Reactions after booster injections of human diploid cell rabies vaccine (HDCV) were investigated to determine the possibility of IgE-type antibody involvement. Although normal manufacture of HDCV involves the inactivation of the virus with β-propiolactone (BPL), the effect of BPL on nonviral vaccine components, such as host cell components or stabilizing proteins, may be typical of the haptenic action of small molecular weight chemicals. Specific IgE to commercial HDCV preparations, BPL-treated preparations of noninfected host MRC5 cell sonicate (BPL-MRC5), and a human albumin (HA) (BPL-HA) used as a stabilizing agent were detected in sera from five individuals who reported reactions after booster doses of HDCV. However, these patients had no detectable IgE to normal HA. Sera from nonvaccinated individuals, vaccinated individuals who reported no reaction after HDCV booster, and pollen-allergic individuals had no detectable IgE to HDCV, BPL-MRC5, or BPL-HA. Changes in the ratios of pre- to postbooster serum levels of specific IgE to HDCV and BPL-HA were significantly different in a group of 19 individuals who reported reactions to HDCV boosters; these changes in pre- to postbooster IgE levels in nonreactive vaccinees were not significant. Prebooster serum IgE RAST ratios to HDCV or BPL-HA were not predictive of potential reactions to HDCV. A number of experimental BPL-HA reaction mixtures were assayed to examine the effect of variable concentrations of BPL to HA. Increasing relative molar concentrations of BPL to HA resulted in increased electrophoretic mobility, whereas the highest relative specific IgE binding was detected in BPL-HA molar reaction mixtures of approximately 12.5:1. Specific IgE to nonviral HDCV components appears to be related to reactions after booster doses of BPL-inactivated HDCV.

https://www.jacionline.org/article/S0091-6749(87)80278-6/pdf

The role of specific IgE and beta-propiolactone in reactions resulting from booster doses of human diploid cell rabies vaccine.

Serum sickness. II. Demonstration and characteristics of antibodies.

Tetanus immune globulin (human) in prophylaxis against tetanus

Thiazides and cerebral ischaemia.

Prevention of tetanus by antitoxin of bovine origin

Administration of bovine tetanus antitoxin to a patient who was sensitive to horse serum was followed by serum disease. Immunological studies revealed a preexisting hemagglutinating antibody titer of 2,000 against horse serum, but none to bovine serum. After the onset of symptoms, both titers rose. The reaction against bovine serum reached a titer of 100,000. A transitory skin-sensitizing antibody against bovine serum was also produced. An alpha globulin component of bovine serum was found to be the precipitating antigen. Thus, this patient probably reacted to a serum fraction other than the active antitoxin. The results suggest an antigenic cross relationship between horse and beef sera, limiting the usefulness of bovine antitoxin. Greater use of toxoid could help eliminate the problem of serum reactions. Certainly, horse-serum sensitivity should make active immunization mandatory.

Immunologic studies of serum sickness from bovine antitetanus toxin.

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Immunologic studies of serum sickness from bovine antitetanus toxin.