Grandière Pérez Lucia, Brisse Sylvain
Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Le Mans, Le Mans, France.
Université d'Angers, Angers, France.
Mem Inst Oswaldo Cruz. 2025 Jan 20;120:e240214. doi: 10.1590/0074-02760240214. eCollection 2025.
Diphtheria, a severe respiratory infection, was a major killer of children until the early years of the 20th century. Although diphtheria is now largely controlled globally thanks to vaccination, it is still endemic in some world regions and large epidemics can occur where vaccination coverage is insufficient. The pathological effects caused by its main virulence factor, diphtheria toxin, can be diminished by passive transfer of antibodies. Equine diphtheria antitoxin (eDAT), the cornerstone of treatment against toxinic complications of diphtheria, was invented more than 130 years ago, in 1890, and is still in use today. A method to concentrate anti-diphtheria antibodies from hyperimmune equine serum was described in the first issue of Memórias do Instituto Oswaldo Cruz in 1909. On this historic occasion, we present recent knowledge on taxonomic, epidemiological and clinical aspects of diphtheria agents that produce diphtheria toxin, and provide a historical perspective on eDAT treatment, adverse effects, threats on its scarce international supply, and current avenues for alternative therapeutic strategies.
白喉是一种严重的呼吸道感染疾病，在20世纪初之前一直是儿童的主要杀手。尽管由于接种疫苗，白喉目前在全球范围内已基本得到控制，但在世界一些地区仍呈地方性流行，在疫苗接种覆盖率不足的地方可能会发生大规模疫情。其主要毒力因子白喉毒素所引起的病理效应可通过抗体的被动转移而减轻。马源白喉抗毒素（eDAT）是治疗白喉毒素并发症的基石，于130多年前的1890年发明，至今仍在使用。1909年，《奥斯瓦尔多·克鲁兹研究所纪要》第一期描述了一种从超免疫马血清中浓缩抗白喉抗体的方法。在这个具有历史意义的时刻，我们介绍了关于产生白喉毒素的白喉病原体的分类学、流行病学和临床方面的最新知识，并对白喉抗毒素治疗、不良反应、其稀缺的国际供应面临的威胁以及替代治疗策略的当前途径提供了历史视角。
