RESUMO
We used liposomal amphotericin B as first-choice treatment of visceral leishmaniasis in 106 immunocompetent children who acquired the infection in a temperate region of southern Europe (Italy) where Leishmania infantum visceral leishmaniasis is endemic. The aim of the study was to identify the minimum total dose of liposomal amphotericin B needed to cure the infection in children and reduce the period of hospitalization. We conclude that the optimal regimen in immunocompetent children with L. infantum visceral leishmaniasis to be a total dose of 18 mg/kg of liposomal amphotericin B (3 mg/kg per day for 5 days, followed by 3 mg/kg administered as an outpatient regimen on day 10).
Assuntos
Anfotericina B/administração & dosagem , Antiprotozoários/administração & dosagem , Leishmaniose Visceral/tratamento farmacológico , Adolescente , Assistência Ambulatorial , Animais , Medula Óssea/parasitologia , Criança , Pré-Escolar , Esquema de Medicação , Portadores de Fármacos , Eletroforese , Doenças Endêmicas , Feminino , Técnica Indireta de Fluorescência para Anticorpo , Seguimentos , Hospitalização , Humanos , Imunocompetência , Lactente , Isoenzimas/análise , Itália , Leishmania infantum/efeitos dos fármacos , Leishmania infantum/enzimologia , Tempo de Internação , Lipossomos , MasculinoRESUMO
We studied the immunogenicity of an acellular pertussis vaccine composed of genetically detoxified pertussis toxin (PT-9K/129G), filamentous haemagglutinin, and a 69-kilodalton protein, pertactin, in 30 children aged 12 to 24 months and in 80 infants aged 2 to 4 months. A significant increase of the neutralizing titer and of the titers against pertussis toxin, filamentous hemagglutinin, and pertactin, as determined by enzyme-linked immunosorbent assay, was achieved after three doses of vaccine in all the children; a significant increase of these antibody titers was obtained in 100%, 96.1%, 93.5%, and 98.7% of the infants, respectively.
Assuntos
Adesinas Bacterianas , Antígenos de Bactérias/imunologia , Proteínas da Membrana Bacteriana Externa/imunologia , Bordetella pertussis/imunologia , Hemaglutininas/imunologia , Toxina Pertussis , Vacina contra Coqueluche/imunologia , Fatores de Virulência de Bordetella/imunologia , Anticorpos Antibacterianos/sangue , Pré-Escolar , Avaliação de Medicamentos , Humanos , Esquemas de Imunização , Imunoglobulina G/sangue , Lactente , Testes de Neutralização , Vacina contra Coqueluche/administração & dosagem , Fatores de Tempo , Vacinas de Produtos Inativados/administração & dosagem , Vacinas de Produtos Inativados/imunologiaRESUMO
To determine whether a nontoxic derivative of pertussis toxin obtained by recombinant DNA technology, PT-9K/129G, is a good candidate for a new pertussis vaccine, we examined the safety and the immunogenicity in children of a vaccine containing 15 micrograms of PT-9K/129G protein and 0.5 mg of aluminum hydroxide per dose. Fifty-three children 12 to 24 months of age and 21 infants aged 2 to 4 months were injected with two and three doses, respectively. The vaccine did not induce significant local or systemic reactions and elicited an increase of antibody titer in more than 98% of the children. The geometric mean of the toxin-neutralizing titers increased after each dose and was 85 units in children given two doses and 196 units in those given three doses. Two children who had detectable antibody levels before the first immunization had a high response (greater than 320 units) to the first vaccine dose. The findings suggest that PT-9K/129G is a promising antigen to be included in the development of acellular pertussis vaccines.