Safety and immunogenicity of chromatographically purified Vero cell rabies vaccine for intradermal pre- and post-exposure rabies prophylaxis.

UNLABELLED: Improved rabies pre- and post-exposure prophylaxis (PrEP and PEP) in developing countries uses an economic multi-site intradermal vaccination. AIM: To evaluate immunogenicity of chromatographically purified Vero cell vaccine (CPRV) for intradermal PrEP and PEP. METHOD: The subjects received conventional PrEP with CPRV or PVRV in PrEP study or received intradermal PEP with CPRV or PVRV and rabies immunoglobulin in PEP study. RESULT: All subjects who received PrEP with CPRV had protective neutralizing antibody (Nab) titers (≥0.5 IU/ml) 14 days after completing vaccination. In PEP study, Nab titers in the CPRV groups reached ≥ 0.5 IU/ml in all subjects by day 14 through day 90 after vaccination. The geometric mean titers of Nab in the CPRV groups had significantly higher titers than the PVRV group on day 14 through day 365 (p < 0.05). No serious adverse reactions were observed. CONCLUSIONS: CPRV is safe and immunogenic when given for intradermal PrEP and PEP.

Trend of human rabies prophylaxis in developing countries: toward optimal rabies immunization.

Rabies is a fatal infectious disease. Because prevention is the key management for rabies, many vaccination regimens have been developed and used worldwide. The aims for developing rabies vaccination regimens include decreasing the number and amount of dosages, decreasing the duration and the number of clinical visits, and reducing cost. Interestingly, some intradermal (ID) regimens have proved to be as effective as the standard intramuscular (IM) regimens, and have been increasingly used in developing countries because they are less expensive. In this article, we reviewed rabies vaccines based on results obtained from clinical trials and international treatment guidelines for post-exposure prophylaxis, pre-exposure prophylaxis for the high risk group, and booster vaccination.

Scorpion venoms, kidney and potassium.

Scorpion venoms cause renal injury by the interaction of renal ischemia due to intense renal vasoconstriction and inflammatory reactions due to proinflammatory cytokines and mediators. Renal vasoconstriction is not only induced by catecholamine storm but also by angiotensin II and the direct action of venom on vascular ion channels. Increased aldosterone also contributes to hypertension. Blocking of renal tubular K channels decreases renal K excretion and increases serum K level which increases aldosterone release. Hyperaldosteronism increases K excretion mostly through ROMK2 and ROMK3 unblocked by the venom. The presence of angiotensin converting enzyme inhibitor in some scorpion species can increase serum K. Therefore, there are both K increasing and K decreasing effects in renal K excretion. Serum K in scorpionism is the net result of the two opposing effects. Hyperkalemia is therefore inconsistent.