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A New Diphtheria Prophylactic

Nature volume 135, page 299 (23 February 1935) | Download Citation



OWING to the prevalence of diphtheria during the last year, a considerable demand has followed for immunising agents for preventive, inoculation, which is now extensively practised with good results. Various agents have been employed for this purpose, such as toxin-antitoxin mixtures and preparations of modified diphtheria toxin known as ‘toxoid’. An alum-precipitated toxoid (A.P.T.) of high immunising efficiency is now available, and is issued by Messrs. Burroughs Wellcome and Co., in germ-proof containers of 1 c.c. and 5 c.c. This substance was first prepared in the Wellcome Physiological Research Laboratories in 1926. The results of animal tests showed that it possessed considerable immunising power against diphtheritic infection, and since that date its high immunising efficiency in human beings has been established. Caution has been exercised in applying the inoculation of A.P.T. in human beings on account of the production of a tissue response at the site of injection. This, though medically trivial, may disturb parents of inoculated children. The efficiency of A.P.T. probably depends upon the deposition of the relatively insoluble aluminium-toxoid compound at the site of injection, and from this the immunising toxoid is gradually liberated. The complex toxoid compound, however, excites a tissue response in the form of a small painless nodule, and this tissue response is probably an essential factor in the potent immunisation that ensues. Unpublished experiments made in the Wellcome Research Laboratories have shown that in animals two spaced injections of one tenth, or less, of the ordinary human dose results in a more rapid, or a higher, immunity than one single larger dose. It is possible that a similar method may prove useful in human immunisation, the chance of troublesome local reaction being lessened by this course.

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