Raettig H
Zentralbl Bakteriol Orig A. 1979;245(3):287-300.
The infectious diseases of the human intestinal tract which are caused by bacteria must be distinguished into two groups on account of their different pathogenesis: the cyclic infections (typhoid fever, parathyphoid fever) and the local infections (cholera, dysentery, Salmonella enteritis, dyspepsia coli infections). The local infections of the intestine do not cause a systemic but only a local immunity of the intestinal mucosa. It is necessary therefore to induce local immunity as active immunoprophylaxis by orally administering inactivated antigens. The twelve-fold enteritis vaccine consists of full antigens of 6 Salmonella strains, 2 Shigella strains, and 4 enteropathogenic coli strains pretreated by heat-inactivation (3 min/100 degrees C). The following should be considered as indication to effect active immunoprophylaxis against enteritis: Travelling into tropical and subtropical countries, people in emergency areas, children in developing countries, workers in food industries, secondary hospital infections, and carriers. The active mouse protection test revealed that oral immunization with enterobacteriaceae does not only deliver the well-known specific effect but also a non-specific effect which included the protection against other related enterobacteriaceae. Moreover, the specific component of the combined vaccine is enhanced by heterologous components. The resulting synergism or the adjuvantal effect, respectively, allows to employ a relatively limited number of germs which are selected on the basis of high pathogenicity, good immunogenicity, and great frequency. The first field trial with the twelve-fold vaccine was completed successfully: Following an infection with Salmonella which affected the employees of a fowl slaughtery, eight different species could be demonstrated; the above described polyvalent vaccine was orally administered and proved to be successful. The latter case clearly demonstrates the fast-acting effect of the vaccine on account of the heterologous bacterial antigens contained therein. 51 out of 60 Salmonella carriers excreted germs of a different antigen pattern not contained in the vaccine. However, the good results obtained showed that the species chosen for the vaccine were still sufficiently effective to cover the wide spectrum of other species of related enterobacteriaceae.
由细菌引起的人类肠道传染病,因其发病机制不同,必须分为两组:周期性感染(伤寒、副伤寒)和局部感染(霍乱、痢疾、沙门氏菌肠炎、大肠消化不良菌感染)。肠道局部感染不会引起全身免疫,只会引起肠黏膜的局部免疫。因此,有必要通过口服灭活抗原来诱导局部免疫作为主动免疫预防措施。十二价肠炎疫苗由6种沙门氏菌菌株、2种志贺氏菌菌株和4种肠道致病性大肠杆菌菌株经热灭活(3分钟/100摄氏度)处理后的全抗原组成。以下情况应被视为进行针对肠炎的主动免疫预防的指征:前往热带和亚热带国家旅行、紧急地区的人群、发展中国家的儿童、食品行业的工人、医院继发性感染以及带菌者。主动小鼠保护试验表明,用肠杆菌科进行口服免疫不仅能产生众所周知的特异性效果,还能产生非特异性效果,包括对其他相关肠杆菌科的保护作用。此外,联合疫苗的特异性成分会因异源成分而增强。由此产生的协同作用或佐剂效应,使得可以使用相对有限数量的病菌,这些病菌是根据高致病性、良好的免疫原性和高出现频率来选择的。十二价疫苗的首次现场试验成功完成:在一家家禽屠宰场的员工感染沙门氏菌后,检测出了8种不同的菌株;口服了上述多价疫苗,证明是成功的。后一个案例清楚地证明了疫苗因其所含的异源细菌抗原而具有快速起效的作用。60名沙门氏菌携带者中有51人排出了疫苗中未包含的具有不同抗原模式的病菌。然而,所取得的良好结果表明,为疫苗所选的菌株仍然足够有效,能够涵盖其他相关肠杆菌科的广泛种类。