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PubMed1991

Poor antibody response after tetanus and pneumococcal vaccination in immunocompromised, HIV-infected patients.

Ten patients with symptomatic HIV infection (six with ARC, four with AIDS) received tetanus and 23-valent pneumococcal vaccination. Anti-tetanus IgG and IgM, and anti-pneumococcal IgG against all 23 capsular types of the vaccine were measured on days 0, 11, 17, 30, and 90. Anti-pneumococcal IgG were simultaneously determined in two plasma pools of 100 healthy unimmunized blood donors and of 112 healthy adults who had previously received a 14-valent pneumococcal vaccination. Peak IgG responses to both vaccines were observed on day 17; thereafter, the antibody levels gradually fell again. Anti-tetanus IgG rose from 0.6 U/ml (geometric mean) to 2.0 U/ml on day 17. Anti-tetanus IgM remained unchanged. Anti-pneumococcal IgG increased only by 1.14-fold compared with pre-vaccination levels (geometric mean of IgG rises against all 23 polysaccharides in 10 patients), and exceeded the upper 95% limit of unvaccinated blood donors in only 30 out of 230 specimens. Pre-vaccination levels for pneumococcal type-specific IgG were significantly higher in HIV-infected patients compared with the pool of unimmunized healthy controls, possibly indicating a higher rate of previous pneumococcal infections in HIV-seropositive subjects. However, post-pneumococcal vaccination levels were significantly lower in HIV-infected patients than in the pool of healthy controls. The increase in anti-tetanus IgG significantly correlated with the level of CD4 lymphocytes and with in vitro lymphocyte proliferation by pokeweed mitogen (5 micrograms/ml) and phytohaemagglutinin (2.5 micrograms/ml), confirming a particularly low vaccination response in patients who were severely immunocompromised.

AIDS-Related Complex↗
PubMed1992

Neuropathology of the chronic epileptic syndrome induced by intrahippocampal tetanus toxin in rat: preservation of pyramidal cells and incidence of dark cells.

A few nanograms of tetanus toxin injected into a rat hippocampus causes a chronic epileptic syndrome characterized by brief seizures that recur intermittently for about 6 weeks. Cognitive and other behavioural impairments persist after the seizures and other epileptic electrographic activity have remitted, and may be permanent. Our previous studies suggested that the behavioural changes following seizure remission were an indication of functional impairment associated with decreased neuronal excitability rather than with neuronal loss. The conclusion that neurons were preserved relied on qualitative histological observations and, indirectly, on electrophysiological measurements of the amplitudes of antidromic population spikes. Recently, gross histopathology has been described in a quantitative histological study of rats 7-10 days after they had received rather higher doses of intrahippocampal tetanus toxin. Here we report a quantitative histological study of hippocampi from rats which had gained remission from seizures induced by low doses of tetanus toxin. Adult Sprague Dawley rats received unilateral injections of 3-4 ng (about 6-8 mouse LD50) tetanus toxin, or vehicle, into the dorsal hippocampus. The first experiment confirmed that postsynaptic evoked responses recorded from pyramidal cells were depressed 10-19 weeks after injection. Unexpectedly, there also was a decrease of 20% in the antidromic response from CA3a contralateral to the injection. However, cell counts in these hippocampi revealed no change in pyramidal cell numbers. The second experiment used rats from two breeding colonies, prepared for histology 7 weeks after injection. Hippocampal pyramidal cell numbers were within the normal range in all but three of the 24 rats that had received tetanus toxin. These three had lesions of the CA1 pyramidal layer contralateral to the injection. The lesions were of the order of 2 mm in diameter, and were associated with glial proliferation. When these three cases were excluded, there remained a small increase in glial density in CA1 of the toxin-injected rats. In addition, toxin-injected rats from one of the colonies were susceptible to a pathology known as acidophylic or dark cell change. These occurred in 11 of 18 toxin-injected rats from this colony, in all divisions of the pyramidal layer, in both the injected and the contralateral hippocampus (where parallel studies revealed independent secondary epileptic foci). We conclude that loss of pyramidal neurons is not necessary for the persistent behavioural changes in this model.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1991

On the role of polysialoglycosphingolipids as tetanus toxin receptors. A study with lipid monolayers.

Lipid monolayers of different compositions were used to study the interaction of tetanus toxin with membrane lipids and to evaluate the role of polysialoglycosphingolipids as membrane receptors. At neutral pH, the toxin binds to dioleoylglycerophosphocholine monolayers and inserts into the phospholipid layer. This effect is potentiated by acidic phospholipids without an apparent preference for a single class of phospholipids. Polysialoglycosphingolipids further increase the fixation and penetration of tetanus toxin in lipid monolayers, but no specific requirement for a particular ganglioside was identified. The ganglioside effect is abolished in the presence of other nervous tissue lipids: cerebrosides and glycosphingolipid sulfates are partially responsible for this effect. The penetration of tetanus toxin in the lipid monolayer is pH dependent. It increases with lowering pH, it is facilitated by acidic phospholipids and by glycosphingolipid sulfates and it is mediated both by hydrophobic and electrostatic interactions as deduced from an analysis of the effect of ionic strength. Fragment B of tetanus toxin the low-pH-driven lipid interaction of the toxin. On the basis of the present findings, the possible role of polysialoglycosphingolipids in the neurospecific binding of tetanus toxin is discussed.

Gangliosides↗
PubMed1986

Interaction between tetanus toxin and rabbit kidney: a comparison with rat brain preparations.

125I-Tetanus toxin is bound by basolateral membranes from rabbit kidneys. Fixation is specific, as it is minimally inhibited by the nonbinding (fragment B) moiety of tetanus toxin, whereas the binding moiety (fragment C) is equivalent to the native toxin in inhibiting fixation. Competition is also pronounced with mildly toxoided toxin. Association and dissociation of 125I-toxin are delayed in kidney when compared to brain membranes. The binding sites in kidney membranes are partially sensitive to neuraminidase and resist heating to 56 degrees C, in contrast to those in brain membranes which are very sensitive to both treatments. The binding sites of the two preparations can be discriminated further by variation of the ionic environment. Sodium dodecyl sulfate-disc gel electrophoresis followed by transfer to nitrocellulose, and TLC with consecutive overlay indicate that tetanus toxin exclusively binds to long-chain gangliosides from rat brain. Binding sites in kidney membranes from rabbits and rats can be made visible by the overlay technique. They are apparently heterogeneous and more hydrophobic. We conclude that rabbit kidney contains binding sites for tetanus toxin which resemble gangliosides but differ from the major gangliosides in brain both chemically and with respect to their interaction with tetanus toxin.

Animals↗
PubMed1986

Reevaluation of the role of gangliosides as receptors for tetanus toxin.

Binding of tetanus toxin to rat brain membranes was of lower affinity and capacity when binding was determined in 150 mM NaCl, 50 mM Tris-HCl (pH 7.4) than in 25 mM Tris-acetate (pH 6.0). Binding under both conditions was reduced by treating the membranes with neuraminidase. Pronase treatment, however, reduced toxin binding only in the Tris-saline buffer (pH 7.4). In addition, the concentration of gangliosides required to inhibit toxin binding was 100-fold higher in Tris-saline compared to Tris-acetate buffer. The toxin receptors in the membranes were analyzed by ligand blotting techniques. Membrane components were dissolved in sodium dodecyl sulfate, separated by polyacrylamide gel electrophoresis, and transferred to nitrocellulose sheets, which were overlaid with 125I-labeled toxin. Tetanus toxin bound only to material that migrated in the region of the dye front and was extracted with lipid solvents. Gangliosides isolated from the lipid extracts or other sources were separated by TLC on silica gel and the chromatograms were overlaid with labeled tetanus toxin. The toxin bound to areas where the major rat brain gangliosides migrated. When equimolar amounts of different purified gangliosides were applied to the chromatogram, binding of the toxin was in the order GD1b approximately equal to GT1b approximately equal to GQ1b greater than GD2 greater than GD3 much greater than GD1a approximately equal to GM1. Thus, the toxin appears to have the highest affinity for gangliosides with a disialyl group linked to the inner galactosyl residue. When binding of tetanus toxin to transfers and chromatograms was determined in the Tris-saline buffer (pH 7.4), the toxin bound to the same components but the extent of binding was markedly reduced compared with the low-salt and -pH conditions. Our results indicate that the interaction of tetanus toxin with rat brain membranes and gangliosides is greatly reduced under more physiological conditions of salt and pH and raise the possibility that other membrane components such as sialoglycoproteins may be receptors for the toxin under these conditions.

Animals↗
PubMed1988

Effects of tetanus toxin on catecholamine release from intact and digitonin-permeabilized chromaffin cells.

Tetanus exotoxin inhibited Ca2+-dependent catecholamine secretion in a dose-dependent manner in digitonin-permeabilized chromaffin cells. The inhibition was specific for tetanus exotoxin and the B fragment of tetanus toxin; the C fragment had no effect. Inhibition required the introduction of toxin into the cell, and was not seen when intact cells were preincubated with the toxin or toxin fragments. The degree of inhibition was related to the length of preincubation with toxin, as well as the concentration of toxin used. A short preincubation with toxin was sufficient to inhibit secretion, and the continued presence of toxin in the incubation medium was not required during the incubation with Ca2+. The inhibition of secretion by tetanus toxin or the B fragment was not overcome with increasing Ca2+ concentrations. Tetanus toxin also inhibited catecholamine secretion enhanced by phorbol ester-induced activation of protein kinase C. Thus, the toxin or a proteolytic fragment of the toxin can enter digitonin-permeabilized cells to interact with a component of the Ca2+-dependent exocytotic pathway to inhibit secretion.

Adrenal Medulla↗
PubMed1991

Stereotaxic injection of tetanus toxin in rat central nervous system causes alteration in normal levels of monoamines.

A single intraventricular injection of tetanus toxin produced a time-dependent elevation of serotonin levels in brain and spinal cord of adult rats. This tetanus toxin-induced increase was produced in areas of high density of serotonergic innervation, such as the hypothalamus, hippocampus, and spinal cord. Little or no effect was found in the thalamus, cerebellum, and frontal cortex, areas that are poorly innervated by serotonergic terminals. The responses of catecholamines (no change in dopamine level and generalized decrease in norepinephrine) pointed to a specific action of tetanus toxin on the serotonergic system. Stereotaxic injections of tetanus toxin in dorsal or magnus raphe nuclei did not have an evident effect on biogenic amine levels in the brain and spinal cord, respectively. Because direct stereotaxic injections of the toxin in the hypothalamus or hippocampus produced significant serotonin increases in both areas, it is proposed that tetanus toxin interacts with presynaptic targets to produce serotonin accumulation; this is probably due in part to an activation of tryptophan 5-hydroxylase.

Animals↗
PubMed2005

The tetanus neurotoxin-sensitive and insensitive routes to and from the plasma membrane: fast and slow pathways?

Intracellular membrane trafficking in eukaryotes involves the budding of vesicles from a donor compartment, their translocation, and subsequent fusion with a target membrane. This last step has been shown to involve SNARE proteins, classified into two categories, vesicular (v)-SNAREs and target (t)-SNAREs. It is the pairing of v- and t-SNAREs that is responsible for bringing the lipid bilayers together for membrane fusion. Key to the discovery of SNAREs is the sensitivity of their neuronal synaptic prototypes, which mediate the release of neurotransmitters, to clostridial neurotoxins. In this review, we focus on tetanus neurotoxin-sensitive and tetanus neurotoxin-insensitive v-SNAREs, in particular synaptobrevin and cellubrevin, both tetanus neurotoxin-sensitive and Tetanus neurotoxin-Insensitive Vesicle-Associated Membrane Protein (TI-VAMP, also called VAMP7). The brevins are characterized by an RD sequence in the middle of their SNARE motif whereas TI-VAMP has an RG sequence. These two categories of exocytic v-SNAREs define two important routes to and from the plasma membrane: one sensitive, the other insensitive to tetanus neurotoxin. We also discuss the central role of the endosomal system that could be considered, as already suggested for Rab proteins, as a mosaic of v-SNAREs, thus raising the question of whether or not these two routes can merge, and if so, how and where.

Animals↗
PubMed1992

Immunity against diphtheria and tetanus in human immunodeficiency virus-infected Danish men born 1950-59.

To evaluate the possible need for vaccination against diphtheria and tetanus of patients infected with the human immunodeficiency virus (HIV), antibodies were measured in blood samples from 78 Danish HIV-infected men, born 1950-59, who could be expected to have received primary vaccination before they contracted the HIV infection. No patients (95% confidence interval: 0-4) had tetanus antibodies below the protective level, whereas 24 of the 78 patients (16-33) were unprotected against diphtheria. In the background population of the same age group and sex, 5% and 10% have been found unprotected against tetanus and diphtheria, respectively. No relationship between disease stages and antibody levels could be found. Neither was there any difference between patients with normal and reduced numbers of CD4+ lymphocytes. From 25 patients two blood samples were taken at an interval of at least one year. Anti-tetanus titres showed a decrease comparable to that found in the background population, whereas the change in anti-diphtheria titres was more variable with rising antibody concentrations in nine patients. The fall off in antibodies did not increase with progression of the disease. It is concluded that HIV-positive younger men who have followed the vaccination program against tetanus prior to the HIV infection can be expected to be protected, whereas revaccination against diphtheria must be considered.

Adult↗
PubMed2003

Tetanus seroprevalence among farmers: a preliminary study.

BACKGROUND: Farmers are at increased risk of contracting tetanus. However, no difference in immunity to tetanus has been reported between rural and urban dwellers in large epidemiological studies. We hypothesized that tetanus antibody concentrations would be lower in farmers than in nonfarmers within the rural population. METHODS: We recruited 102 adult subjects attending an agribusiness trade show who identified themselves as farmers in Wisconsin. The nonfarmer group (n = 120) was composed of adults attending the agribusiness show who were not engaged in farming or were participating in another research study. Concentrations of antibody to tetanus toxin (antiTT) in sera were measured by an enzyme-linked immunosorbent assay (IBL, Hamburg). AntiTT levels of >0.15 IU/mL were considered protective. RESULTS: The antiTT concentrations for the farmer population (median = 2.74 IU/mL) were much higher than those for the nonfarmer group (median = 1.82 IU/mL) (P<.008). As in other studies, being male, being younger, and having a history of military service were positively correlated with protective antiTT concentrations. However, only farming, age, and the farming-sex interaction term were significantly associated with antiTT concentrations in the multiple-regression model. CONCLUSIONS: The farmers we studied had high antiTT concentrations and a high tetanus seroprevalence rate. Occupation may be an important consideration in the development of immunization policies. A broader seroepidemiological study of farmers must be undertaken before any such considerations can be made.

Agricultural Workers' Diseases↗
PubMed2005

[Generalized tetanus with intractable autonomic cardiovascular instability in an aged woman].

Tetanus is characterized by tetanic convulsions related to the actions of tetanospasmin produced by Clostridium tetani. Another important characteristic of tetanus is the instability of the cardiovascular system related to sympathetic hyperactivity in the autonomic nervous system, and it may be an important prognostic factor. We report a patient with tetanus in whose unstable circulatory kinetics made circulation management difficult. A 77-year-old woman who injured in a fall, 11 days after trismus appeared and 3 day after convulsion appeared. It was not severe case in the acuity classification. However, repeated generalized convulsions and autonomic imbalance involving the cardiovascular system were observed clinically, suggesting a severe case. Because of the unstable circulatory kinetics, the patient was carefully managed was performed in the intensive care unit (ICU), and she improved. ICU management may be essential for treating severe tetanus with cardiovascular complications. Acquired immunity is not achieved after the onset of tetanus, and since elderly people, in particular, as in our own caset, are easily injured when they fall, we recommend vaccination.

Aged↗
PubMed1999

Immunoglobulin G (IgG) subclass distribution and IgG1 avidity of antibodies in human immunodeficiency virus-infected individuals after revaccination with tetanus toxoid.

In human immunodeficiency virus (HIV)-infected individuals the amount of antibodies formed after vaccination with T-cell-dependent recall antigens such as tetanus toxoid is proportional to the peripheral blood CD4(+) T-lymphocyte counts. To investigate whether the immunoglobulin G (IgG) subclass distribution and avidity of the antibodies produced after vaccination are affected as well, we gave 13 HIV-infected adults with low CD4(+) T-lymphocyte counts (<200 x 10(6)/liter; group I), 11 HIV-infected adults with intermediate CD4(+) T-lymphocyte counts (>/=200 x 10(6)/liter; group II), and 5 healthy controls booster immunizations with tetanus toxoid. The prevaccination antibody concentrations against tetanus toxoid were similar in the HIV-infected and healthy adults. After vaccination the total IgG and the IgG1 anti-tetanus toxoid antibody concentrations were significantly lower in group I than in group II and the controls. The avidity of the IgG1 anti-tetanus toxoid antibodies formed by HIV-infected adults was within the range for healthy controls, irrespective of their CD4(+) T-lymphocyte counts.

Adult↗
PubMed1983

Immunological evaluation of meningococcal group C polysaccharide-tetanus toxoid conjugate in mice.

Neisseria meningitidis group C polysaccharide-tetanus toxoid conjugate was prepared to obtain the polysaccharide component in a thymus-dependent form and to preserve the immunogenic properties of the tetanus toxoid component. Biochemical and immunochemical analyses of this conjugate revealed that (i) it was composed of equal amounts of polysaccharide and protein; (ii) the antigenic activity of the polysaccharide component was greatly reduced; (iii) it contained about 10% free polysaccharide; (iv) the composition was not homogeneous; and (v) only 5% of the tetanus toxoid component was present at the surface of the conjugate molecules. In this study, the influence of these characteristics on the antibody response to both components in mice was investigated. The dose-response relationship, the persistence of antibodies, a possible antigenic competition, and the specificities of the antibodies induced were also studied. Our data suggest that the conjugate behaves as a pronounced thymus-dependent antigen, that the tetanus toxoid component is more immunogenic at lower dosages (0.8 and 20 ng) than equivalent doses of tetanus vaccine, that the presence of free polysaccharide does not influence the induction of antibodies to polysaccharide by the conjugate, and that no antibodies to new structures in the conjugate are induced. These characteristics favor the application of this conjugate as a vaccine for human use.

Animals↗
PubMed1983

Monoclonal antibodies as probes of tetanus toxin structure and function.

Monoclonal antibodies specific for fragment B, fragment C, and light chain of tetanus toxin were prepared by fusion of P3X63Ag8 BALB/c myeloma cells with spleen cells from BALB/c mice immunized with tetanus toxoid or fragment B. Hybridoma colonies were assayed for antibody production by an enzyme-linked immunosorbent assay. Fourteen positive clones were identified, cloned by limiting dilution, and injected intraperitoneally into mice to obtain ascites fluids. Thirteen of the monoclonal antibodies were of the immunoglobulin G1 subclass and one was immunoglobulin G2. Two of the antibodies were directed against sites on fragment C, nine were directed against the light chain, and three were directed against the portion of fragment B which does not comprise the light chain of tetanus toxin. At least one antibody in each group exhibited significant toxin neutralization activity. However, only one of these neutralizing antibodies strongly inhibited the binding of 125I-tetanus toxin to ganglioside-coated plates. These data indicate that interference with receptor recognition is not the only means of neutralizing tetanus toxin. Monoclonal antitoxins as potential therapeutic and prophylactic reagents are discussed.

Animals↗
PubMed1990

Cloning and expression of functional fragment C of tetanus toxin.

A segment of Clostridium tetani DNA corresponding to fragment C of tetanus toxin was amplified by using the polymerase chain reaction. This fragment was cloned into expression vector pTTQ8, under the control of the tac promoter. Expression of this plasmid in Escherichia coli resulted in the production of a protein consisting of 8 amino acids of the vector fused to the C-terminal 460 amino acids of tetanus toxin. This protein (rFragment C) was recognized by an antipeptide antibody specific for fragment C in an enzyme-linked immunosorbent assay and on immunoblots. rFragment C could be purified significantly in one step by immunoaffinity chromatography. Immunization of mice with rFragment C resulted in the production of antibodies that were able to protect the mice against a challenge with tetanus toxin. rFragment C bound to ganglioside GT1b and to neuronal cells in a manner indistinguishable from that of fragment C obtained by papain cleavage of tetanus toxin. For many applications, rFragment C appears to be a suitable alternative to tetanus toxin or toxin-derived fragment C.

Animals↗
PubMed2005

Immunogenicity of routine vaccination against diphtheria, tetanus, and Haemophilus influenzae type b in Asian infants born in the United Kingdom.

AIM: To determine the immunogenicity of routine vaccination against diphtheria, tetanus, and Haemophilus influenzae type b (Hib) in Asian infants born in the UK, and whether maternal antibody suppression occurs. METHODS: A cohort study with 80% power, within 95% confidence limits, to show that 80% or fewer Asian infants would respond with an anti-PRP antibody concentration >0.15 microg/ml. Infants of South Asian origin born in Berkshire were enrolled at two general practices in Reading: 41 Asian families sequentially asked to participate within 2 weeks of birth; 36 infants were enrolled and 34 completed the study. Main outcome measures were: antibody concentration against diphtheria, tetanus, and Hib expressed as geometric mean titres (GMT) and proportion of infants about a threshold protective antibody concentration. RESULTS: Median age for completing primary vaccination course was 5 months. All 34 achieved anti-PRP antibody concentration of >0.15 microg/ml, 33 were >1.0 microg/ml, and the GMT was 15.0 microg/ml. All infants developed protective antibody concentration >0.1 IU/ml for tetanus and diphtheria; the respective GMTs were 1.94 and 5.57 IU/ml. Infants with high (>0.25 IU/ml) antibody concentrations against diphtheria and tetanus at 2 months achieved lower antibody concentrations after their three dose course than those with low concentrations (<0.1 IU/ml) (p = 0.06 and 0.03, respectively). CONCLUSIONS: Despite evidence for maternal antibody suppression of the response to tetanus and diphtheria vaccination, excellent antibody responses were achieved by routine vaccination according to the accelerated schedule. High vaccine coverage should be encouraged to provide protection against the possibility of imported infection.

Antibodies, Bacterial↗
PubMed1989

Tetanus antitoxin titres in military personnel.

A study was made of the titres of tetanus antitoxin in the sera of 186 recruits and 886 serving personnel. All were found to have titres of more than 0.01 IU per ml, the titre regarded as sufficient to provide protection from tetanus. The percentage of recruits with tetanus antitoxin titres less than 0.1 IU per ml was significantly greater than the percentage of serving personnel with antitoxin titres less than 0.1 IU per ml and the overall geometric mean titre of the antitoxin in the sera of the recruits was significantly lower than that in the sera of the serving personnel. In the light of the finding that all of the recruits had protective levels of tetanus antitoxin and in view of the imminent withdrawal of TABT Vaccine, alternative strategies for immunisation against tetanus are presented.

Adolescent↗
PubMed1977

Partially restricted antitoxins of tetanus and diphtheria in man.

Antibodies of restricted specificity have been identified in the human in response to certain antigens. The present study analyzed tetanus and diphtheria antitoxins isolated from selected human sera and suggested a restricted response in antibody production to each of these antigens. Purified antibodies from eight serum specimens with elevated hemagglutination titers to tetanus and four to diphtheria yielded only IgG proteins in concentrations of 160-500 microgram/ml. Although some of the tetanus specimens were derived from cord sera and tetanus immunoglobulin, none of the total group had antibodies of the IgA and IgM classes. Utilizing immunoelectrophoresis against heavy chain subclasses, genetic markers, and kappa and lambda quantitations, a predeliction for the kappa IgG1 subclass was established for both tetanus and diphtheria antibodies. The lambda light chains were present in diminished quantities, IgG2 heavy chains were absent, and the IgG3 and IgG4 chains were variably identified.

Antibody Specificity↗