Diphtheria antitoxin

from Wikipedia, the free encyclopedia
Diphtheria antitoxin from the blood serum of horses (1895)

The diphtheria antitoxin ( DAT ) is an antitoxin against the diphtheria toxin from Corynebacterium diphtheriae . The diphtheria antitoxin is on the World Health Organization's list of essential medicines .

properties

The active component of diphtheria antitoxin are neutralizing antibodies . It is used in humans as a passive immunization to treat diphtheria . An ampoule consists of 10,000 injection units in one milliliter of sterile aqueous solution, which are injected intravenously or intramuscularly (as of 2018). The diphtheria antitoxin is obtained from the blood serum of horses that have previously been immunized with the diphtheria toxin.

Possible side effects are serum sickness and allergic reactions up to anaphylaxis . It is not available all the time and everywhere in the EU. The diphtheria antitoxin is used in the USA under the Investigational New Drugs Protocol, as it has no drug approval. It is also used as a comparison standard and positive control when measuring human antibodies against the diphtheria toxin.

Alternatively, some of the human monoclonal antibody 315C4 or antibodies from sera from convalescents can be used for passive immunization against the diphtheria toxin.

history

Immunization against C. diphtheriae was first achieved in 1890 by Emil von Behring and Shibasaburo Kitasato through passive immunization and described as serum therapy . Emil von Behring received the Nobel Prize for Physiology or Medicine for this in 1901 . From 1895 the diphtheria antitoxin was used regularly in humans. One unit was defined by Paul Ehrlich as the dose to neutralize a dose of diphtheria toxin which is lethal for guinea pigs . With the development of a preventive diphtheria vaccine , the diphtheria antitoxin has been used less frequently.

literature

  • Jann Hau, Steven J. Schapiro, Gerald L. Van Hoosier, Jr: Handbook of Laboratory Animal Science, Second Edition: Animal Models . CRC Press, 2004, ISBN 1-4200-3962-8 , pp. 6 (English, google.com ).

Individual evidence

  1. ^ WHO Model List of Essential Medicines (19th List). (PDF) In: World Health Organization. April 2015, archived from the original on December 13, 2016 ; Retrieved December 8, 2016 .
  2. ↑ a b c d Our Formulary | Infectious Diseases Laboratories | CDC. Archived from the original on December 16, 2016 ; accessed on March 7, 2018 .
  3. ↑ L. Both, J. White, S. Mandal, A. Efstratiou: Access to diphtheria antitoxin for therapy and diagnostics. In: Euro surveillance: bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin. Volume 19, Number 24, June 2014, p. 20830. PMID 24970373 .
  4. ↑ P. Stickings, P. Rigsby, L. Coombes, C. von Hunolstein, L. Ralli, A. Pinto, D. Sesardic: Calibration and commutability assessment of the 1st International Standard for Diphtheria Antitoxin Human. In: Biologicals. Volume 41, number 6, November 2013, pp. 384-392, doi: 10.1016 / j.biologicals.2013.08.001 . PMID 24011675 .
  5. ↑ LM Sevigny, BJ Booth, KJ Rowley, BA Leav, PS Cheslock, KA Garrity, SE Sloan, W. Thomas, GJ Babcock, Y. Wang: Identification of a human monoclonal antibody to replace equine diphtheria antitoxin for treatment of diphtheria intoxication. In: Infection and Immunity. Volume 81, Number 11, November 2013, pp. 3992-4000, doi: 10.1128 / IAI.00462-13 . PMID 23940209 , PMC 3811848 (free full text).
  6. ↑ JF Bermejo-Martin, A. Avila-Alonso, M. González-Rivera, E. Tamayo, JM Eiros, R. Almansa: Postbooster Antibodies from Humans as Source of Diphtheria Antitoxin. In: Emerging infectious diseases. Volume 22, number 7, 07, 2016, pp. 1265–1267, doi: 10.3201 / eid2207.151670 . PMID 27314309 , PMC 4918160 (free full text).
  7. ↑ E. Behring, S. Kitasato: About the coming about of diphtheria immunity and tetanus immunity in animals. 1890 [The mechanism of diphtheria immunity and tetanus immunity in animals. 1890]. In: Mol Immunol. 28 (12), 1991, pp. 1317, 1319-1320.
  8. ↑ RS Schwartz: Paul Ehrlich's magic bullets. In: The New England Journal of Medicine . Volume 350, Number 11, March 2004, pp. 1079-1080, doi: 10.1056 / NEJMp048021 . PMID 15014180 .
  9. ^ William Hallock Park, James P. Atkinson: The relation of the toxicity of diphtheria toxin to its neutralizing value upon antitoxin at different stages in the growth of culture. In: Journal of Experimental Medicine. 3, 1898, p. 513, doi: 10.1084 / jem.3.4-5.513 .
  10. ↑ BH Aboul-Enein, WC Puddy, JE Bowser: The 1925 Diphtheria antitoxin Run to Nome - Alaska: A Public Health Illustration of Human-Animal Collaboration. In: The Journal of medical humanities. [Electronic publication before printing] December 2016, doi: 10.1007 / s10912-016-9428-y . PMID 28032302 .