[en] Tetanus is a life threatening disease. Reported mortality for tetanus is 15-39%. Conventional treatment includes heavy sedation and artificial ventilation. Complications resulting from long term heavy sedation and artificial ventilation contribute to 60% of the total mortality caused by tetanus. In this study magnesium sulphate was used to reduce the need for sedation and artificial ventilation. Objectives of this prospective study were to determine the role of magnesium sulphate in post traumatic tetanus. The study was carried out in surgical Intensive Care at Pakistan Institute of Medical Sciences (PIMS), Islamabad from Jan 2004 to Dec 2007. Forty-four patients presented during this period and 33 patients were included in the study. All patients had tracheostomy done within 48 hours. Every patient was started Magnesium Sulphate therapy for control of spasms after sending baseline investigations. Patients were given ventilatory support when needed. All data was entered in well structured proforma. SPSS-10 was used to analyse data. Thirty-three patients were included in the study and all patients were given magnesium sulphate. Out of these, 45.5% cases were grade 4 tetanus, 73.6% and 63.3% cases did not require artificial ventilation and additional sedation respectively, 51.1% patients remained free of complications of tetanus. Overall mortality was 30.3%. Use of Magnesium Sulphate is safe and reduces the need for sedation and artificial ventilation in high grade tetanus thus contributing to survival benefit in adult post-traumatic tetanus cases. (author)

[en] To measure tetanus antibodies a trace amount of ¹²⁵I-labeled tetanus toxin is mixed with appropriate dilutions of human serum or blood. The labeled antigen-antibody complexes are adsorbed to heat-killed staphylococci (Cowan I) via their surface protein A. The radioactivity of the washed solid phase is a function of the initial antibody concentration. The test allows the measurement of 6 x 10^-0U of tetanus antitoxin in a volume of 0.03 ml. In order to avoid possible interferences, serum has to be diluted 20-fold before use. Taking that into account the real border limit of sensitivity is 4 x 10^-3U/ml serum. Antibodies may be measured in serum, in plasma, and even in heparinized blood. As to its sensitivity, the test compares well with the toxin neutralization procedure. It is superior to the previous radioimmunologic, enzymoimmunologic, and hemagglutination techniques with respect to sensitivity and reproducibility. It reflects the values obtained in the toxin neutralization test better than the other in vitro procedures, as shown by parallel assays of 17 sera. (orig.)

[en] Pakistan is one of the remaining 24 countries which have not yet achieved Maternal and Neonatal Tetanus Elimination (MNTE). The country adopted high-risk approach for 56 out of 119 districts with country-wide Tetanus Toxoid (TT) provision in Routine Immunization (RI) during early 2000-2003. The TT's mass campaigns could only cover 13% of high risk districts for 2009-2011, and mostly for the Punjab province. To achieve MNT elimination, the country needs risk mapping for cost-effective intervention. Methods: We used both the quantitative and qualitative methods to conduct risk characterization. All the three available data sets (Reported EPI coverage data, PDHS 2012-13, and PSLM 2010-11) were assessed. A mix of core and surrogate indicators for risk categorization was used through ranking and scoring the aggregated data and considering the past tetanus campaigns coverage. Tetanus Toxoid (TT2+) coverage of pregnant women and delivery in health facility, both received more weightage in scoring. We based the higher and lower cuts off points for each indicator on data ranges. The districts with higher scores, i.e., 10.5 and above were ranked good followed by medium (5.5-10.4) and low performing (less than 5.5). Consultations with the national and provincial field officers were utilized to understand the local context. Results: In Pakistan, there are 139 districts out of which, 60 are the high risk districts for tetanus. Highest percentage is for Baluchistan (83%) followed by Sindh (52%), and Khyber Pakhtunkhwa (40%). Most of the Punjab is at medium risk (55%), followed by KP (52%), and Sindh (39%). Conclusion: Pakistan is at medium to high risk of MNT with a great variation at the sub-national level. Campaigns aiming to these districts may bring the country closer to MNT elimination target. (author)

[en] In this study, the role of SNARE-mediated membrane traffic in regulating integrin localization was examined and the requirement for SNARE function in cellular spreading was quantitatively assessed. Membrane traffic was inhibited with the VAMP-specific catalytic light chain from tetanus toxin (TeTx-LC), a dominant-negative form (E329Q) of N-ethylmaleimide-sensitive fusion protein (NSF), and brefeldin A (BfA). Inhibition of membrane traffic with either E329Q-NSF or TeTx-LC, but not BfA, significantly inhibited spreading of CHO cells on fibronectin. Spreading was rescued in TeTx-LC-expressing cells by co-transfection with a TeTx-resistant cellubrevin/VAMP3. E329Q-NSF, a general inhibitor of SNARE function, was a more potent inhibitor of cell spreading than TeTx-LC, suggesting that tetanus toxin-insensitive SNAREs contribute to adhesion. It was found that E329Q-NSF prevented trafficking of α₅β₁ integrins from a central Rab11-containing compartment to sites of protrusion during cell adhesion, while TeTx-LC delayed this trafficking. These results are consistent with a model of cellular adhesion that implicates SNARE function as an important component of integrin trafficking during the process of cell spreading

[en] Frequencies of circulating T cells producing IFN-γ, TNF-α, and IL-2, and percentages of T cells proliferating after stimulation with rotavirus (RV), tetanus toxoid, and influenza were evaluated in PBMC derived from healthy adults and children. In addition, the potential anergic state of RV-specific T cells was analyzed by stimulation of PBMC with RV antigen in the presence of three anergy inhibitors (rIL-2, rIL-12, or DGKα-i). The quality and magnitude of RV-T cell responses were significantly lower than those of tetanus toxoid and influenza antigens. RV-CD4 T cell response was enriched in monofunctional IFN-γ"+ cells, while influenza-CD4 and tetanus toxoid-CD4 T cell responses were enriched in multifunctional T cells. Moreover, rIL-2 – unlike rIL-12 or DGKα-i – increased the frequencies of RV-CD4 TNF-α"+, CD4 IFN-γ"+, and CD8 IFN-γ"+ cells. Thus, circulating RV-T cells seem to have a relatively poor functional profile that may be partially reversed in vitro by the addition of rIL-2. - Highlights: • The quality and magnitude of circulating RV-T cell responses are relatively poor. • Circulating RV-CD4 T cells are enriched in monofunctional IFN-γ+ cells. • Treatment with rIL-2 increased the frequencies of cytokine secreting RV-T cells

[en] Antisera were raised in rabbits against immunosorbent-purified F(ab')₂ fragments of IgG antitetanus toxoid (TT) antibodies obtained from three different donors. The antisera were rendered idiotype specific by absorption with insolubilized TT-nontreactive F(ab')₂. The resulting anti-idiotypic antisera precipitated more than 85% of ¹²⁵I-radiolabeled F(ab')₂ anti-TT and were shown to be individual specific in that they reacted only with the immunizing F(ab')₂ anti-TT and not with F(ab')₂ anti-TT derived from other donors. Anti-idiotypic antiserum inhibited binding of ¹²⁵I-TT but not of ¹²⁵I-DT to IgG derived from the donor of the immunizing F(ab')₂ anti-TT, but did not inhibit ¹²⁵I-TT binding to IgG derived from other donors. Finally, binding of ¹²⁵I-F(ab')₂ anti-TT to the anti-idiotypic antiserum was completely inhibited by IgG derived from the same donor but only partially inhibited by a great excess of TT antigen, suggesting that the anti-idiotypic antiserum is recognizing nonantigen-binding idiotypic determinants on F(ab')₂ anti-TT. The data presented demonstrate that anti-idiotypic heteroantisera can be successfully raised against human antibodies to TT, indicate minimal cross-reactivity of idiotypic determinants between unrelated individuals, and suggest the presence of nonantigen binding-idiotypic determinants on the antibody molecule

[en] The authors describe a lateral flow assay (LFA) for the antibody against the infectious bacterium Clostridium tetani. Gold nanoparticles (AuNPs) were linked to tetanus antigen and are captured in the test line via the formation of a sandwich structure composed of AuNP-labeled tetanus antigen, tetanus antibody, and tetanus antigen. This leads to the formation of a characteristic red line due to the accumulation of AuNPs. The formation of the color line allows for a highly sensitive and selective detection of tetanus antibody, both with bare eyes and by smartphone-based quantitative analysis. This assay offers a wide detection range from 0 to 0.5 IU·mL⁻¹ and has a linear relationship from 0.01 to 0.1 IU·mL⁻¹ with an experimental detection limit of 0.01 IU·mL⁻¹. This assay is simple, fast, inexpensive and highly selective. When applied to the detection of tetanus antibody in spiked whole blood, it provided reliable results that compared well to those obtained with a commercial ELISA kit. .

[en] A solid-phase radioimmunoassay has been developed as a screening technique for tetanus antibodies in blood plasma. It is based on the principle of a commercial test for Hepatitis B antibody. Compared to previous screening techniques, the radioimmunoassay showed better stability with no apparent loss of sensitivity over a 2 month period. This technique has proved useful in determining tetanus immunity and in monitoring free antibody level in treated cases of clinical tetanus. (U.K.)

No abstract available

[en] A radioimmunoassay was developed to quantitate antitetanus toxoid antibody in whole plasma which can detect 0.75 ng IgG antibody (0.75 μg/ml plasma) and 1.60 ng IgM antibody (0.40 μg/ml plasma). The IgG antibody was measured by direct binding to a tetanus toxoid-Sepharose immunoadsorbent. The IgM antibody was measured by inhibition of binding by soluble tetanus toxoid because of the relatively high and erratic non-specific reaction between IgM and the immunoadsorbent. The immunoglobulin standards were [¹³¹I]IgG or [¹³¹I]IgM coupled to Sepharose, respectively, and the amount of antibody activity in the ¹²⁵I-labeled antiglobulin reagents could be calculated from the amount bound to the immunoadsorbent and the specific activity of the appropriate immunoglobulin standard. The assay is sensitive, reproducible and suitable for use with large numbers of samples: it should find wide applicability in both clinical and experimental settings. (Auth.)