Subcutaneous Injection Route Research Articles

Dendritic Cells Matured With TNF can be Further Activated In Vitro and After Subcutaneous Injection In Vivo Which Converts Their Tolerogenicity Into Immunogenicity

Dendritic cell (DC) maturation can occur by different types of stimuli. Previously, we described that murine DC matured with tumor necrosis factor (TNF) up-regulate surface MHC and costimulatory molecules but lack cytokine release, and therefore termed them semi-mature DC. These TNF/DC-induced tolerance after intravenous (i.v.) injection in a model of experimental autoimmune encephalomyelitis (EAE). Here, we show that TNF/DC are not terminally differentiated but can still respond to the microbial stimulus lipopolysaccharide. Subcutaneously injected TNF/DC induce an unpolarized T(H)1/T(H)2 response and are not protective in the experimental autoimmune encephalomyelitis model. Although TNF/DC home to the draining lymph node, they remain negative for intracellular cytokine stainings. However, the nonmigrating, endogenous DC started to produce interleukin (IL)-12p40, TNF and little IL-6, IL-10, and MCP-1 in a bystander fashion. Together, DC matured with the inflammatory stimulus TNF remains responsive to further signals in vitro and in vivo. These signals can be provided by pathogens or the subcutaneous injection route, which can convert them from tolerogenic to immunogenic DC. These findings are important for selecting the appropriate injection route of human DC for tumor immunotherapy.

Comparative study of hydropericardium hepatitis syndrome vaccine in poultry

Two commercial types of Hydro pericardium Hepatitis Syndrome (HHS) oily inactivated vaccines were evaluated. The first was (Angavac) French in origin (Merial Co.) & the 2nd is (Nobilis Hepatitis) Holland in origin (Intervet Co.). A unified program of vaccination had been used for both vaccines. One & ten days old chicks were vaccinated by subcutaneous & intramuscular route of injection with both vaccines in each age separately . Serum antibodies titer weekly measured by using Indirect haemagglutination test (IHA) & agar gel diffusion test. Challenge test at 4 week of age was done by virulent avian adeno virus serotype – 4 (VAAV-4) as well as virulent field isolate was used as challenge virus. The result showed highest antibodies titer at week age. Angavac vaccine gave highest titer than Nobilis Hepatitis vaccine & IHA was more sensitive than AGDT. All groups vaccinated with Angavac gave 100% protection in challenge test with (VAAV-4) at 28 days. While in Holland vaccine the protection ratio was 60-80% only, but the ratio of protection of both vaccines did not exceed than 40-50% when the field isolate was used as challenge virus.

In vivo uptake of an experimental microencapsulated diphtheria vaccine following sub-cutaneous immunisation

Previous studies demonstrated in vitro phagocytosis of poly(lactide-co-glycolide) (PLGA) microspheres (MS) by macrophages and dendritic cells and the biodistribution of fluorescent PLGA particles following oral or intranasal administration. In this study, we report the uptake and biodistribution of sub-cutaneously administered fluorescent labelled PLGA MS loaded with diphtheria toxoid (DT). The cell type and percentage of fluorescent positive cells were determined by flow cytometry and confirmed by fluorescent microscopy. Fluorescent particles were detected inside cells of the peritoneal flush as early as 10 min post-inoculation, predominantly in cells of macrophage morphology. In vivo trafficking of PLGA particles following a sub-cutaneous immunisation of mice appeared to be governed by macrophages. However, in the first week after inoculation, dendritic cells played a significant role in the uptake and digestion of the microspheres, thereby triggering the immune response against the antigen. Fluorescent PLGA MS were also observed in cells of lymphoid tissues such as mesenteric lymph nodes (MLN) and spleen (S). However, microsphere fluorescence in lymphoid tissues decreased rapidly, as they were degraded inside the cells, thereby enabling the presentation of the antigen to specific cells of the immune system. To our knowledge, this is the first time the fate of immunogenic PLGA microspheres was studied in vivo following a sub-cutaneous injection route.

A systematic review of the relation between interleukin-2 schedule and outcome in patients with metastatic renal cell cancer

In Europe, interleukin 2 (IL-2) is one of the two treatment modalities officially approved for patients with metastatic renal cell cancer. Traditionally, IL-2 has been administered by three different routes: intermittent bolus injection (BIV), continuous intravenous infusion (CIV) and subcutaneous injection (SC). There have been few randomized trials designed to compare these routes of administration. This paper describes a systematic review of the literature in which an attempt has been made to determine which schedule of administration is superior. Heterogeneity of the data makes firm conclusions difficult. It appears that the number of complete remissions (CR) is similar between BIV and SC routes and that these are higher than for CIV schedules. The durability of the CRs induced by BIV appeared superior to those induced by SC IL-2 and definitely higher than with CIV protocols. This analysis highlights some of the difficulties of using evidence-based medicine to determine standard of care when the clinical-trial data are heterogeneous. These data emphasize the importance of randomized clinical trials in determining what should be regarded as optimum therapy.

Studies Comparing Low Molecular Weight Heparin with Heparin for the Treatment of Thromboembolism: A Literature Review

The use of heparin for the prophylaxis and treatment of venous and arterial thrombosis had been the standard of care for clinicians until 1982. At that time the introduction of depolymerized heparin for the prophylaxis of deep vein thrombosis in surgical patients was introduced. A number of such products, low molecular weight heparins (LMWH) were patented and introduced as new drugs during the ensuing of 20 years. Each LMWH had to be given a clinical trial against standard heparin for the several thromboembolic disorders for which heparin was the standard of care. By definition LMWH had to have unequal factor Xa and IIa inhibitor potency, expressed as a Xa-IIa ratio of greater than 1. They also had a molecular weight reduction to about one third that of heparin. A major advantage of LMWH over heparin was the subcutaneous route of injection for treatment of thrombotic disorders in contrast to the intravenous route for heparin. They had greater bioavailability than heparin by the subcutaneous route, a longer half-life and better predictability of dose response. It was found that routine laboratory monitoring was unnecessary. When given a trial against heparin, LMWH was equally safe and effective for most venous and arterial disorders. A new synthetic version of (pentasaccharide) both heparin and LMWH has been at least if not more effective than one LMWH (enoxaparin).

A preliminary experiment of absorption of antinuclear antibodies by the hepatitis B vaccine components, in a case of neurolupus

The aim of this work is to propose a method to search for a possible antigenic community between hepatitis B vaccine components and some auto-antibodies produced in rare patients with an autoimmune disease discovered few weeks or months after a hepatitis B vaccine injection. A 12-year-old girl showed symptoms of tranverse myelitis 2 months after a hepatitis B vaccine booster injection. Later, high titers of antinuclear antibodies were found and a diagnosis of neurolupus was established. One serum was then mixed with various concentrations of hepatitis B vaccine. The antinuclear antibodies were totally absorbed at the highest concentration of vaccine, but not by the lowest. Anti-HBs specific antibodies were absorbed by all concentrations of vaccine. The results of this single preliminary experiment (which as to be repeated for other patients, and with large control studies) cannot establish a cross relationship. But it seems that this approach requires to be explored with some improvements. It could also incite us to use lower dosages of HBs antigen in the vaccine and to use the subcutaneous route of injection (to get lower titers of antibodies and to allow a slower diffusion of the antigen).

Radiolabeling, stability, and body distribution in rats, of low molecular weight polylactide homopolymer and polylactide–polyethyleneglycol copolymer

In order to study its fate in vivo, a low molecular-weight polylactide homopolymer was derivatized with a p-methoxyphenyl moiety, so as to make it susceptible to radiolabeling with 125 I . A low molecular weight polylactide–polyethyleneglycol copolymer capped with a p-methoxyphenyl residue was also synthesized. The derivatized polymers were successfully [ 125 I ]iodinated in organic medium. The radiolabeled products were freed from [ 125 I ]iodide by dialysis and shown to be stable for 24 h on incubation at 37°C in buffered saline or in blood. On longer incubation at 37°C in buffered saline the radiolabeled polylactide released [ 125 I ]iodide and [ 125 I ]iodinated 3-( p-methoxyphenyl)propionic acid. The radiolabeled copolymer was more stable on incubation at 37°C in buffered saline, but some [ 125 I ]iodide was released. The tissue distribution of radioactivity was determined 5 min, 1, 5 and 24 h after injecting male rats with 125 I -labeled homopolymer or copolymer. Intravenous, intraperitoneal and subcutaneous injection routes were employed. Further rats were injected with [ 125 I ]iodide, to aid interpretation of the data. After administration of labeled homopolymer, a high concentration of radioactivity was found in the liver tissue. The levels slowly decreased over 24 h, and the polymer was successively found in the small and large intestine and the faeces. This is probably indicative of excretion via the bile. Concurrently radioactivity was excreted in the urine. After administration of labeled copolymer, a high concentration of radioactivity was found in the liver and the residual soft tissue, the latter fraction containing two-thirds of the radioactivity one hour after injection. The precise tissue location that this result indicates was not identified. After 1 h radioactivity was excreted in the faeces, again probably via the bile, and in the urine. Tissue distributions after intraperitoneal or subcutaneous injections were concordant with the above results and interpretations, with the additional factor of slow clearance from the injection site.

In Vivo distribution and behavior of paramagnetic dinitrosyl dithiolato iron complex in the abdomen of mouse

It has been shown that a dinitrosyl dithiolato iron complex is formed under physiological conditions and that it functions as an NO transporter. In the present study, a diglutathionyl dinitrosyl iron complex [DNIC-(GS)2] was injected into mice and its abdominal distribution and behavior were examined by using electron paramagnetic resonance (EPR) spectroscopy. The X-band EPR signal intensity of the blood, liver, kidney, and spleen decreased with time but signals from the liver and kidney were readily detectable even 24h after the injection. The time courses of signal intensity were quite similar when the agent was administered via intravenous and subcutaneous injection routes, suggesting that DNIC-(GS)2 can penetrate readily and rapidly through the membranes. Real-time detection of DNIC-(GS)2 in the upper abdomen of the living mice was performed by employing an in vivo EPR spectroscopy. These results suggest that DNIC-(GS)2, an endogenous NO carrier, has an excellent membrane permeability and has a relatively high affinity for the liver and kidney.

Uterotrophic activity of bisphenol A in the immature rat.

Bisphenol A (BPA) is active in immature AP rat uterotrophic assays when evaluated using either the oral or the subcutaneous (sc) injection routes of exposure (three daily administrations of 400-800 mg/kg BPA). Premature vaginal opening was seen for 8 of 14 animals exposed to 600 and 800 mg/kg BPA by sc injection. Vaginal opening was not produced by BPA in the gavage studies. These results are consistent with those of Dodds and Lawson [Nature 137:96 (1936)] who found that BPA induces persistent vaginal cornification in ovariectomized rats exposed to three twice-daily injections of 85 mg/kg BPA (total daily dose 170 mg/kg), but they conflict with the reported inactivity of BPA in the immature mouse uterotrophic assay. The uterotrophic activity of diethylstilbestrol in the rat is also established (0.04 mg/kg/day for three days).

Uterotrophic Activity of Bisphenol A in the Immature Rat

Bisphenol A (BPA) is active in immature AP rat uterotrophic assays when evaluated using either the oral or the subcutaneous (sc) injection routes of exposure (three daily administrations of 400-800 mg/kg BPA). Premature vaginal opening was seen for 8 of 14 animals exposed to 600 and 800 mg/kg BPA by sc injection. Vaginal opening was not produced by BPA in the gavage studies. These results are consistent with those of Dodds and Lawson [Nature 137:96 (1936)] who found that BPA induces persistent vaginal cornification in ovariectomized rats exposed to three twice-daily injections of 85 mg/kg BPA (total daily dose 170 mg/kg), but they conflict with the reported inactivity of BPA in the immature mouse uterotrophic assay. The uterotrophic activity of diethylstilbestrol in the rat is also established (0.04 mg/kg/day for three days).

Iatrogenic outbreak of M. chelonae skin abscesses.

We describe an outbreak of skin lesions due to Mycobacterium chelonae subsp. abscessus associated with injections of lidocaine (lignocaine) given by a 'bioenergetic' (a practitioner of alternative medicine) in Colombia. The lidocaine carpules and the lesions of the patients yielded mycobacteria with identical biochemical characteristics. Using the methodology of Sartwell and a case control design we examined the incubation period and assessed risk factors. Of 667 potentially exposed individuals, a total of 298 patients were interviewed, of whom 232 had skin lesions. The median incubation period was 30.5 days (range 15-59 days). Male sex (OR 2.85, 95% CI 1.26-6.51), increasing age (OR 1.25, 95% CI 1.03-1.53), subcutaneous injection route (OR 3.72, 95% CI 1.09-12.7) and number of injections (OR 1.01, 95% CI 1.00-1.03) were risk factors for disease. To our knowledge, this is the largest reported outbreak of M. chelonae infection, the first in which the organism has been isolated from the putative vehicle of infection, and the first in which the incubation period could be determined.

Human live anthrax vaccine in the former USSR

The history of the development and use of the Soviet live spore human anthrax vaccine is described. Results of mass field trials on this vaccine following administration by scarification, by subcutaneous injection route or by aerosol exposure are presented. For the immunological assessment of these vaccinations a skin test with an original product ‘Anthraxin’ was used.

A spontaneous subcutaneous tumor in C57BL/6 mice that metastasizes to the liver

A malignant tumor that arose spontaneously in the subcutaneous tissue of the back of a C57BL/6 female mouse was found to metastasize spontaneously to the liver. The primary and metastatic tumors, SML (spontaneous metastasis to the liver) 1 and SML 2, were established in vitro in long-term cell suspension culture and were passaged 10 times in vivo for 18 months. When 100,000 cells were injected subcutaneously in the orthotopic position, tumor growth appeared in 60% of the SML 1 mice and 100% of the SML 2 mice. SML 1 did not grow when injected in the footpad, while SML 2 did. The median survival was 47 days for SML 1 and 48.5 days for SML 2 (P = 0.013). The pattern of metastasis was similar for both tumor cell lines, irrespective of intravenous or subcutaneous injection routes. Spontaneous metastasis of the SML 2 line occurred from both the orthotopic and heterotopic sites, while the SML 1 metastasized spontaneously from the orthotopic site only. Liver metastasis appeared in > 90% of the mice for both SML 1 and SML 2. Metastasis to the spleen occurred in about half the mice. Other sites of metastasis were the ovaries (36% and 52%, respectively, for SML 1 and SML 2), the kidneys (approximately 15%) and the small bowel (very rarely). Metastasis to the lungs did not occur except very rarely in the later passages of the SML 2 line. Histologic, immunohistochemical and electron microscopic studies showed a histiocytic tumor with macrophage characteristics. The cells exhibited chemotaxis toward liver extracellular matrix and reduced motility toward collagen IV, laminin and fibronectin compared to the B16-F10 melanoma line. This spontaneously occurring tumor should prove useful for the study of organ-specific metastasis to the liver.

Subcutaneous injection of factor IX for the treatment of haemophilia B.

Haemophilia B patients are normally treated, either prophylactically or in response to bleeding episodes, by frequent intravenous injections of factor IX purified from blood donors. Here we show in model animal experiments that purified human factor IX, when injected subcutaneously, is rapidly (in 3-11 h) and reasonably efficiently (30-40% of an equivalent intravenous dose) transported at least partly by the lymphatic drainage of the skin into the bloodstream, mostly in a biologically active form. This suggests that patients could be treated prophylactically by subcutaneous rather than intravenous injection, where the short delay in raising plasma factor IX to haemostatic levels would be clinically acceptable. More generally, our studies emphasize that the subcutaneous route of injection should be useful for other therapeutic proteins, including other clotting factors, which have to be delivered to the bloodstream, as long as their half-life is at least a few hours allowing time for transport into the general circulation.

Immune response to rabies vaccine in Thai dogs: A preliminary report

Serum neutralizing antibody to rabies virus was determined in previously unvaccinated Thai pet dogs after receiving one subcutaneous dose of inactivated tissue culture rabies vaccine (Rabdomun, Coopers Animal Health Company, Germany, 4.55 IU ml −1 potency). Geometric mean titres on days 14, 30, 60, 180 and 360 were 2.14, 2.30, 0.45, 0.14 and 0.05 IU ml −1, respectively, by the rapid immunofluorescent focus inhibition test. Titres of neutralizing antibody to rabies virus did not correlate with the age of the dog at the time of vaccination or with the presence or absence of anaemia or blood parasites. Six out of 50 (12%), 11 out of 43 (25.6%) and 13 out of 31 (42%) dogs had not detectable rabies antibody in serum 60, 180 and 360 days, respectively, after vaccination. Three of these antibody-negative dogs were given another dose of vaccine. Antibody reappeared on day 14 but rapidly declined within 60 days. These data suggest that one dose of tissue culture vaccine in dogs by the subcutaneous route of injection is not adequte to maintain rabies neutralizing antibody in serum for 1 year.

Bacterial Ribosomal Immunostimulants Prime Alveolar Macrophages in Vivo to Produce Interleukin 1 in Vitro

Alveolar macrophages (AMs) may play a key role in human respiratory immune defenses, partially by synthesizing and releasing interleukin 1 (IL = 1). D53 (Ribomunyl), a composite bacterial ribosomal immunostimulant, has been recognized as an efficient prevention of respiratory tract infections. In vitro, D53 enhances the IL-1 production by mouse spleen adherent cells. A thymocyte proliferative response assay was used to evaluate the in vitro IL-1 production by AMs in healthy subjects who received D53 immunostimulant. Twelve nonsmoking healthy subjects took part in a prospective double-blind placebo control study. On day 1, a first bronchoalveolar lavage (BAL) was performed to assess IL-1 production by unstimulated and lipopolysaccharide (LPS) stimulated AM. Then, subjects were randomized to receive D53 (n = 6) or its placebo (n = 6) by both oral and subcutaneous injection routes from day 1 to day 15. On day 15, a second BAL was done and AM IL-1 production was again tested. IL-1 production on day 15 did not significantly differ from day 1 in both D53-treated and placebo groups either when AMs were unstimulated or were stimulated with concentrations of LPS resulting in maximal IL-1 production. However, in the D53-treated group, but not in the placebo group, IL-1 production induced by low LPS concentration (5 mg/L) was significantly higher (mean +/- SEM: 1,238 +/- 287 U/10(6) AM) on day 15 in comparison with day 1 (577 +/- 113 U/10(6) AM; p less than 0.05, Wilcoxon W test) and in comparison with the control group (day 15 IL-1 production induced by 5 mg/L LPS, 758 +/- 175 U/10(6) AM; p less than 0.05, Mann-Whitney U test). Moreover, in the D53-treated group, the optimal LPS concentration (ie, LPS concentration that induced maximal IL-1 production) was significantly lower on day 15 (mean +/- SD: 11 +/- 7 mg/L) than on day 1 (16 +/- 7 mg/L; p less than 0.05 Wilcoxon W test). We conclude that D53 immunostimulant in vivo primes AM to produce IL-1 following low LPS concentration stimulation. This may partially explain the protective effect of D53 immunostimulant against respiratory tract infection.

Human neuroblastoma cell growth in xenogeneic hosts: comparison of T cell-deficient and NK-deficient hosts, and subcutaneous or intravenous injection routes

We have examined two features of neuroblastoma cells that had not been well-characterized in a xenogeneic model: The cells display unusual immunologic properties in other experimental systems, and the original tumors display widespread and characteristic patterns of metastasis. To determine the most appropriate immunodeficient host for primary tumor growth, T cell-deficient nude mice, NK-deficient beige mice, beige-nudes, and controls were injected with the well-characterized line CHP-100. To define the pattern of tumor spread, complete autopsies were performed following subcutaneous, intraperitoneal and intravenous injections. CHP-100 consistently formed subcutaneous tumors in T cell-deficient mice (nude and beige-nude), but not in T cell-competent mice (beige, heterozygous nu/+ and bg/+, or wild-type). The growth rate and final size of the subcutaneous tumors were not greater in beige-nudes than in nudes. All mice showed early CHP-100 cell death after subcutaneous injection; the nature of the immunodeficiency was more relevant for the surviving subpopulation. Widespread dissemination was seen following intravenous injection, particularly in beige-nudes. Aspects of the growth patterns were appropriate to the tumor of origin. The behavior in immunodeficient mice suggests that T cells can play a role in controlling the growth of these cells; the next steps will be to define the effector mechanisms, and to determine if they can be exploited for human patients. The hematogenous spread following intravenous injection suggests that insights into the control of blood-borne tumor may also come from further study of this model.

Anti-herpes simplex virus activity of 5-substituted 2-pyrimidinone nucleosides

Several 5-substituted 2-pyrimidinone 2'-deoxyribonucleoside (PdR) analogs were examined for their anti-herpes simplex virus (HSV) activity in cell culture. The order of potency of their antiviral activities against HSV type 1 (HSV-1) and HSV-2 was iodo PdR approximately ethynyl PdR approximately propynyl PdR. The antiviral action of iodo PdR is dependent on the ability of HSV to induce virus-specified thymidine kinase in infected cells. Several HSV-1 variants with altered thymidine kinase changed their sensitivity to iodo PdR, whereas HSV-1 variants with altered DNA polymerase were as sensitive as the parental virus to iodo PdR. Continuous presence of iodo PdR for more than one virus replication cycle was required for optimal antiviral activity. Iodo PdR (100 microM) had no activity against Epstein-Barr virus DNA replication in P3HR-1 cells. With an oral, an intraperitoneal, or a subcutaneous route of injection, iodo PdR administered twice a day for 2.5 days could prevent the death of mice infected with HSV-2. This in vivo activity is unlikely to be related to the potential conversion of iodo PdR to iododeoxyuridine, since iodo PdR is not a substrate of xanthine oxidase.

Experience with preexposure rabies vaccination.

Preexposure rabies vaccination, presently limited to high-risk target populations, is facilitated by cell culture vaccines. Officially recommended programs comprise either two doses administered on days 0 and 28 or three doses given on days 0, 7, and 21 or 28. A first booster 1 year later ensures a good duration of immunity; follow-up studies now cover 5-8 years. These results were obtained by the intramuscular and subcutaneous injection routes; intradermal programs have been explored with the aim of reducing costs. Preexposure immunization is well tolerated, despite some systemic allergic reactions. Efficacy has been observed universally, but certain factors may affect results. Several lines of evidence favor an extension of preexposure vaccination. In Scandinavian countries, the majority of vaccine doses are used preexposure, while about 40%, 15%, and 10% are so used in the United Kingdom, the United States, and France, respectively. However, preventive immunization is rare in developing countries, where the risk of infection is maximal and permanent. The more economical new vaccines, such as purified Vero rabies vaccine, permit a reevaluation of preventive vaccination. Vaccine combinations including rabies may prove economical.

Allergenicity of Concanavalin A in Mice

Concanavalin A (Con A) is a potent allergen in certain strains of mice and in particularly the H-2Kk mice, A/J, CBA/H, and C3H/He. Using a dose of 100 microgram, the subcutaneous route of injection was the most effective means of inducing high, persistent titers of T cell-dependent circulating anti-Con A reagins without the addition of the classical IgE adjuvants, aluminium hydroxide and Bordetella pertussis vaccine. Haptenated Con A induced reagins with antihapten specificity. In the discussion, one possible contributing factor in Con A allergenicity in genetically responder strains of mice is emphasised, namely, persistence in subcutaneous injection sites.