recovered with residual disability. CONCLUSION: Tetanus could follow snakebite in inaccessible rural agricultural communities with inadequate health care provision. Clinical presentation is typical but late and is confounded by snakebite complications leading to considerable morbidity and mortality. The cases highlight the triple problems of inadequacy, inaccessibility and inequality in health care and calls for measures aimed at improvement.

Adult↗
PubMed2007

Seroprotection against tetanus in patients attending an emergency department in Belgium and evaluation of a bedside immunotest.

BACKGROUND: In most emergency departments, tetanus prophylaxis currently relies on vaccination history. Bedside evaluation of tetanus immunity may improve this process. OBJECTIVES: (i) To determine the seroprevalence of tetanus immunity; (ii) to evaluate the accuracy of vaccination history in assessing tetanus immunity; (iii) to identify factors predictive of seroprotection and incorrect history. METHOD: In a prospective observational study, tetanus immunity was assessed in 784 adults using Tétanos Quick Stick (TQS). A questionnaire was completed to obtain vaccination and general histories. Immunity assessed by TQS and by vaccination history were compared with anti-tetanus antibody levels measured by the enzyme-linked immunosorbent assay (seroprotection threshold >0.15 IU/ml). RESULTS: Overall, 64.2% of patients were protected according to TQS results. Four independent predictors of seroprotection were identified: young age, birthplace in Belgium, male sex and occupational medicine consultation. TQS performance was good: kappa=0.71, sensitivity 85.3%, specificity 87.2%, positive predictive value 92.1% and negative predictive value 77.2%. Seven hundred and sixty-two participants responded to the vaccination history: 23.4% said they were protected, 22.1% that they were not and 54.5% did not know. History performance was poor: kappa=0.27, sensitivity 60.3%, specificity 73.3%, positive predictive value 81.8% and negative predictive value 45.8%. Compared with history, TQS offered a significantly better sensitivity, negative and positive predictive values, but specificity was similar. No predictor of an incorrect history was identified. CONCLUSION: Lack of protective immunity against tetanus is frequent but poorly evaluated by history taking. Several demographic characteristics are good predictors of seroprotection. TQS could be a valuable tool in selected patients to improve tetanus prophylaxis in the emergency department.

Adolescent↗
PubMed2004

Antibody response to diphtheria-tetanus-pertussis immunization in preterm infants who receive dexamethasone for chronic lung disease.

OBJECTIVE: To study the effect of dexamethasone in preterm infants with chronic lung disease (CLD) on antibody response to routine immunization against diphtheria, tetanus, and pertussis (DTP). METHODS: Serum samples were obtained before and after immunization with DTP (Trivax-AD) from an unselected cohort of 93 preterm infants in the United Kingdom. Antibodies to diphtheria and tetanus and to 4 pertussis antigens (pertussis toxin, filamentous hemagglutinin, pertactin, and fimbrial agglutinogens 2 + 3) were measured by an enzyme-linked immunosorbent assay. Linear regression models were fitted to the natural log of antibody titers to compare the dexamethasone-treated and -untreated infants adjusting for potential risk factors. RESULTS: Sixty-seven (72%) of 93 infants received dexamethasone. Preimmunization geometric mean titers (GMTs) were comparable in both groups for all antibodies. The rise in GMT after immunization was reduced in the dexamethasone-treated group. Final GMT was significantly lower for tetanus, diphtheria, pertussis toxin, and fimbrial agglutinogens 2 + 3 but not for filamentous hemagglutinin or pertactin. Using the minimum protective titer of 0.01 IU/mL, there was no significant reduction in protection for diphtheria and tetanus in the dexamethasone-treated infants. Using the higher reference titer of 0.1 IU/mL, there was a 16% reduction in protection for diphtheria (95% confidence interval: 3%-27%) and a 9% reduction in protection for tetanus (95% confidence interval: -7% to 20%). CONCLUSIONS: The use of dexamethasone for CLD in preterm infants is associated with a reduction in antibody titer to routine immunization against diphtheria and tetanus. Antibody responses to 2 of 4 pertussis antigens are reduced, but the clinical significance of this observation is unclear. Protection against tetanus and diphtheria is not impaired when the lower reference value for protective antibody is used. On the basis of this study of UK preterm infants who were treated with dexamethasone for the management of CLD, we conclude that the current DTP immunization schedule is adequate and do not recommend additional booster protection against tetanus or diphtheria during early infancy. When diphtheria prevalence is increased, however, additional protection should be considered.

Antibodies, Bacterial↗
PubMed1992

Neonatal tetanus in rural Bangladesh: risk factors and toxoid efficacy.

OBJECTIVES: Tetanus continues to be a leading cause of neonatal death in Bangladesh as in other developing countries, yet little is known about risk factors or the efficacy of tetanus toxoid in this setting. METHODS: In May 1990, mothers of 6148 infants born alive between March 15, 1989, and March 14, 1990, in 30 rural unions of Rajshahi Division in Bangladesh were interviewed. Three surviving controls for each neonatal tetanus death were matched for sex, residence, and date of birth. RESULTS: Of 330 neonatal deaths, 112 met the case definition for tetanus. Risk was increased with a history of neonatal tetanus in a previous child, application of coconut oil to the vagina, and use of multiple ties on the umbilical cord. Risk was reduced by the birth attendant washing hands and using a cleaned cord-cutting tool. Risk was not reduced by a maternal history of two doses of tetanus toxoid (TT2), although estimated efficacy of TT2 was 45% (95% confidence interval = 16% to 64%). Subsequent to the survey, a reference laboratory reported to potency in three consecutive lots of tetanus vaccine from the production laboratory in Bangladesh. CONCLUSIONS: These findings identify high-risk mothers, stress the importance of washing hands and cleaning the cord-cutting tool, and demand improved quality control of tetanus vaccine production.

Administration, Intravaginal↗
PubMed1976

The fourth international conference on tetanus, Dakar, Sénégal, 1975.

The two main conclusions drawn at the Dakar International Conference on Tetanus appeared to be: 1) Tetanus is a real problem in developing countries in both occurrence and mortality rates; and 2) Tetanus can be eliminated by the proper use of tetanus toxoid. Preventive medicine, more important nowadays than before, especially in light of broadened legal responsibilities of medical practitioners, must include tetanus immunology, prophylaxis, and therapy. Some currently listed standards for administration of tetanus antitoxin, immune globulin, and toxoid are perhaps in need for revision, at least in developed countries, and at the same time attention must be paid to the very high incidence of tetanus in developing nations, and to the alleviation and eventual eradication of tetanus everywhere in the world.

Developing Countries↗
PubMed1999

[Epidemiologic data for tetanus prophylaxis. Assessment of the need for vaccination].

OBJECTIVE: In spite of the low morbidity secondary to tetanus, the high fatality rate (about 50%) requires effective and extensive protection of the population by vaccination. Since documentation is often lacking, booster tetanus vaccination is frequently applied in cases of minor injury. This leads to vaccination associated complications such as hyperergic reactions. The more intense the vaccination-associated side effects are, the less revaccination is possible. We investigated the tetanus immune status of a selected Austrian population. MATERIALS AND METHODS: Tetanus antitoxin antibodies were measured with ELISA (Immunozym Tetanus, Immuno AG) in serum samples from 218 subjects who were hospitalised in a dermatology unit. In addition, patient history and data concerning vaccination were collected. RESULTS: Based on the assumption that an antitoxin level of 0.1 IU/ml provides sufficient protection, 63% of the subjects were found to be adequately protected. 56% showed high antibody concentrations above 0.5 IU/ml. However, the data also revealed no protection by vaccination in 37% of the subjects. Data obtained by case history or vaccination certificates could not serve as a discrimination factor for applying revaccination or not. CONCLUSION: We strongly recommend better documentation of tetanus vaccination. In some cases, a search for tetanus antibodies before applying booster tetanus vaccination might be necessary.

Adult↗
PubMed2000

Tetanus of the elderly.

The medical records of 20 tetanus patients who were treated at a university teaching hospital in Taiwan during the period from October 1991 to July 1999 were retrospectively analyzed. There were 18 adults (six males and 12 females) with unknown previous immunization status and ages ranging from 34 to 87 years old (mean 63 years). Two patients were children, aged 3 and 5 years old, respectively; both of them had incomplete tetanus immunization. Of the 17 patients reporting previous acute injury, 10 had tetanus-prone wounds. Four of six patients who sought medical help for wound management received tetanus toxoid, but none received tetanus immunoglobulins. The most common symptoms were trismus, dysphagia, and muscular rigidity. Specific treatment consisted of active and passive immunization, wound management, parenteral antibiotics, and benzodiazepines, muscle relaxants or neuromuscular blockades for control of spasms and sedation. All adults were admitted to the intensive care unit and an artificial airway was established. Fourteen of them required ventilator support during the illness. Prophylactic tracheostomy was performed within 24 h after arrival in 12 (92%) of 13 patients. Two patients died with an overall mortality rate of 10%. Sequelae were rare in the patients who survived. Because of inclusion of the diphtheria-pertussis-tetanus (DPT) vaccine in the national Children's Vaccine Program and improvement in obstetrical practices and neonatal care in Taiwan, tetanus mainly occurs in people older than 65 years instead of neonates or children. Waning immunity to tetanus in the elderly and poor wound management practices by primary care physicians were contributory factors.

Adult↗
PubMed2001

The prevention of tetanus in England and Wales.

Today, tetanus is a rare disease in England and Wales although in less developed and less affluent areas of the World it is still a major cause of morbidity and mortality, particularly in neonates and women following childbirth. An estimated 400,000 deaths worldwide occur annually from neonatal tetanus and in 1989 the World Health Organization adopted the goal of eliminating neonatal tetanus as a public health problem by 1995-2000. This goal has not yet been achieved worldwide; however in England and Wales tetanus in neonates and young women has been extremely rare for the last 50 years. We can attribute the success in eliminating tetanus in the UK to the adoption of highly effective preventative measures as we know that the causative organism is still ubiquitous in the environment. This article outlines how we have achieved the elimination of tetanus in the UK through the development and introduction of appropriately targeted immunisation, combined with an appreciation of the importance of adequate wound toilet measures. The discovery of tetanus toxoid and its applicability for vaccination has been of great benefit and the new challenges which we face relate to the introduction of new multi-component vaccines and how we might better protect the elderly. In other parts of the world, for the cost of a few pence, one dose of tetanus toxoid can still mean the difference between life and death.

Communicable Disease Control↗
PubMedDate not supplied

Deficiencies in tetanus prophylaxis in wound management in Ibadan, Nigeria.

In a review of 94 paediatric patients treated for post-neonatal tetanus over a period of 11 years at the University College Hospital, Ibadan, Nigeria, reliable data regarding the care received for wounds that eventually resulted in tetanus was available in 58 patients. Seventeen of these patients had orthodox medical care for their wounds before developing tetanus. While some of the patients had received antibiotics and/or tetanus toxoid, no patient received antitetanus serum despite the fact that most of them had no previous immunization against tetanus. All the 3 victims of road traffic accidents were given tetanus toxoid but none of the 6 patients with chronic suppurative otitis media had any form of tetanus prophylaxis. The findings highlight the adverse consequences of failure to adhere to basic guidelines for management of the tetanus-prone wound.

Adult↗
PubMed2005

[Epidemiology, clinical features and prognosis of juvenile tetanus in Dakar, Senegal].

This study was conducted to determine the prevalence of juvenile tetanus and to describe its epidemiological aspects, clinical features and prognosis. We prospectively recruited tetanus cases among patients in the age group 1-15 years admitted to the Infectious Diseases Clinic in Fann teaching hospital, Dakar, from March to September 2002. Forty cases of juvenile tetanus were recruited, accounting for 5.3% of total patients and 43% of all tetanus cases hospitalized during the study period. Mean age was 8.8 years +/- 4.4 years and sex-ratio M/F was 3. None of the patients was reported to have completed a full course of tetanus toxoid and most of them (77%) had been living in suburbs in Dakar were uneducated (77%) and had parents with no occupation (70%). Portals of entry were: skin injuries (62%), circumcision (20%), ear pearcing (5%) and suppurative otitis (8%). Tetanus became widespread in all cases, most of which having mild grade disease (72%). Pseudomonas aeruginosa bacteremia was diagnosed in the development of two fatal cases of otogenous tetanus. The overall case fatality rate was 8% (three deaths) and no sequelae was observed among those who recovered. The expanded programme on immunization should be reinforced and complemented with booster doses strategy to avoid tetanus whatever the age group.

Adolescent↗
PubMed1989

Surveillance of neonatal tetanus in Thailand, 1977-1986.

Information on the morbidity and mortality of neonatal tetanus was reviewed to evaluate the impact of the immunization programme among pregnant women in Thailand from 1977. We also analysed the epidemiological characteristics of investigated neonatal tetanus cases during the period 1984-1986. The neonatal tetanus case rate declined from 72.1 per 100,000 livebirths in 1977 to 53.7 per 100,000 livebirths in 1986. Reduction in the incidence rate was inversely associated with increasing vaccination coverage of pregnant women with tetanus toxoid. The ratio of male to female neonatal tetanus was 1.5 to 1. Approximately 95 per cent of the cases occurred within the first 14 days of life, with the highest number recorded at 6-8 days of life. The majority of investigated cases were infants who became ill following delivery assisted by traditional birth attendants or relatives of mothers. About 88 per cent of these cases were infants whose mothers had no tetanus immunization. Razor blades and bamboo splits were the most frequently used instruments for cutting the umbilical cord. Strategies to control neonatal tetanus in Thailand should include immunization of pregnant women with tetanus toxoid, and more comprehensive training and supervision of untrained birth attendants.

Female↗
PubMed1970

Replacement of the international standard for tetanus antitoxin and the use of the standard in the flocculation test.

Since 1935 the International Unit for Tetanus Antitoxin has been defined as the activity contained in a certain weight of the first International Standard for Tetanus Antitoxin. As stocks of this standard had become depleted, 11 laboratories in 8 countries were requested to participate in a collaborative assay of a preparation proposed as a replacement.The assay results were analysed and presented to the WHO Expert Committee on Biological Standardization in 1969 which established the preparation studied as the second International Standard for Tetanus Antitoxin and defined the International Unit for Tetanus Antitoxin as the activity contained in 0.03384 mg of the second International Standard for Tetanus Antitoxin. This definition would ensure the continuity of the size of this international unit.The analysis of the collaborative studies also showed that the second International Standard for Tetanus Antitoxin has suitable properties for use in the flocculation test for the determination of the antigen content of tetanus toxoids in Lf values. The designation Lf-equivalent is described and the problems relating to the use of this term for the expression of results of in vitro assays are analysed in relation to the use of international units for expressing results of in vivo assays. As the second International Standard for Tetanus Antitoxin has an in vivo/in vitro ratio of 1.4, the Lf-equivalent of this antitoxin is 1.4 times less than its unitage.

Animals↗
PubMed1997

Adverse events after school leavers received combined tetanus and low dose diphtheria vaccine.

Since October 1994, children in the United Kingdom have been offered tetanus vaccine combined with a low dose of diphtheria vaccine (Td) at the age of 15 to 18 years. It is recommended that schoolchildren who have already received a booster of tetanus vaccine at the time of an injury should be given low dose diphtheria vaccine alone. When this vaccine is not available, however, it is recommended that Td vaccine should be given to all children. This study was performed to compare the frequency of adverse events after Td vaccine in 15 year old children with and without a history of an additional tetanus booster in the preceding 10 years. Two hundred and sixty-five children were followed up-52 pupils (20%) with a history of an additional tetanus booster, 157 (59%) with no such history, and 56 (21%) whose history was unclear. Mild local reactions were common and occurred more commonly in children with a history of an additional tetanus booster. Twenty-three pupils (44%) who had received an additional tetanus booster had swelling over 2 cm diameter at the injection site, compared with only 39 (25%) of those with no such history (p < 0.013). Systemic symptoms were equally unusual in both groups. Only three children experienced symptoms attributed to vaccine that were severe enough for them to miss school or attend a doctor; and none of these had received an additional tetanus booster. We conclude that, in the absence of a supply of low dose diphtheria vaccine, offering Td vaccine to children with a history of additional tetanus booster is an acceptable policy.

Adolescent↗
PubMed1981

Tetanus toxin and botulinum A neurotoxin inhibit and at higher concentrations enhance noradrenaline outflow from particulate brain cortex in batch.

Tetanus toxin and, to a lesser degree, botulinum A toxin partially depress the basal and the potassium evoked outflow of [3H]noradrenaline from preloaded particulate rat forebrain cortex. The effect is due to the toxins and not to any contaminant, as shown by dialysis, heating and antitoxin treatment, and also by replacement of crystalline botulinum A toxin with purified neurotoxin. Tetanus toxin also depresses the outflow due to sea anemone toxin II, 4-aminopyridine and d-amphetamine. The effect of the toxins proceeds with time and strongly depends on temperature. Once manifest the tetanus toxin effect is not reversed by antitoxin. Pretreatment with V. cholerae neuraminidase degrades the long-chain gangliosides quantitatively to GM1. Tetanus toxin, applied subsequently remains fully active. High concentrations of tetanus toxin and botulinum A neurotoxin promote the outflow of small amounts of tritium within short incubation times. It is concluded: a) Tetanus toxin is a broad range neurotoxin which acts on processes subsequent to the depolarization step. b) Long-chain gangliosides are only binding sites, but not receptors of tetanus toxin. c) Botulinum A toxin is less potent but resembles tetanus toxin in both promoting and depressing the outflow of noradrenaline.

Animals↗