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Botulism and vaccines for its prevention

机译：肉毒中毒及其预防疫苗

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Botulism is a severe neuroparalytic disease caused by toxins produced by several Clostridium species. Botulinum toxin has been of concern to the US military and its allies as a biowarfare weapon since World War II and, in more recent times, by the Centers for Disease Control and Prevention (CDC) as a potential bioterrorist threat to the public. The most effective means of defending against the toxin is by inducing a protective immune response through vaccination. Vaccination with an appropriate antigen will produce neutralizing antibodies that will bind to and clear toxin from the circulation before it can enter nerve cells and block neurotransmission. Immunity from botulism, however, has the disadvantage of precluding an individual from realizing the potential benefits of therapeutic botulinum toxin, if such a need were to arise. Botulinum toxin has been used in the treatment of numerous neuromuscular, autonomic, and sensory disorders since it was first approved for the management of strabismus and blepharospasm by the Food and Drug Administration (FDA) in 1989. Notwithstanding the value of the neurotoxin as a therapeutic drug, vaccines have been and will continue to be an important line of defense for those who work with the toxin (at-risk workers) and a select population of the military, law enforcement, and first responders. The first vaccine used to protect against botulinum neurotoxin was a chemically detoxified extract from Clostridium botulinum. A Pentavalent botulinum toxoid (PBT) vaccine in service today is administered under an Investigational New Drug (IND) application held by the CDC. Recombinant subunit vaccines are in development and a bivalent Hc vaccine (rBV A/B (Pichia pastoris)) is presently being evaluated in a phase II clinical trial. This review focuses on botulism and the development of vaccines for its prevention.
机译：肉毒杆菌中毒是一种严重的神经麻痹性疾病，由几种梭菌产生的毒素引起。自第二次世界大战以来，肉毒杆菌毒素一直是美军及其盟友关注的生物战武器，而最近，疾病控制与预防中心（CDC）也将其视为对公众的潜在生物恐怖威胁。防御毒素的最有效方法是通过疫苗接种诱导保护性免疫应答。接种适当的抗原会产生中和抗体，该抗体会结合并清除循环中的毒素，然后才能进入神经细胞并阻止神经传递。但是，如果需要，则肉毒中毒的免疫力有一个缺点，就是使个人无法意识到治疗性肉毒杆菌毒素的潜在益处。自1989年美国食品药品监督管理局（FDA）批准肉毒杆菌毒素首次用于斜视和眼睑痉挛的治疗以来，它已被用于治疗多种神经肌肉，自主神经和感觉障碍。尽管这种神经毒素具有治疗价值。对于使用毒素的人（处于危险中的工人）以及一定数量的军人，执法人员和急救人员，疫苗，疫苗一直是并将继续成为重要的防线。用于预防肉毒杆菌神经毒素的第一种疫苗是肉毒梭菌的化学解毒提取物。今天正在服役的五价肉毒杆菌毒素（PBT）疫苗是由CDC持有的研究性新药（IND）申请进行管理的。重组亚单位疫苗正在开发中，目前正在II期临床试验中评估一种二价Hc疫苗（rBVA / B（巴斯德毕赤酵母））。这篇综述着重于肉毒中毒和预防其的疫苗开发。

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