Antidiphtheria Antibody Responses in Patients and Carriers ofCorynebacterium diphtheriaein the Arkhangelsk Region of Russia

Abstract

Diphtheria is under control in industrialized countries. However, single cases and outbreaks still occur and the disease is not completely understood. Forty-three individuals suspected of having diphtheria who were referred to the Infectious Disease Hospital of Arkhangelsk from December 1994 to March 1995 were included in this study. Fifteen patients were diagnosed as having diphtheria and received equine hyperimmune antidiphtheria toxin antiserum, and 28 were diagnosed as carriers, 12 with nondiphtherial tonsillitis or pharyngitis and 16 without symptoms. Serum samples were obtained on admission and during the course of the disease or during follow-up of carrier status. Samples were analyzed for antibodies against diphtheria toxin with both an in vitro neutralization test (NT) and a human-specific enzyme immunoassay. All of the cases but one were confirmed by a positive culture. Twelve patients had pharyngeal diphtheria, and three had combined laryngeal and pharyngeal disease. Half of the patients had life-threatening disease, and one died. On admission, the median antibody titers measured with the NT were 0.085 IU/ml for the patients, 5.12 IU/ml for the symptomatic carriers, and 10.24 IU/ml for the healthy carriers. All of the diphtheria patients but one and nine of the carriers (six symptomatic and three healthy) had increased antibody levels during the first 7 to 10 days after admission. No obvious correlation was revealed between the antibody level or its kinetics and the course of the disease. Antibody levels on admission of >1 IU/ml were associated with a low risk of diphtheria.

Two Japanese Corynebacterium ulcerans isolates from the same hospital: ribotype, toxigenicity and serum antitoxin titre

“…The fully protective level of antitoxin titre against diphtheria is believed to be 0.1 IU ml 21 (Galazka, 1993;Hasselhorn et al, 1998). This result indicates that human respiratory C. ulcerans infection can induce an antibody response against diphtheria toxin, as well as in the reported cases of C. diphtheriae infection (Danilova et al, 2006), and that the rise in antibody titre can be utilized as a marker of C. ulcerans infection.…”

“…Respiratory infection with toxigenic C. diphtheriae is known to cause elevation of serum antitoxin during the course of infection (Danilova et al, 2006); however, it is not yet clear if C. ulcerans respiratory infection can cause such an elevation. From the second case reported in our study (in which strain 0211 was isolated), patient serum was obtained periodically from the time of first presentation to the hospital on 28 October 2002 until 16 February 2005.…”

“…Diphtheria caused by Corynebacterium diphtheriae results in a detectable rise in the serum antitoxin titre against diphtheria toxin during the course of infection (Danilova et al, 2006). We were interested to know whether toxigenic C. ulcerans would be capable of inducing a similar reaction.…”

A Dominant-Negative Approach That Prevents Diphthamide Formation Confers Resistance to Pseudomonas Exotoxin A and Diphtheria Toxin

“…The implementation of a vaccine program in the 1940s and 1950s based on diphtheria toxoid had nearly eliminated diphtheria in developing countries. However, recent outbreaks of diphtheria have been reported in countries like Russia, in newly independent states of the former Soviet Union, and in poor socio-economically disadvantaged groups living in crowded conditions in Europe and the US [17] , [18] . One reason for the re-emergence of epidemics in countries where immunization have been performed has been explained by a lack of exposure to toxigenic strains of diphtheria necessary for the boost and maintenance of immunity against this pathogen [17] .…”

Reviewing the role of peptide rarity in bacterial toxin immunomics

“…B. pertussis infection and reinfection still occurs despite immunization (26), and, in general, susceptibility to diseases preventable by vaccine (19) pose crucial questions that remain unanswered. Also, antitoxin antibody levels vary during the course of an infection (27) and add to the cross-reactivity phenomena (28), possibly indicating diagnostic sensitivity and therapeutic specificity as well as correlations between humoral antitoxin levels and the course of the infection (29). Hence, understanding the peptide targets and the antigen-antibody interactions that occur during bacterial infections is a key priority in further understanding toxin-neutralizing antibodies, the extent of the humoral response, and the course of the infection.…”