Butz O. Clinical and diagnostic value of the toxicity degree and the state of antitoxic immunity in diphtheria in children

In this paper, on the basis of the study of diphtheria toxin, the state of antitoxic immunity and immunochemical properties of Corynebacterium diphtheriae with the help of the enzyme multiplied immunoassay method, problems of the improvement in diagnosis, differential diagnosis of diphtheria in children, prognosis of diphtheria myocarditis and its severity, were solved. The C. diphtheriae toxigenic strains were discovered to have a specific peptide with a molecular mass of 17 kD. By means of the dot-ELISA method the toxins in the C. diphtheriae culture fluid were detected. Diphtheria toxin in the blood identification by means of the ELISA solid-phase enzyme immunoassay method of the "sandwich" variant was determined to be used as an additional method of diagnosis of diphtheria. It is shown that titers of antitoxic antibodies in children with mild and moderate forms of diphtheria were significantly higher than in the severe course of the disease (p = 0.007 and p = 0.026 respectively). There is a correlation between antitoxin indicators obtained using TPHA and ELISA in the first study. The synthesis of antibodies to A subunit of diphtheria toxin was found to predominate during diphtheria infection. The C. diphtheriae toxigenic states have a specific axid with a molecular weight of 17 kD.