Matokhina A G, Kapustian V A, Perelygina O V
Zh Mikrobiol Epidemiol Immunobiol. 2010 Jan-Feb(1):81-4.
Efficacy of different treatment regimens with equine diphtheria antitoxin (EDA) was assessed on clinical samples as well as in experiments on animals.
Protective properties and serum concentration kinetics of heterologous antibodies was studied on 12 rabbits and 51 guinea pigs after intramuscular injection of different doses of EDA, in serum samples from 26 patients, which received one intramuscular injection of EDA in various doses as well as in serum samples from 10 patients with diphtheria of different severity, which were treated with EDA in total course dose 100,000-1,500,000 IU. Antitoxin concentration in serum sample was measured with passive hemagglutination assay as well as Jensen toxin neutralization test on rabbits.
Experiments on laboratory animals received EDA in dose 150 IU/kg showed high protective effect. For example, rabbits with antitoxin level 1.0-1.25 IU/ ml in serum 24 hours after injection of EDA were 50-250 times resistant to dermonecrotic effect of diphtheria toxin compared with rabbits not received EDA. Guinea pig with antitoxin level 0.5-2.0 IU/ ml in serum 2-48 hours after injection of EDA in dose 150 IU/kg were all protected against 35-50 LD50 of diphtheria toxin. After termination of EDA injection there was sharp decrease of antitoxin level and it was not detected in serum 7 days after. Increase of antitoxin level in serum of animals was not adequate to quantity of injected EDA. Study of serum samples from 26 patients received one intramuscular injection of different doses of EDA showed that doses of antitoxin from 20,000 to 30,000 IU resulted in its presence in serum in concentration 0.5-3.0 IU/ml whereas injection of 50,000 IU or 70,000-100,000 IU resulted in serum concentrations 1.25-10.0 IU/ ml and 2.5-20.0 IU/ml respectively.
Relatively low doses of EDA provided relatively high level of protection against diphtheria toxin that should be taken into account during treatment of diphtheria patients.
评估马白喉抗毒素（EDA）不同治疗方案对临床样本以及动物实验的疗效。
对12只兔子和51只豚鼠肌内注射不同剂量的EDA后，研究其异源抗体的保护特性和血清浓度动力学；对26例患者进行肌内注射不同剂量的EDA后采集血清样本进行研究，这些患者接受了不同剂量的单次肌内注射EDA；还对10例不同严重程度的白喉患者的血清样本进行研究，这些患者接受了总量为100,000 - 1,500,000国际单位的EDA治疗。采用被动血凝试验以及对兔子进行詹森毒素中和试验来测定血清样本中的抗毒素浓度。
对实验动物肌内注射150国际单位/千克剂量的EDA显示出高保护效果。例如，注射EDA后24小时血清中抗毒素水平为1.0 - 1.25国际单位/毫升的兔子，与未接受EDA的兔子相比，对白喉毒素的皮肤坏死作用的抵抗力高50 - 250倍。对肌内注射150国际单位/千克剂量EDA后2 - 48小时血清中抗毒素水平为0.5 - 2.0国际单位/毫升的豚鼠，全部受到保护，免受35 - 50半数致死量白喉毒素的影响。停止注射EDA后，抗毒素水平急剧下降，7天后在血清中未检测到。动物血清中抗毒素水平的升高与注射的EDA量不相符。对26例接受单次肌内注射不同剂量EDA的患者的血清样本研究表明，20,000至30,000国际单位的抗毒素剂量导致其在血清中的浓度为0.5 - 3.0国际单位/毫升，而注射50,000国际单位或70,000 - 100,000国际单位则分别导致血清浓度为1.25 - 10.0国际单位/毫升和2.5 - 20.0国际单位/毫升。
相对低剂量的EDA能提供相对高水平的对白喉毒素的保护作用，这在白喉患者治疗过程中应予以考虑。
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