Nanoparticle-Based Vaccines for Brucellosis: Calcium Phosphate Nanoparticles-Adsorbed Antigens Induce Cross Protective Response in Mice.

INTRODUCTION: Vaccine formulation with appropriate adjuvants is an attractive approach to develop protective immunity against pathogens. Calcium phosphate nanoparticles (CaPNs) are considered as ideal adjuvants and delivery systems because of their great potential for enhancing immune responses. In the current study, we have designed nanoparticle-based vaccine candidates to induce immune responses and protection against B. melitensis and B. abortus. MATERIALS AND METHODS: For this purpose, we used three Brucella antigens (FliC, 7α-HSDH, BhuA) and two multi-epitopes (poly B and poly T) absorbed by CaPNs. The efficacy of each formulation was evaluated by measuring humoral, cellular and protective responses in immunized mice. RESULTS: The CaPNs showed an average size of about 90 nm with spherical shape and smooth surface. The CaPNs-adsorbed proteins displayed significant increase in cellular and humoral immune responses compared to the control groups. In addition, our results showed increased ratio of specific IgG2a (associated with Th1) to specific IgG1 (associated with Th2). Also, immunized mice with different vaccine candidate formulations were protected against B. melitensis 16M and B. abortus 544, and showed same levels of protection as commercial vaccines (B. melitensis Rev.1 and B. abortus RB51) except for BhuA-CaPNs. DISCUSSION: Our data support the hypothesis that these antigens absorbed with CaPNs could be effective vaccine candidates against B. melitensis and B. abortus.

A comparison between adjuvant and delivering functions of calcium phosphate, aluminum hydroxide and chitosan nanoparticles, using a model protein of Brucella melitensis Omp31.

Vaccination is the most efficient and economic approach used to hinder infection and intense consequences caused by viruses, bacteria, or other pathogenic organisms. Since the intrinsic immunogenicity of recombinant antigens is usually low, safe and potent vaccine adjuvants are needed to ensure the success of those recombinant vaccines. Nanoparticles (NPs) have attracted much interest as adjuvants and delivery systems. Previous studies have shown that calcium phosphate (CP), aluminum hydroxide (AH) and chitosan (CS) NPs are promising delivery systems for immunization. In addition, it has been determined that Omp31 is a good candidate for inducing protection against Brucella (B) melitensis and B. ovis. Our aim in the present study was to compare the functions of CP, AH and CS NPs for stimulation of the immune response and protection against B. melitensis by using omp31 as a model protein. Based on the cytokine profile and subclasses of the antibody, vaccination with Omp31 load CP (CP/Omp31) and Omp31 load AH (AH/Omp31) NPs induced T helper type 1 (Th1)-T helper type 2 (Th2) immune response, whereas immunization by Omp31 load CS (CS/Omp31) NPs induced Th1 immune response. CP/Omp31 NPs elicited protection toward B. melitensis challenge equivalent to the vaccine strain B. melitensis Rev.1. Compared to CS/Omp31 NPs, CP/Omp31 NPs elicited a low increase in protection level against B. melitensis 16 M. In conclusion, the obtained results indicated that CP NPs were potent antigen delivery systems to immunize brucellosis.

Development and evaluation of in murine model, of an improved live-vaccine candidate against brucellosis from to Brucella melitensis vjbR deletion mutant.

Brucellosis is an infectious disease that brings enormous economic burdens for developing countries. The Brucella melitensis (B. melitensis) M5-90 vaccine strain (M5-90) has been used on a large scale in China, but may cause abortions if given to pregnant goats or sheep subcutaneously during the late stages of gestation. Moreover, the vaccine M5-90 cannot differentiate natural from vaccinated infection. Therefore, a safer and more potent M5-90 vaccine is required. In this study, a vjbR mutant of M5-90 (M5-90ΔvjbR) was constructed and overcame these drawbacks. M5-90ΔvjbR strain showed reduced survival capability in murine macrophages (RAW 264.7) and BALB/c mice and induced high protective immunity in mice. In addition, M5-90ΔvjbR induced an anti-Brucella-specific immunoglobulin G (IgG) response and stimulated the expression of gamma interferon (INF-γ) and interleukin-4 (IL-4) in vaccinated mice. Furthermore, M5-90ΔvjbR induced IgG response and stimulated the secretion of IFN-γ and IL-4 in immunized sheep. Moreover, the VjbR antigen allowed serological differentiation between infected and vaccinated animals. These results suggest that M5-90ΔvjbR is an ideal live attenuated and efficacious live vaccine candidate against B. melitensis 16 M infection.

[Different aluminum adjuvants significantly enhances the effect of immunization on Brucella Omp31].

Objective To investigate the effect of aluminum phosphate (AP) and aluminum hydroxide (AH) as adjuvants on Brucella outer membrane protein 31 (Omp31) in inducing humoral and cellular immune responses and immune protection. Methods AP and AH adjuvants were prepared and separately mixed with Brucella Omp31 protein to measure the adsorption rates. The AP- and AH-absorbed Omp31 protein were intraperitoneally injected into BLAB/c mice at 0, 2, and 4 weeks, and meanwhile, unabsorbed Omp31 protein and PBS were used as controls. The levels of serum IgG, IgG1, IgG2a and genital tract secretion sIgA were determined by ELISA at 0, 2, 4 and 6 weeks. Spleen cells were collected for culture at 6 weeks, and the cells were stimulated by Omp31 for 48 hours followed by the analysis of IFN-γ and IL-10 levels in the supernatants by ELISA, and the determination of lymphocyte proliferation by CCK-8 assay. The mice were challenged with Brucella at 6 weeks, and bacterial content in spleen tissue was determined 1 and 2 weeks later. Results AP and AH could absorb over 70% and 85% of the Omp31 protein, respectively, for solutions at all the tested concentrations. ELISA suggested that serum IgG, IgG1, IgG2a and genital tract sIgA levels peaked 2 weeks after the last immunization for both AP and AH groups, and antibody level was higher in the AP and AH groups than the control groups, and higher in the AH group than in the AP group. CCK-8 assay showed that the proliferating rate of lymphocytes induced by the AH group was significantly higher than that by the AP group, and the AH group also showed significantly higher IFN-γ level in the supernatant than the AP group, but no significant difference in IL-10 level. The AH group had remarkably lower bacterial load in the spleen than the AP group 2 weeks after challenged by Brucella 16M strain. Conclusion Both AP and AH adjuvants effectively enhanced immunogenicity and immune protection of the Brucella Omp31 protein, and AH was superior to AP in this respect.

Improved influenza viral vector based Brucella abortus vaccine induces robust B and T-cell responses and protection against Brucella melitensis infection in pregnant sheep and goats.

We previously developed a potent candidate vaccine against bovine brucellosis caused by Brucella abortus using the influenza viral vector expressing Brucella Omp16 and L7/L12 proteins (Flu-BA). Our success in the Flu-BA vaccine trial in cattle and results of a pilot study in non-pregnant small ruminants prompted us in the current study to test its efficacy against B. melitensis infection in pregnant sheep and goats. In this study, we improved the Flu-BA vaccine formulation and immunization method to achieve maximum efficacy and safety. The Flu-BA vaccine formulation had two additional proteins Omp19 and SOD, and administered thrice with 20% Montanide Gel01 adjuvant, simultaneously by both subcutaneous and conjunctival routes at 21 days intervals in pregnant sheep and goats. At 42 days post-vaccination (DPV) we detected antigen-specific IgG antibodies predominantly of IgG2a isotype but also IgG1, and also detected a strong lymphocyte recall response with IFN-γ production. Importantly, our candidate vaccine prevented abortion in 66.7% and 77.8% of pregnant sheep and goats, respectively. Furthermore, complete protection (absence of live B. melitensis 16M) was observed in 55.6% and 66.7% of challenged sheep and goats, and 72.7% and 90.0% of their fetuses (lambs/yeanlings), respectively. The severity of B. melitensis 16M infection in vaccinated sheep and goats and their fetuses (index of infection and rates of Brucella colonization in tissues) was significantly lower than in control groups. None of the protection parameters after vaccination with Flu-BA vaccine were statistically inferior to protection seen with the commercial B. melitensis Rev.1 vaccine (protection against abortion and vaccination efficacy, alpha = 0.18-0.34, infection index, P = 0.37-0.77, Brucella colonization, P = 0.16 to P > 0.99). In conclusion, our improved Flu-BA vaccine formulation and delivery method were found safe and effective in protecting pregnant sheep and goats against adverse consequences of B. melitensis infection.

Identification of potential antigens from non-classically secreted proteins and designing novel multitope peptide vaccine candidate against Brucella melitensis through reverse vaccinology and immunoinformatics approach.

Brucella melitensis is an intracellular pathogen resides in the professional and non-professional phagocytes of the host, causing zoonotic disease brucellosis. The stealthy nature of the Brucella makes it's highly pathogenic, and it is hard to eliminate the bacteria completely from the infected host. Hitherto, no licensed vaccines are available for human brucellosis. In this study, we identified potential antigens for vaccine development from non-classically secreted proteins through reverse vaccinology approach. Based on the systemic screening of non-classically secreted proteins of B. melitensis 16M, we identified nine proteins as potential vaccine candidates. Among these, Omp31 and Omp22 are known immunogens, and its role in the virulence of Brucella is known. Roles of other proteins in the pathogenesis are yet to be studied. From the nine proteins, we identified six novel antigenic epitopes that can elicit both B-cell and T-cell immune responses. Among the nine proteins, the epitopes were predicted from Omp31 immunogenic protein precursor, Omp22 protein precursor, extracellular serine protease, hypothetical membrane-associated protein, iron-regulated outer membrane protein FrpB. Further, we designed a multitope vaccine using Omp31 immunogenic protein precursor, Omp22 protein precursor, extra cellular serine protease, iron-regulated outer membrane protein FrpB, hypothetical membrane-associated protein, and LPS-assembly protein LptD and polysaccharide export protein identified in the previous study. Epitopes were joined using amino acid linkers such as EAAAK and GPGPG. Cholera toxin subunit B, the nontoxic part of cholera toxin, was used as an adjuvant and it was linked to the N-terminal of the multitope vaccine candidate. The designed vaccine candidate was modeled, validated and the physicochemical properties were analyzed. Results revealed that the vaccine candidate is soluble, stable, non-allergenic, antigenic and 87% of residues of the designed vaccine candidate is located in the favored region. In conclusion, the computational analysis showed that the newly designed multitope protein could be used to develop a promising vaccine for human brucellosis.

The host immune enhancing agent Korean red ginseng oil successfully attenuates Brucella abortus infection in a murine model.

ETHNOPHARMACOLOGICAL RELEVANCE: Panax ginseng Meyer (Araliaceae), is one of the most valuable traditional Chinese medicines and is used for the treatment of various human diseases. In this study, we elucidated the protective mechanism of the essential oil from Korean red ginseng (RGO) against Brucella infection. MATERIALS AND METHODS: The effects of RGO on Brucella abortus viability, NO production, uptake and intracellular growth in macrophages were investigated. Mice were intraperitoneally infected with B. abortus and orally treated with RGO for 14 days. The weights and bacterial numbers from each spleen were monitored, and the sera were evaluated for cytokine production. RESULTS: B. abortus viability was not affected, whereas NO production, internalization and intracellular replication were inhibited in RGO-treated macrophages. Bacterial adherence, F-actin polymerization and MAPK signaling protein phosphorylation (ERK1/2, JNK and p38α) were reduced and the co-localization of B. abortus-containing phagosomes with LAMP-1 was augmented in RGO-treated cells compared to untreated cells. RGO displayed protective effects against cell damage by inhibiting nitrite production during B. abortus infection in macrophages. Moreover, the spleen weight and bacterial burden were lower in the RGO-treated group than in the control group. The uninfected RGO-treated mice displayed increased TNF-α and IFN-γ production, whereas the B. abortus-infected RGO-treated mice showed reduced IL-10 production compared to the control. CONCLUSION: RGO exhibits protective effects against B. abortus infection in vitro and in vivo, which emphasize the beneficial effects of RGO in the prevention and treatment of brucellosis.

Use of S-[2,3-bispalmitoyiloxy-(2R)-propyl]-R-cysteinyl-amido-monomethoxy polyethylene glycol as an adjuvant improved protective immunity associated with a DNA vaccine encoding Cu,Zn superoxide dismutase of Brucella abortus in mice.

This study was conducted to evaluate the immunogenicity and protective efficacy of a DNA vaccine encoding Brucella abortus Cu,Zn superoxide dismutase (SOD) using the Toll-like receptor 2/6 agonist S-[2,3-bispalmitoyiloxy-(2R)-propyl]-R-cysteinyl-amido-monomethoxy polyethylene glycol (BPPcysMPEG) as an adjuvant. Intranasal coadministration of BPPcysMPEG with a plasmid carrying the SOD-encoding gene (pcDNA-SOD) into BALB/c mice elicited antigen-specific humoral and cellular immune responses. Humoral responses were characterized by the stimulation of IgG2a and IgG1 and by the presence of SOD-specific secretory IgA in nasal and bronchoalveolar lavage fluids. Furthermore, T-cell proliferative responses and increased production of gamma interferon were also observed upon splenocyte restimulation with recombinant SOD. Cytotoxic responses were also stimulated, as demonstrated by the lysis of RB51-SOD-infected J774.A1 macrophages by cells recovered from immunized mice. The pcDNA-SOD/BPPcysMPEG formulation induced improved protection against challenge with the virulent strain B. abortus 2308 in BALB/c mice over that provided by pcDNA-SOD, suggesting the potential of this vaccination strategy against Brucella infection.

Evaluation of the immunogenicity and the protective efficacy in mice of a DNA vaccine encoding SP41 from Brucella melitensis.

INTRODUCTION: Brucella melitensis is a facultative intracellular Gram-negative bacterial pathogen that may enter the host via ingestion or inhalation, or through conjunctiva or skin abrasions. Some Brucella spp surface proteins (SPs) play an important role in bacterial adhesion and invasion and thus represent targets for the host immune system. Brucella spp surface protein with apparent molecular mass of 41 kDa interacts selectively with HeLa cells. METHODOLOGY: To evaluate the role of SP41 (41 kDa) as a DNA vaccine against Brucella spp., pCISP41, a plasmid construct for protein expression in mammalian cells, was established. Exogenous SP41 was detected in pCISP41-transfected Vero cell line by immune blotting using specific polyclonal antibody. The protective role of pCISP41 against B. melitensis 16M in mice was evaluated by measuring B and T cell responses in comparison to those achieved with attenuated B. melitensis Rev. 1 vaccine. RESULTS: BALB/c mice injected with pCISP41 were able to develop SP41-specific serum immunoglobulin G (IgG) antibodies. In addition, splenocytes from DNA-SP41-vaccinated mice elicited a T-cell-proliferative response and also induced gamma interferon (IFN-γ) production, but not interleukin-5 (IL-5), suggesting the induction of a T-helper-1-dominated immune response. Vaccination with attenuated B. melitensis Rev.1 strain induced better protection levels than DNA vaccination with SP41 against B. melitensis 16M in mice. CONCLUSIONS: Such responses play an important role against intracellular infecting agents such as Brucella spp. Altogether, our data suggest that SP41 may represent a promising candidate for DNA vaccination against brucellosis, but more investigation to increase its protective efficacy should be done.

Immunization of mice with recombinant protein CobB or AsnC confers protection against Brucella abortus infection.

Due to drawbacks of live attenuated vaccines, much more attention has been focused on screening of Brucella protective antigens as subunit vaccine candidates. Brucella is a facultative intracellular bacterium and cell mediated immunity plays essential roles for protection against Brucella infection. Identification of Brucella antigens that present T-cell epitopes to the host could enable development of such vaccines. In this study, 45 proven or putative pathogenesis-associated factors of Brucella were selected according to currently available data. After expressed and purified, 35 proteins were qualified for analysis of their abilities to stimulate T-cell responses in vitro. Then, an in vitro gamma interferon (IFN-γ) assay was used to identify potential T-cell antigens from B. abortus. In total, 7 individual proteins that stimulated strong IFN-γ responses in splenocytes from mice immunized with B. abortus live vaccine S19 were identified. The protective efficiencies of these 7 recombinant proteins were further evaluated. Mice given BAB1_1316 (CobB) or BAB1_1688 (AsnC) plus adjuvant could provide protection against virulent B. abortus infection, similarly with the known protective antigen Cu-Zn SOD and the license vaccine S19. In addition, CobB and AsnC could induce strong antibodies responses in BALB/c mice. Altogether, the present study showed that CobB or AsnC protein could be useful antigen candidates for the development of subunit vaccines against brucellosis with adequate immunogenicity and protection efficacy.

[Experimental evaluation of the brucellosis therapeutic vaccine efficacy].

Use of antibiotics can't completely solve the problem of brucellosis treatment, especially its chronic forms, because antibacterial preparations do not eliminate main pathogenetic factor of the disease--sensibilization of the macroorganism. It makes actual the question about complex immuno- and antibacterial therapy. Long-term clinical experience proved high effectiveness of a therapeutic brucellosis vaccine. Earlier this preparation was manufactured in Research Institute of Vaccines and Sera in Tbilisi (Georgia). To date new composition of components of the vaccine has been developed, and manufacturing and control methods have been improved. Marked desensitizing effect of the vaccine and its stimulatory action on cellular and humoral immunity has been observed. In 2002 technological normative documentation for manufacturing and use of the vaccine was developed in the Research Institute of Microbiology (Kirov) and production of the vaccine began.

Use of enrofloxacin in the treatment of canine brucellosis in a dog kennel (clinical trial).

To date, no totally effective antibiotic for the eradication of canine brucellosis has been found. The purpose of this study was to evaluate the efficacy of enrofloxacin in a kennel infected with Brucella canis. Twelve dogs, 2 males and 10 females (including 1 in estrus, 3 pregnant, and 6 in anestrus) infected with B. canis were given 5 mg/kg of enrofloxacin orally every 12 h for 30 days. Females received additional courses of enrofloxacin during the estral and luteal phases of the subsequent cycles (0-2 cycles). They were repeatedly mated by infected males. A serological follow-up was carried out for 38 months. The clinical, serological and bacteriological findings were recorded. In a trial carried out 14 months after the beginning of this study, all dogs were negative on the Rapid Slide Agglutination Test (RSAT). No abortions were observed. All mated female dogs conceived and gave birth to healthy puppies. Cultures of postpartum vaginal discharges (lochia) were negative for B. canis. Similar to other treatments, although enrofloxacin was not completely efficacious in treating canine brucellosis, it maintained fertility and avoided the recurrence of abortions, transmission of the disease to the puppies and dissemination of microorganisms during parturition. We inferred that enrofloxacin could be used as an alternative drug for the treatment of canine brucellosis.

The effect of the doxycycline-rifampicin and levamisole combination on lymphocyte subgroups and functions of phagocytic cells in patients with chronic brucellosis.

BACKGROUND: Brucellosis is one of the important health problems for both humans and animals in Turkey since agriculture and stock raising appears to be the most important means of subsistence. Investigations on the pathogenesis of brucellosis reveal that the etiologic agent can survive in phagocytic cells, and cell-mediated immunity plays an important role in immunity against bacteria. METHODS: In this study, we investigated whether supplementation of levamisole, a well-known antihelminthic agent with immune-stimulating activity to conventional antibiotic therapy, would improve the anergy against Brucella. RESULTS: The results of our study reveal that a 6-week course of levamisole as a supplement to conventional antibiotic therapy in chronic brucellosis is not superior to conventional antibiotic treatment alone with respect to lymphocyte subgroup ratios and phagocytic function. CONCLUSION: In chronic brucellosis, levamisole administered as a supplement concomitantly with conventional antibiotic therapy has no immunostimulating effect on the basis of the lymphocyte subgroups ratios measured and the ability of phagocytosis in the present study. Further large clinical and laboratory trials are necessary to investigate the immunological and physiological effects of levamisole on T(H1) subtypes and cytokine secretion.

Seroprevalencia de anticuerpos anti-Brucella en disponentes de sangre con fines terapéuticos en tres bancos de sangre del Instituto Mexicano del Seguro Social / Anti-Brucella Antibody Seroprevalence in Blood Donors for Therapeutic Ends at Three Blood Banks of the Mexican Institute of Social Security

Introducción: la brucelosis es una zoonosis, que causa grandes pérdidas económicas en las zonas conurbanas de la Ciudad de México y es un problema importante de salud pública en los habitantes circunvecinos al Distrito Federal. El objetivo fue detectar anticuerpos anti-Brucella y según los resultados que proporcionó esta investigación, se propone como prueba de laboratorio de escrutinio en los donadores de sangre. Material y métodos: se analizaron 500 sueros sanguíneos de disponentes efectivos seleccionados y cuya muestra fue representativa de acuerdo al análisis estadístico elaborado. Las pruebas de laboratorio incluyeron Rosa de Bengala, Aglutinación Estándar en Microplaca y 2 Mercaptoetanol. Resultados: de los 500 sueros analizados 18 mostraron seropositividad con una tasa de seroprevalencia de 3.6%, predominando el sexo masculino (83.4%), por grupo de actividad las secundarias (72.2%), por grado de estudios académicos los de secundaria fueron los de mayor positividad (55.6%). Conclusión: la brucelosis posee características epidemiológicas peculiares en los bancos de sangre participantes en esta investigación, por lo que es importante incluir pruebas de escrutinio en búsqueda de anticuerpos anti-Brucella en los disponentes de sangre efectivos.

Introduction: to determine seroprevalence for Brucella sp. in blood donors, a serologic study was carried out at three blood banks of the Instituto Mexicano del Seguro Social (IMSS). Methods: 500 blood samples were taken from selected blood donors. Laboratory tests were used, such as Bengal rose (BR), Standard agglutination in microplate (SAM) and in presence of 2-Mercaptoethanol agglutination in microplate (2ME), which were applied to 500 blood sera from selected effective blood donors. The sample was representative according to the statistical analysis developed. Results: 18 of 500 analyzed sera were positive, with seroprevalence of 3.6%, male sex (83.4%), predominating, as secondary activity group (72.2%). According to academic archivement, blood donors with secondary school had highest seropositivity (55.6%). Conclusion: In this study, we conclude that brucellosis has peculiar epidemiologic characteristics in blood banks that participated in this research; therefore it is highly recommended to perform screening tests such as BR, SAM, and 2ME to identified anti-Brucella antibodies in the sera of effective blood donors.

[Ciprofloxacin in the treatment of patients with brucellosis]. / Opyt primeneniia tsiprofloksatsina dlia lecheniia bol'nykh brutselezom.

With the aim to estimate the clinical and immunological efficiency of the ciprofloxacin (cifloxinal) 105 patients with acute (51), subacute (19) and chronic (35) brucellosis were studied. Control group (17 patients with acute and 30 patients with chronic brucellosis) have been treated with combination of two antibiotics: doxycycline and rifampicin. Ciprofloxacin in a dose 500 mg bid within 14 days in acute stage and 20 days in chronic stage of disease essentially reduced duration of local inflammatory processes of brucellosis with simultaneous treatment of the chronic infection focus, provides good proximate and distant outcomes of treatment. Ciprofloxacin can be considered as an alternative drug for the treatment of brucellosis, more effective (clinically and immunologically) than a combination of two antibiotics: doxycycline and rifampicin.

[Clinical and experimental studies of supplemented sini san in treating chronic brucellosis].

OBJECTIVE: To observe the effect of supplemented Sini San (SSNS) in treating chronic Brucellosis (CB). METHODS: One hundred and twenty-seven patients were randomly divided into two groups, 76 cases in the treatment group were treated with SSNS and 51 cases in the control group treated with Dioscorea Nipponica Power. The effect of SSNS on mice model of CB was also observed simultaneously. RESULTS: The short-term effects were that the total effective rate and markedly effective rate of the treatment were 98.7% and 92.1%, which were better than those of the control group (82.4% and 41.2%) respectively, P < 0.01. The long-term follow-up result of the treatment group also showed its superiority to the control group, the total effective rates of the two groups were 98.7% and 51.0%, and the markedly effective rates were 90.8% and 21.6% respectively (P < 0.01). Animal experiments indicated SSNS has obvious effect of antibiotics and immunomodulation. CONCLUSION: SSNS was effective in treating CB, including the long-term follow-up result.

Immunosuppression in murine brucellosis.

Brucellosis in mice results in a distinct immunosuppression which may be abrogated by immunomodulators, such as levamisole, bestatin, interleukin-2 (IL-2) and Polyporus umbellatus. The data presented here provide evidence that immunosuppression in addition to infection of target tissues and allergic reactions (including types 3 and 4) contributes to the pathogenesis of brucellosis. The present study also provides some basic data regarding the value of this animal model, and criteria for observing the effect of therapy on chronic brucellosis.

[Treatment of chronic Brucellosis with combined traditional Chinese medicine and Western medicine therapy].

66 patients of chronic Brucellosis were treated by two programs and their differences were analysed. 30 (control) were treated with Brucella phenol insoluble portion (PI), injected intramuscularly by increasing the doses gradually, 2 times a week, 20 times as a course. 36 treated with combined traditional Chinese and Western medicine (TCM-WM), besides using PI, they were treated with Modified Duhuo Jisheng Tang. Results were evaluated 70 days later. The basic cure rate between two groups were 86.11% and 53.17%, the effective rates were 99.22% and 86.66% respectively. The difference is significant (P < 0.01 and 0.05). Most symptoms disappeared or alleviated in both groups, but improved more quickly in TCM-WM group. The side effect in control group was more serious. The objective indexes, such as serological test, skin hypersensitivity reaction and WBC count, etc. were improved better in combined therapy group than that in control group (P < 0.05-0.01). Duhuo Jisheng Tang has the function of replenishing Liver and Kidney, nourishing the Blood and Qi, getting rid of rheumatism and relieving pain, if used with PI, it could strengthen immunity and inhibit the release of alergin.

[Increasing the effectiveness of antibiotic therapy by correcting immunologic disorders with vitamin A in patients with brucellosis]. / Povyshenie éffektivnosti antibiotikoterapii bol'nykh brotsellezom putem korrektsii narushenii immuniteta vitaminom A.

Experimental studies and clinical trials were performed on possible increase of antibiotic therapy efficacy in brucellosis patients by correction of the immunity disorders with vitamin A. It was experimentally shown that vitamin A increased cellular immunity and accelerated sanation of guinea pigs sensitized with Brucella abortus 19 BA. The clinical trials demonstrated that the use of vitamin A in a dose of 33,000 IU thrice a day for 10 to 12 days during the complex treatment of patients with acute (36 persons) and subacute (57 persons) brucellosis lowered the average period of manifestation of the disease clinical signs and formation of the antibodies, increased the skin allergic sensitivity, the lymphocyte blast cell transformation, the total number and subpopulations of the active T-cells, theophylline-resistant lymphocytes, phagocytic and metabolic activity of neutrophils, showed 1.5- and 2-fold increased in the frequency of the infection transformation into a chronic process in patients with acute or subacute brucellosis, respectively.