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Human Vaccines & Immunotherapeutics content • February 2014<br />

Toward a mechanism-based<br />

in vitro safety test for pertussis toxin<br />

Stefan FC Vaessena, Martijn WP Bruystersb, Rob J Vandebrielb*,<br />

Saertje Verkoeijena, Rogier Bosc, Cyrille AM Krula & Arnoud M Akkermansb<br />

Research Centre Technology & innovation<br />

innovative testing in Life sciences and Chemistry<br />

University of Applied Sciences; Utrecht, the Netherlands<br />

Center for Health Protection<br />

National institute for Public Health and the environment<br />

Bilthoven, the Netherlands<br />

Central Committee on Research involving Human Subjects<br />

Den Haag, the Netherlands<br />

Abstract<br />

Pertussis vaccines are routinely administered to infants to protect them from whooping<br />

cough. Still, an adequate safety test for pertussis toxin (PT), one of the main antigens<br />

in these vaccines, is not available. The histamine sensitization test is currently the only<br />

assay accepted by regulatory authorities to test for the absence of active PT in vaccines.<br />

This is however, a lethal animal test with poor reproducibility. In addition, it is not clear<br />

whether the assumed underlying mechanism, i.e., ADP-ribosylation of G proteins, is the<br />

only effect that should be considered in safety evaluation of PT. The in vitro safety test<br />

for PT that we developed is based on the clinical effects of PT in humans. For this, human<br />

cell lines were chosen based on the cell types involved in the clinical effects of PT. These<br />

cell lines were exposed to PT and analyzed by microarray. In this review, we discuss the<br />

clinical effects of PT and the mechanisms that underlie them. The approach taken may<br />

provide as an example for other situations in which an in vitro assay based on clinical<br />

effects in humans is required.<br />

From the full report:<br />

“Taken together, the main clinical effects<br />

in humans where Pertussis Toxin is involved are<br />

increased insulin secretion with resulting<br />

hypoglycemia, leukocytosis, lung edema and<br />

inflammatory responses, together resulting in<br />

pulmonary hypertension and pneumonia.<br />

Moreover, PT can induce systemic hypotension,<br />

and is possibly involved in inducing<br />

neurological problems.”<br />

Full Report<br />

http://www.tandfonline.com/doi/pdf/10.4161/hv.28001

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