Detection of antibodies against botulinum toxins

After immunisation with botulinum vaccine, antibodies to multiple epitopes are produced. Only some of these will have the capacity to neutralise the toxin activity. In fact, the ability of toxoid vaccine to induce toxin neutralising antibodies has provided the basis for the use of therapeutic antitoxins and immunoglobulins for the prophylaxis and treatment of diseases caused by bacterial toxins. Increasing indications for the chronic use of botulinum toxin for therapy have inevitably resulted in concern for patients becoming unresponsive because of the presence of circulating toxin-specific antibodies. Highly sensitive and relevant assays to detect only clinically relevant toxin neutralising antibodies are essential. Although immunoassays often provide the sensitivity, their relevance and specificity is often questioned. The mouse protection LD(50) bioassay is considered most relevant but can often only detect 10 mIU/ml of antitoxin. This sensitivity, although sufficient for confirming protective immunity, is inadequate for patients undergoing toxin therapy. An intramuscular paralysis assay improves the sensitivity to ca. 1 mIU/ml, and a mouse ex vivo diaphragm assay, with sensitivity of < 0.5 mIU/ml, is the most sensitive functional assay to date for this purpose. Alternative approaches for the detection of antibodies to botulinum toxin have included in vitro endopeptidase activity neutralisation. Unlike any other functional assay, this approach is not reliant on serotype-specific antibodies for specificity. Most recent promising developments are focused on cellular assays utilising primary rat embryonic cord cells or more conveniently in vitro differentiated established cell lines such as human neuroblastoma cells.

Removal of peripheral blood monocytes by phenylalanine methyl ester has no effect on the colony growth of hematopoietic progenitor cells

Purification of hematopoietic cells often includes an adherence step for the removal of monocytes. Recent studies have shown that some hematopoietic cells are adherent and that plastic adhesion might activate monocyte/macrophage for cytokine production. We investigated the possibility of using L-phenylalanine methyl ester (PME) as an alternative approach to monocyte removal, particularly for large-scale cell separations. Cell yield, extent of monocyte removal and cloning efficiency of colony-forming progenitor cells were compared to that produced by plastic adhesion. Starting with mononuclear cells (MNC) from adult peripheral blood, cell recovery after PME treatment was higher than that achieved with adherence and fewer monocytes were present. Cloning efficiency of the granulocyte-monocyte colony-forming progenitor cells (CFU-gm) was not affected by the PME treatment. PME treatment and plastic adhesion of low-density cord blood cells produced comparable cell recovery, monocyte depletion and cloning efficiencies for CFU-gm and burst forming units for erythroid progenitor cells (BFU-e). The PME procedure was optimized for the purification of hematopoietic cells from large quantities (less than 1 x 10(9)) of low density. T cell-depleted peripheral blood MNC containing 60% to 85% monocytes. Compared to two cycles of plastic adhesion, PME treatment permitted higher cell recovery (5.9% vs. 1.3%), lower monocyte contamination (4.5% vs. 10.7%) and substantial cost, time and labor savings without compromising CFU-gm growth.