Use of a patch containing heat-labile toxin from Escherichia coli against travellers' diarrhoea: a phase II, randomised, double-blind, placebo-controlled field trial

Secretory IgA-mediated protection againstV. choleraeand heat-labile enterotoxin-producing enterotoxigenicEscherichia coliby rice-based vaccine

“…Transcutaneous immunization with LT supplied in patch form has recently been reported to be protective against ETEC-induced travelers' diarrhea; the increase in serum LT-specific IgA levels induced is correlated with the mucosal immune response (17). A recent study revealed that transcutaneous immunization induces the activity of Ag-specific IgA-secreting cells expressing CCR9 and CCR10 in the small intestine in a retinoic acid-dependent manner and that cross-talk between the skin and gut immune systems might be mediated by langerin(+) dendritic cells in the mesenteric lymph nodes (30).…”

“…LT is found in approximately two thirds of cases of ETEC-induced diarrhea (12)(13)(14). In addition, previous studies have shown that anti-LT immunity protects against ETEC-induced diarrhea in human (15)(16)(17). LT is structurally and biologically similar to CT (2,18), and several studies have demonstrated cross-protective immunity between CT and LT (19)(20)(21).…”

A systematic review of experimental infections with enterotoxigenic Escherichia coli (ETEC)

“…As reported by McKenzie et al, an LT skin patch vaccine failed to protect against diarrhea in an experimental infection study with the strain E34277A, although there were trends toward a less severe illness in the vaccinated subjects [21]. However, when that vaccine (with minor modifications in the administration) was evaluated in a relatively small logistics field trial, a statistically significant reduction was observed in the rate of moderate to severe diarrhea of any cause and in the number of loose stools and duration of illness among those who developed ETECassociated diarrhea [22]. Those data were not corroborated in an expanded field trial and subsequent development of the ETEC patch vaccine was halted [29].…”

“…Most recently, Frech et al described the results of a placebocontrolled clinical trial evaluating an LT skin patch vaccine in travelers to Guatemala or Mexico [22]. Placebo recipients with ETEC-attributable disease experienced a median of 2.2 days of diarrhea and a median of 10.5 (range: 5-30) loose stools.…”

Neue Impfstoffkonzepte auf Basis moderner Erkenntnisse der Immunologie

“…Ein neuer Grippeimpfstoff, der bei älteren und immununterdrückten Personen gute Wirkung zu zeigen scheint, wird zum Beispiel durch Mikronadeln direkt in die Epidermis appliziert [39]. Kürzlich wurde auch ein Impfstoff gegen den Durchfallerreger ETEC erfolgreich in einer klinischen Phase-II-Prüfung getestet [40]. Das Vakzin wird hier mithilfe eines Impfpflasters in die Epidermis eingebracht.…”