Efficacy and safety of a new Botulinum Toxin Type A free of complexing proteins in the treatment of blepharospasm

NT 201 is a new development of Botulinum Toxin Type A free of complexing proteins. In this double-blind Phase III trial, we compared the efficacy and safety of NT 201 and BOTOX in patients suffering from blepharospasm. Of 304 enrolled patients, 300 patients received study medication (intent-to-treat population), and 256 patients completed the study as planned (per-protocol population). At baseline, patients received a single injection of NT 201 or BOTOX (<or=35 units per eye). No significant differences were found between NT 201 and BOTOX for all efficacy and safety variables three weeks after injection. Both the NT 201 and the BOTOX group showed a decrease in the Jankovic Rating Scale (JRS) sum score signifying an improvement in the symptoms of blepharospasm during this time period. These data show that NT 201* is an effective and safe treatment for patients suffering from blepharospasm.

Safety and immunogenicity of two acellular pertussis vaccines with different pertussis toxoid and filamentous hemagglutinin content in infants 2-6 months old

The optimal composition and antigen content of acellular pertussis vaccines is not known. Two vaccines with different quantities of pertussis toxoid (10 and 20 micrograms) and filamentous hemagglutinin (5 and 20 micrograms) and identical 69 kD protein (3 micrograms) and fimbriae 2 and 3 (5 micrograms) combined with diphtheria and tetanus toxoids were compared in a randomized, double-blind study in 2,050 infants undergoing their primary immunization series at 8 centers in the US and Canada. A 6:1 increased antigen to lower antigen allocation was used; 96% of infants received 3 doses and completed the study. A 'clinically significant' local reaction was reported in 3-6% of participants after each dose. Erythema was the most common reaction occurring in 3-5% of infants after the second or third dose. A clinically significant systemic adverse reaction was reported in 28-34% of vaccinees (or vaccinated children) after each dose; fever (7-18%) and fussiness (12-17%) were most common. There were no differences in adverse events between the 2 vaccine formulations. Antibody responses were measured in 292 infants at 1 center. At 7 months, geometric mean anti-filamentous hemagglutinin antibody titers were higher in recipients of the higher antigen content vaccine (p < 0.001) whereas recipients of the lower antigen content formulation had higher anti-fimbriae antibody (p < 0.001) and agglutinin titers (p < 0.05). No differences were detected in anti-pertussis toxin or other antibody responses between the formulations. We conclude that increasing the antigen content of the acellular pertussis vaccine had a variable effect on antibody response but was not associated with increased adverse reactions.

Immunogenicity of a five-component acellular pertussis vaccine in infants and young children

OBJECTIVE

To compare the reactogenicity and immunogenicity of an acellular vaccine containing pertussis toxoid, filamentous hemagglutinin, and fimbriae 2 and 3, with and without the 69-kd membrane protein, alone or combined with diphtheria and tetanus toxoids.

PARTICIPANTS AND SETTING

One hundred thirty-seven 17- to 18-month-old and 22 4- to 6-year-old children who had received three or four previous doses of whole-cell vaccine, respectively, were recruited from public health immunization clinics.

DESIGN AND INTERVENTIONS

Three groups of children were sequentially enrolled in the study to receive the acellular pertussis vaccine with or without a 69-kd protein (CP4 or CP5, 17- to 18-month-old children), the two vaccines combined with diphtheria and tetanus toxoids (CP4DT or CP5DT, 17- to 18-month-old children), or the CP5DT vaccine (4- to 6-year-old children). Children were assigned to the first two groups in a randomized and double-blind fashion; the last group was formed by open enrollment. Data regarding adverse reactions were recorded by the parents and collected via a structured interview administered seven times, five times during the first 72 hours. Serum samples were obtained before and 1 month after the immunization, and antibodies against each constituent of the vaccine were measured.

RESULTS

A systemic adverse reaction was reported in 40% to 65.7% of 17- to 18-month-old and 38.1% of 4- to 6-year-old children; no severe reactions occurred. A local reaction was reported in 8.6% to 29.4% and 71.4% of children, respectively. No differences were detected between respectively. No differences were detected between vaccines; inclusion of the 69-kd membrane protein did not increase reactogenicity. All vaccines elicited an antibody response to all antigens contained in the formulation.

CONCLUSIONS

The five-component acellular pertussis vaccine (Connaught Laboratories Ltd, Willowdale, Ontario) is safe and immunogenic in 17- to 18-month-old and 4- to 6-year-old children. The 69-kd protein was immunogenic, and its inclusion neither increased side effects associated with the vaccine nor adversely affected the antibody response to the other components.

Comparison of a three-component acellular pertussis vaccine with a whole-cell pertussis vaccine in 4- through 6-year-old children. Elmwood Pediatric Associates, Pennridge Pediatric Associates

OBJECTIVE

To compare the safety and immunogenicity of a three-component acellular pertussis (DTaP) vaccine containing pertussis toxin (PT), filamentous hemagglutinin (FHA), and pertactin with whole-cell pertussis (DTwP) vaccine in 4- through 6-year-old children.

PARTICIPANTS

One hundred seventy-two healthy 4- through 6-year-old children previously immunized with the DTwP vaccine at or near 2, 4, 6, and 18 months of age.

INTERVENTIONS

Prevaccination serum samples were obtained on all study participants. One hundred twelve children received 0.5 mL of the DTaP vaccine intramuscularly. Fifty-three children received 0.5 mL of a commercially available DTwP vaccine intramuscularly. Approximately 30 days following vaccination, additional serum samples were obtained.

MEASUREMENTS

Parents monitored adverse reactions for 7 days following immunization. Significantly fewer children in the DTaP group reported temperatures of greater than 38.1 degrees C and an area of redness of more than 10 mm and moderate-to-severe pain at the injection site.

RESULTS

Antibody responses to PT, FHA, pertactin, and diphtheria and tetanus toxoids were measured by enzyme-linked immunosorbent assay. Among subjects who were seronegative prior to vaccination, response was defined as the detection of antibody levels following vaccination; among children with detectable antibody levels prior to vaccination, in terms of the rise in antibody titers. Data using a twofold and a fourfold rise in antibody titers as criteria to define response were evaluated. Children in the DTaP group had significantly greater increases in geometric mean titers of antibodies against PT, FHA, and pertactin. Over 90% of the DTaP group responded to PT, FHA, and pertactin according to the criteria of both the twofold and the fourfold rise in antibody titers. Significantly fewer of the DTwP group responded to PT, FHA, and pertactin with at least a fourfold rise in antibody titers. When analyzing subjects with at least a twofold increase in antibody titers, a statistically significant difference remained in regard to anti-FHA antibodies. All study subjects had protective antibody titers against diphtheria and tetanus toxoids following vaccination. The geometric mean titer of antibodies against tetanus was significantly greater in the DTwP group than in the DTaP group.

CONCLUSION

The three-component DTaP vaccine administered as a booster immunization in 4-through 6-year-old children produced less fever and less redness and pain at the injection site than the DTwP vaccine and was as immunogenic as the DTaP vaccine.

Allelochemicals in plant foods and feedingstuffs: 1. Nutritional, biochemical and physiopathological aspects in animal production

Several allelochemicals (anti-nutritional/anti-quality factors) contained in some plant foods and feedingstuffs are outlined. These include the trypsin and amylase inhibitors, hemagglutinins, gossypol, cyanogenic glycosides, tannins, oxalates, phytin, saponins, glucosinolates, estrogens, coumarins, alkaloids and aflatoxins. The nutritional, biochemical and physiopathological implications of their ingestion in a wide range of animals are reviewed. These include impaired growth, feed consumption, efficiency of feed utilization, alterations of normal enzyme activities, organ atrophy, necrotic changes, lesions and changes in normal hematological indices. The induction of increased dietary requirements for such nutrients as methionine, lysine, vitamins and divalent ions (eg Fe, Ca, Mg and Zn) by some of these factors is discussed. Ameliorative measures aimed at minimizing the concentrations and anti-nutritional effects of these factors are processing and including additives in the diet, or genetic manipulations. There is a need to prevent both functional and nutritional damage of food proteins and other nutrients arising from excessive heat treatment.

Phase I clinical trial of an acellular pertussis vaccine composed of genetically detoxified pertussis toxin combined with FHA and 69 kDa

An acellular pertussis vaccine composed of genetically detoxified pertussis toxin (PT-9K/129G), filamentous haemagglutinin (FHA) and pertactin (69 kDa protein) was evaluated in adult volunteers, in double blind, versus placebo. No fever was reported in either group. Mild local reactions were reported after injection of both vaccine and placebo. After the first dose a marked increase in antibodies to PT, FHA and 69 kDa protein was seen in vaccinated subjects with the exception of one who responded well to PT and FHA but did not show a humoral response to the 69 kDa protein. All vaccinees acquired cellular immunity against the three antigens. No significant variation was observed in the humoral or cellular responses after the second dose.

Synergistic teratogenic effect produced in mice by whole cell pertussis vaccine

Pertussis whole cell bacterial vaccine was injected in mice during early pregnancy to disclose any teratogenic effect on the brain of the fetuses. Cytochalasin D by itself induced exencephaly in a dose dependent way in fetal mice. When pregnant mice received a single injection of pertussis vaccine on day 8 of gestation and a subteratogenic dose of cytochalasin D on days 8, 9 and 10 of gestation a synergistic teratogenic action of pertussis vaccine and cytochalasin D in mice was observed. When autopsy was performed after a further 9 to 10 days a significant number of brain malformations was found. In order to analyse which component in the vaccine might be responsible for the co-teratogenic effect, purified pertussis components, pertussis toxin and filamentous haemagglutinin were used in combination with cytochalasin D, but no malformations occurred. The same results were obtained by using diphtheria-tetanus-polio (DiTePol) vaccine and acellular pertussis component vaccine, whereas the use of whole cell typhoid vaccine resulted in a high rate of fetuses with exencephalies. Experiments with purified Bordetella pertussis and Escherichia coli lipopolysaccharides indicated that lipopolysaccharides in whole cell pertussis vaccine as well as in typhoid vaccine were the factors causing teratogenicity in fetal mice.

Nutritional composition, processing, and utilization of horse gram and moth bean

Horse gram and moth bean are the unexploited legumes of the tropics and subtropics grown mostly under dry-land agriculture. The chemical composition is comparable with commonly cultivated legumes. Like other legumes, these are deficient in methionine and tryptophan. Horse gram is an excellent source of iron and molybdenum. Comparatively, horse gram seeds have higher trypsin inhibitor and hemagglutinin activities and polyphenols than moth bean seeds. Dehusking, germination, cooking, and roasting have been shown to produce beneficial effects on nutritional quality of both the legumes. Both the legumes require prolonged cooking to obtain product of acceptable nature. A soak solution (1.5% NaHCO3 + 0.5% Na2CO3 + 0.75% citric acid) treatment has been shown to reduce cooking time and improve protein quality. Moth bean is mostly consumed as dhal or sprouts. The whole seeds of horse gram are generally utilized as cattle feed. However, it is consumed as a whole seed, sprouts, or whole meal by a large population in rural areas of southern India. Medical uses of these legumes have been discussed.