Contribución al estudio de la difteria / No disponible

Conocida desde la antigüedad, la difteria adquiere especial incidencia en España en el siglo XVI, siendo ya entonces conocida como garrotillo, por la similitud de la muerte de estos enfermos con los ajusticiados mediante garrote. Durante gran parte de los siglos XVII y XVIII, tuvo una presencia muy limitada en España. Bretonneau, es el primero que estudia la enfermedad en profundidad, entre 1818 y 1820, durante la epidemia de Tours (Francia), dándole el nombre de difteritis. A mediados del siglo XIX, vuelve a España y a otros países de Europa y poco después se extiende a todos los continentes, con una mortalidad que, al finalizar el siglo, era aún del 42%. A comienzos del siglo XX, la antitoxina diftérica de Behring supone un cambio importante en el pronóstico de la difteria y, a partir de 1923, se da el paso definitivo en el control de la enfermedad, mediante la anatoxina de Ramón

Known since ancient times, diphteria acquired a special incidence in Spain in the XVI century. Known then by "garrotillo", due to the similaraties its mortal victims showed with those executed by " garrote". Diphteria had a limited incidence in Spain during the XVII and XVIII centuries. Bretonneau was the first one to study this entity in depth between 1818 and 1820, during an epidemy in Tours, France and named it diphteritis. Around the middle of the XIX century, diphteria returns to Spain, and to other countries in Europe, and it is spread out to other continents. Its mortality by the end of XIX century was estimated at 42%. At the beginning of the XX century, the diphteric antitoxin of Behring established an important change in the prognosis of diphteria. A definite step to control the pathological entity was taken in 1923, by the use of the anatoxin of Ramón

Blood-borne human plasma cells in steady state are derived from mucosal immune responses.

Providing humoral immunity, antibody-secreting plasma cells and their immediate precursors, the plasmablasts, are generated in systemic and mucosal immune reactions. Despite their key role in maintaining immunity and immunopathology, little is known about their homeostasis. Here we show that plasmablasts and plasma cells are always detectable in human blood at low frequency in any unimmunized donor. In this steady state, 80% of plasmablasts and plasma cells express immunoglobulin A (IgA). Expression of a functional mucosal chemokine receptor, C-C motif receptor 10 (CCR10) and the adhesion molecule beta(7) integrin suggests that these cells come from mucosal immune reactions and can return to mucosal tissue. These blood-borne, CCR10(+) plasmablasts also are attracted by CXCL12. Approximately 40% of plasma cells in human bone marrow are IgA(+), nonmigratory, and express beta(7) integrin and CCR10, suggesting a substantial contribution of mucosal plasma cells to bone marrow resident, long-lived plasma cells. Six to 8 days after parenteral tetanus/diphtheria vaccination, intracellular IgG(+) cells appear in blood, both CD62L(+), beta(7) integrin(-), dividing, vaccine-specific, migratory plasmablasts and nondividing, nonmigratory, CD62L(-) plasma cells of different specificities. Systemic vaccination does not impact on peripheral IgA(+) plasmablast numbers, indicating that mucosal and systemic humoral immune responses are regulated independent of each other.

[Recovery of the cardiovascular system and the state of its autonomic regulation after prior long hemorrhagic shock during vaccination with tetanus and diphtheria anatoxins].

Tetanus anatoxin was shown to have a stimulant effect on the cardiovascular system and its autonomic regulation, which produced a longer posthemorrhagic survival in the controls with the least pronounced dystrophic changes in the myocardium. Prior vaccination with diphtheria anatoxins was found to promote animals' survival, by reducing reperfusion injury in the presence of long-term systemic hypoperfusion, early exhaustion of sympathetic autonomic cardiac rhythm regulation, and myocardial dystrophic and necrobiotic changes resulting in the development of cardiosclerosis.

Immunogenicity and reactogenicity of a single dose of a diphtheria--tetanus--acellular pertussis component vaccine (DTaP) compared to a diphtheria--tetanus toxoid (Td) and a diphtheria toxoid vaccine (d) in adults.

We compared immunogenicity and reactogenicity of a single dose of DTaP vaccine (containing tetanus and diphtheria toxoids and four acellular pertussis antigens) with conventional Td- or d-vaccines in 180 German adults. Antibody values against diphtheria and tetanus toxin and against the pertussis antigens fimbriae (FIM), filamentous hemagglutinin (FHA) and pertussis toxin (PT) were measured in pre- and post-immunization sera. Reactogenicity was determined by a patient diary card. Pre-immunization antibody values against diphtheria toxin were low in all three vaccine groups. After immunization, > or = 80% of the vaccinees in all three groups were fully protected (> or = 0.1 IU/ml), but geometric mean values were significantly higher in DTaP recipients compared to Td or d recipients (1.65 vs. 0.44 and 0.48, respectively; both P < 0.05). Pre-immunization antibody values against tetanus toxin were high in all three groups, and after immunization 100% of the vaccinees were protected (> or = 0.1 IU/ml). Furthermore, substantial antibody responses against pertussis antigens were elicited in DTaP recipients with geometric mean rises of 22.5, 4.1 and 7.5 for antibodies against FHA, fimbriae and PT, respectively. All three vaccines were well tolerated. Frequency and severity of local reactions were similar between DTaP and Td recipients and even less common in d recipients. Since DTaP did provide a significant boost of anti-pertussis antibodies and a significantly higher anti-diphtheria response than conventional Td vaccine without an increase of side effects, it might be an appropriate candidate for use in adults.