| 
			 
			  
			
			  
			
			
			 
			
			  
			by Viera Scheibner, Ph.D.  
			
			extracted from Nexus 
			Dec 2000 (Vol 8, No1) & Feb 2001 (Vol 8, Number 2) 
			from 
			Whale Website 
			
			  
			
			  
			
			  
			
			  
			
			ADJUVANTS, 
			PRESERVATIVES AND TISSUE FIXATIVES IN VACCINES 
			 
			Vaccines contain a number of substances which can be divided into 
			the following groups: 
			
				
					- 
					
					Micro-organisms, either bacteria or viruses, thought to be 
			causing certain infectious diseases and which the vaccine is 
			supposed to prevent. These are whole-cell proteins or just the 
			broken-cell protein envelopes, and are called antigens.   
					 
					- 
					
					Chemical substances which are supposed to enhance the immune 
			response to the vaccine, called adjuvants.    
					- 
					
					Chemical substances which act as preservatives and tissue 
			fixatives, which are supposed to halt any further chemical reactions 
			and putrefaction (decomposition or multiplication) of the live or 
			attenuated (or killed) biological constituents of the vaccine. 
					 
				 
			 
			
			All these constituents of vaccines are toxic, and their toxicity may 
			vary, as a rule, from one batch of vaccine to another.
			In this article, the first of a two-part series, we shall deal with 
			adjuvants, their expects role and the reactions (side effects). 
  
			
			  
			
			  
			
			 
			ADJUVANTS 
			 
			The desired immune response to vaccines is the production of 
			antibodies, and this is enhanced by adding certain substances to the 
			vaccines. These are called adjuvants (from the Latin adjuvare, 
			meaning "to help"). 
			 
			The chemical nature of adjuvants, their mode of action and their 
			reactions (side effect) are highly variable. According to Gupta et 
			al. (1993), some of the side effects can be ascribed to an 
			unintentional stimulation of different mechanisms of the immune 
			system whereas others may reflect general adverse pharmacological 
			reactions which are more less expected. 
			 
			There are several types of adjuvants. Today the most common 
			adjuvants for human use are aluminium hydroxide, aluminium phosphate 
			and calcium phosphate. However, there are a number of other 
			adjuvants based on oil emulsions, products from bacteria (their 
			synthetic derivatives as well as liposomes) or gram-negative 
			bacteria, endotoxins, cholesterol, fatty acids, aliphatic amines, 
			paraffinic and vegetable oils.  
			
			  
			
			Recently, monophosphoryl lipid A, 
			ISCOMs with Quil-A, and Syntex adjuvant formulations (SAFs) 
			containing the threonyl derivative or muramyl dipeptide have been 
			under consideration for use in human vaccines. 
			 
			Chemically, the adjuvants are a highly heterogenous group of 
			compounds with only one thing in common: their ability to enhance 
			the immune response - their adjuvanticity. They are highly variable in 
			terms of how they affect the immune system and how serious their 
			adverse effects are due to the resultant hyperactivation of the 
			immune system. 
			 
			The mode of action of adjuvants was described by Chedid (1985) as: 
			 
			
				
				the formation of a depot of antigen at the site of inoculation, with 
			slow release; the presentation of antigen immuno-competent cells; and 
			the production of various and different lymphokines (interleukins 
			and tumor necrosis factor). 
			 
			
			The choice of any of these adjuvants reflects a compromise between a 
			requirement for adjuvanticity and an acceptable low level of adverse 
			reactions. 
			 
			The discovery of adjuvants dates back to 1925 and 1926, when Ramon 
			(quoted by Gupta et al., 1993) showed that the antitoxin response to 
			tetanus and diphtheria was increased by injection of these vaccines, 
			together with other compounds such as agar, tapioca, lecithin, 
			starch oil, saponin or even breadcrumbs. 
			 
			The term adjuvant has been used for any material that can increase 
			the humoral or cellular immune response. to an antigen. In the 
			conventional vaccines, adjuvants are used to elicit an early, high 
			and long-lasting immune response. The newly developed purified 
			subunit or synthetic vaccines using biosynthetic, recombinant and 
			other modern technology are poor immunogens and require adjuvants to 
			evoke the immune response. 
			 
			The use of adjuvants enables the use of less antigen to achieve the 
			desired immune response, and this reduces vaccine production costs. 
			With a few exceptions, adjuvants are foreign to the body and cause 
			adverse reactions. 
			 
			Part 1 deals with the following types of adjuvants (after Gupta et 
			al, 1993): 
			
				
					- 
					
					Oil emulsions 
					 
					- 
					
					Freund’s 
					emulsified oil adjuvants (complete and incomplete) 
					 
					- 
					
					Arlacel A 
					 
					- 
					
					Mineral oil 
					 
					- 
					
					Emulsified 
					peanut oil adjuvant (adjuvant 65)  
					- 
					
					Mineral 
					compounds  
					- 
					
					Bacterial 
					products  
					- 
					
					Bordetella 
					pertussis  
					- 
					
					Corynebacterium 
					granulosumderived P40 component  
					- 
					
					
					Lipopolysaccharide  
					- 
					
					Mycobacteriwn 
					and its components  
					- 
					
					Cholera toxin 
					 
					- 
					
					Liposomes 
					 
					- 
					
					
					Immunostimulating complexes (ISCOMs)  
					- 
					
					Other adjuvants 
					 
					- 
					
					Squalene 
					 
				 
			 
			
			  
			
				
				Oil Emulsions In the 1960s, emulsified water-in-oil and water-in-vegetable-oil 
			adjuvant preparations used experimentally showed special promise in 
			providing exalted "immunity" of long duration (Hilleman, 1966). 
				 
				  
				
				The 
			development of Freund’s adjuvants emerged from studies of 
			tuberculosis. Several researchers noticed that immunological 
			responses in animals to various antigens were enhanced by 
			introduction into the animal of living Mycobacterium tuberculosis. 
			In the presence of Mycobacterium, the reaction obtained was of the 
			delayed type, transferable with leukocytes.  
				  
				
				Freund measured the 
			effect of mineral oil in causing delayed-type hypersensitivity to 
			killed mycobacteria. There was a remarkable increase in 
			complement-fixing antibody response as well as in delayed 
			hypersensitivity reaction.
  Freund’s adjuvant consists of a water-in-oil emulsion of aqueous 
			antigen in paraffin (mineral) oil of low specific gravity and low 
			viscosity. Drakeol 6VR and Arlacel A (mannide monooleate) are 
			commonly used as emulsifiers.
  There are two Freund’s adjuvants: incomplete and complete. The 
			incomplete Freund’s adjuvant consists of water-in-oil emulsion 
			without added mycobacteria; the complete Freund’s adjuvant consists 
			of the same components but with 5 mg of dried, heat-killed 
			Mycobacterium tuberculosis or butyricum added.
  The mechanism of action of Freund’s adjuvants is associated with the 
			following three phenomena: 
				
					
						- 
						
						The 
						establishment of a portion of the antigen in a 
						persistent form at the injection site, enabling a 
						gradual and continuous release of antigen for 
						stimulating the antibody  
						- 
						
						The 
						provision of a vehicle for transport of emulsified 
						antigen throughout the lymphatic system to distant 
						places, such as lymph nodes and spleen, where new foci 
						of antibody formation can be established  
						- 
						
						Formation and accumulation of cells of the mononuclear series 
			which are appropriate to the production of antibody at the local and 
			distal sites  
					 
				 
				
				The pathologic reaction to the Freund’s adjuvants starts at the 
			injection site with mild erythema and swelling followed by tissue 
			necrosis, intense inflammation and the usual progression to the 
			formation of a granulomatous lesion. Scar and abscess formation may 
			occur.  
				  
				
				The reactions observed following the administration of the 
			complete adjuvant are generally far more extensive than with the 
			incomplete adjuvant.  
				  
				
				The earliest cellular response is polymorphonuclear, then it changes into mononuclear and later 
			includes plasmocytes. The adjuvant emulsion may be widely 
			disseminated in varrious organs, depending on the route of 
			inoculation, with the development of focal granulomatous lesions at 
			distal places. Various gram-negative organisms may show a 
			potentiating effect of the adjuvant, similar to that displayed by 
			mycobacteria.
  The earliest use of oil emulsion adjuvants was made with the 
			influenza, vaccine by Friedwald (1944) and by Henle and Henle 
			(1945). Following their promising results on animals, Salk (1951) 
			experimented with such adjuvants on soldiers under the auspices of 
			the US Armed Forces Epidemiological Board. He used a highly refined 
			mineral oil, and developed a purified Arlacel A emulsifier which was 
			free of toxic substances, such as oleic acid which had caused 
			sterile abscesses at the injection site, and he administered the 
			vaccine by intramuscular route.
  Subsequently, Miller et al. (1965) reported their, failure to 
			enhance the antibody and protective response to types 3, 4 and 7 
			adenovirus vaccines in mineral oil adjuvant compared with aqueous 
			vaccine. Unpublished studies have revealed the need for an adequate 
			minimal amount of antigen to trigger an antibody response to the 
			emulsified preparations.
  Salk et al. (1953) applied Freund’s adjuvant to poliomyelitis 
			vaccine, and later followed with extensive testing of killed crude 
			as well as purified polio virus vaccine in animals and humans, where 
			the reactions in humans were considered inconsequential.
  Grayston et al. (1964) reported highly promising results with the 
			trachoma vaccine using an oil adjuvant. However, the trachoma 
			vaccine lost its relevance because, as demonstrated by Dolin et al. 
			(1997) in their 37 years of research in a sub-Saharan village, the 
			dramatic fall in the disease occurrence was closely connected with 
			improvements in sanitation, water supply, education and access to 
			health care. According to Dolin et al. (1997), the decline in 
			trachoma occurred without any trachoma-specific intervention. 
				 Allergens in Freund’s adjuvant deserve special attention because 
			they can be dangerous. These dangers include an overdose, i.e., the 
			immediate release of more than the tolerated amount of properly 
			emulsified vaccine in sensitive persons, or the breaking of the 
			emulsion with the release of all or part of the full content of the 
			allergen within a brief period of time.  
				  
				
				Long-term delayed reactions 
			include the development of nodules, cysts or sterile abscesses 
			requiring surgical incision. It is also likely that some allergens 
			used, such as house dust or mould, might have acted like mycobacteria to potentiate the inflammatory response. Such reactions 
			have been reduced with the use of properly tested and standardized 
				regains.
  One must also consider that the first application of Freund’s 
			adjuvants was made at a time when modern concepts of safety were 
			non-existent Indeed, mineral oil adjuvants have not been approved 
			for human use in some countries, including the USA.   
				
				 
				Mineral Compounds Aluminium phosphate or aluminium hydroxide (alum) are the mineral 
			compounds most commonly used as adjuvants in human vaccines. Calcium 
			phosphate is another adjuvant that is used in many vaccines. Mineral 
			salts of metals such as cerium nitrate, zinc sulphate, colloidal 
			iron hydroxide and calcium chloride were observed to increase the 
			antigenicity of’ the toxoids, but alum gave the best results. 
				 The use of alum was applied more than 70 years ago by Glenny et al. 
			(1926), who discovered that a suspension of alum-precipitated 
			diphtheria toxoid had a much higher immunogenicity than the fluid 
			toxoid.  
				  
				
				Even though a number of reports stated that alum-adjuvanted 
			vaccines were no better than plain vaccines (Aprile and Wardlaw, 
			1966), the use of alum as an adjuvant is now well established. The 
			most widely used is the antigen solution mixed with pre-formed 
			aluminium hydroxide or aluminium phosohate under controlled 
			conditions.  
				  
				
				Such vaccines are now called aluminium-adsorbed or 
			aluminium-adjuvanted. However, they are difficult to manufacture in 
			a physico-chemically reproducible way, which results in a 
			batch-to-batch variation of the same vaccine. Also, the degree of 
			antigen absorption to the gels of aluminium phosphate and aluminium 
			hydroxide varies.  
				  
				
				To minimize the variation and avoid the 
			non-reproducibility, a specific preparation of aluminium hydroxide (Alhydrogel) 
			was chosen as the standard in 1988 (Gupta et al., 1993).
  The aluminium adjuvants allow the slow release of antigen, 
			prolonging the time for interaction between antigen and 
			antigen-presenting cells and lymphocytes. However, in some studies, 
			the potency of adjuvanted pertussis vaccines was more than that of 
			the plain pertussis vaccines, while in others no effect was noted. 
			The serum agglutinin titres, after vaccination with adjuvanted 
			pertussis vaccines, were higher than those of the plain vaccines, 
			with no difference in regard to protection against the disease 
			(Butler et al., 1962).  
				  
				
				Despite these conflicting results, aluminium 
			compounds are universally used as adjuvants for the DPT (diphtheriapertussis-tetanus) 
			vaccine. Hypersensitivity reactions following their administration 
			have been reported which could be attributed to a number of factors, 
			one of which is the production of IgE along with IgG antibodies. 
				 It was suggested that polymerased toxoids, such as the so-called 
			glutaraldehyde-detoxifled purified tetanus and diphtheria toxins, 
			should be used instead of aluminium compounds. They are used 
			combined with glutaraldehyde-inactivated pertussis vaccine.
  Calcium phosphate adjuvant has been used for simultaneous 
			vaccination with diphtheria, pertussis, tetanus, polio, BCG, yellow 
			fever, measles and hepatitis B vaccines and with allergen (Coursaget 
			et al., 1986). The advantage of this adjuvant has been seen to be 
			that it is a normal constituent of the body and is better tolerated 
			and absorbed than other adjuvants. It entraps antigens very 
			efficiently and allows slow release of the antigen.  
				  
				
				Additionally, it 
			elicits high amounts of IgG-type antibodies an much less of IgE-type 
			(reaginic) antibodies.   
				
				 
				Bacterial Products Micro-organisms in bacterial infections and the administration of 
			vaccines containing whole killed bacteria and some metabolic 
			products and components of various micro-organisms have been known 
			to elicit antibody response and act as immuno-stimulants. 
				 
				  
				
				The 
			addition of such micro-organisms and substances into vaccines 
			augments the immune response to other antigens in such vaccines. 
				 The most commonly used micro-organisms, whole or their parts, are 
				
				Bordetella pertussis components, Corenybacterium derived P40 
			component, cholera toxin and mycobacteria.
    
				
				B. pertussis components The killed Bordetella pertussis has a strong adjuvant effect on the 
			diptheria and tetanus toxoids in the DPT vaccines. However, there 
			are a number of admitted and well-describe reactions to it, such as 
			convulsion, infantile spasms, epilepsy, sudden infant death syndrome 
			(SIDS), Reye syndrome, Guilain-Barre syndrome, transverse myelitis 
			and cerebral ataxia.  
				  
				
				Needless to say, the causal link to it is often 
			(even though not always) vehemently disputed and generally 
			considered "coincidental".
  Paradoxically, in one case of shaken baby syndrome in which the baby 
			developed subdural and retinal hemorrhages from the disease 
			whooping cough, doctors accused the father of causing these injuries 
			and strenuously denied that the disease pertussis can and does cause 
			such haemorrhages - forgetting that this is the very reason why
				
				pertussis vaccine was developed against such potentially devastating 
			disease in the first place.  
				  
				
				Such devastating effects are caused by 
			the 
				pertussis toxin, the causative agent of the disease (pertussis 
			is a toxin-mediated disease), employed as the active ingredient in 
			all pertussis vaccines whether whole-cell or acellular (Pittman, 
			1984).
  Gupta et al. (1993) concluded that PT is too toxic to be 
			administered to humans, but chemically detoxified or genetically 
			inactivated PT may not exhibit the adjuvant effects comparable to 
			the native PT.   
				
				 
				Corynebacterium-derived P40 P40 is a particulate fraction isolated from Corynebacterium 
			granulosum, composed of the cell wall peptidoglycan associate with a 
			glycoprotein. In animals, it displays a number of activities such as 
			stimulation of the reticulo-endothelial system, enhancement of 
			phagocytosis and activation of macrophages.
  P40 abolishes drug-induced immuno-suppression and increase 
			non-specific resistance to bacterial, viral, fungal and parasitic 
			infections. It induces the formation of IL-2, tumor necrosis 
			factor, and interferon alpha and gamma (Bizzini et al., 1992). In 
			clinical trials, P40 was claimed to be efficacious in the treatment 
			of recurrent infections of the respiratory and genito-urinary 
			tracts.  
				  
				
				Allergens coupled to P40 have been said to be instrumental 
			in desensitizing allergic patients without any side effects.   
				
				 
				Lipopolysaccharide (LPS) 
				LPS is an adjuvant for both humoral and cell-mediated immunity. It 
			augments the immune response to both protein and polysaccharide 
			antigens. It is too toxic and pyrogenic, even in minute doses, to be 
			used as an adjuvant in humans.   
				
				 
				Mycobacterium and its components Interestingly, Mycobacterium and its components, as originally 
			formulated, were too toxic to be used as adjuvants in humans. 
			 
				  
				
				However, the efforts to detoxify them resulted in the development of 
			N-acetyl muramyl-L-alanyl-D-isoglutamine, or muramyl dipeptide (MDP). 
			When given without antigen, it increased nonspecific resistance 
			against infections with bacteria, fungi, parasites, viruses, and 
			even against certain tumours (McLaughlin et al., 1980).  
				  
				
				However, MDPs are potent pyrogens (maybe that’s why they may be effective 
			against certain tumours - my comment) and their action is not 
			completely understood; hence they are not acceptable for use in 
			humans.   
				
				 
				Cholera Toxin A major drawback with cholera toxin as a mucosal adjuvant is its 
			intrinsic toxicity.   
				
				 
				Liposomes Liposomes are particles made up of concentric lipid membranes 
			containing phospholipids and other lipids in a bilayer configuration 
			separated by aqueous compartments.  
				  
				
				They have been used parenterally 
			in people as carriers of biologically active substances (Gregoriadis, 
			1976) and considered safe.   
				
				 
				Immunostimulating complexes (ISCOMs) 
				ISCOMs (DeVries et al., 1988; Morein et al., 199&, Lovgren : al., 
			1991) represent an interesting approach to stimulation of the 
			humoral and cell-mediated immune response towards amphipathic 
			antigens. It is a relatively stable but non-covalently-bound complex 
			of saponin adjuvant Quil-A, cholesterol and amphipathic antigen in a 
			molar ratio of approximately 1:1:1.  
				  
				
				The spectrum of viral capsid 
			antigens and non-viral amphipathic antigens of relevance for human 
			vaccination, incorporated into ISCOMs, comprises influenza, measles, 
			rabies, gp340 from EB-virus, gp120 from HIV, Plasmodium falciparum 
			and Trypanosoma cruzi.
  ISCOMs have been shown to induce cytotoxic T-lymphocyte (CTL). 
			Following oral administration, some types of CTLs were found in 
			mesenteric lymph nodes and in the spleen, and specific IgA response 
			could be induced.
  ISCOMs have only been used in veterinary vaccines, partly due to 
			their haemolytic activity and some local reactions all reflecting 
			the detergent activity of the Quil-A molecule.   
				
				 
				Other Adjuvants - Squalene Squalene is an organic polymer with some antigenic epitopes which 
			might be shared with other organic polymers acting as 
			immuno-stimulators. It has been used in experimental vaccines since 
			1987 (Asa et aL, 2000) and it was used in the experiments vaccines 
			given to a great number of the participants in the Gulf War. 
				 
				  
				
				These 
			included those who were not deployed but received the same vaccines 
			as those who were deployed.
  The adjuvant activity of non-ionic block copolymer surfactants was 
			demonstrated when given with 2% squalene-in-water emulsion. However, 
			this adjuvant contributed to the cascade of reactions called "Gulf 
			War syndrome", documented in the soldiers involved in the Gulf War. 
				 
				  
				
				The symptoms they developed included: 
				
					
						- 
						
						arthritis 
						 
						- 
						
						fibromyalgia 
						 
						- 
						
						lymphadenopathy 
						 
						- 
						
						rashes 
						 
						- 
						
						
						photosensitive rashes  
						- 
						
						malar rashes 
						 
						- 
						
						chronic fatigue 
						 
						- 
						
						chronic headaches 
						 
						- 
						
						abnormal body hair loss 
						 
						- 
						
						non-healing 
						skin lesions  
						- 
						
						aphthous ulcers 
						 
						- 
						
						dizziness 
						 
						- 
						
						weakness 
						 
						- 
						
						memory loss 
						 
						- 
						
						seizures 
						 
						- 
						
						mood changes 
						 
						- 
						
						neuropsychiatric problems 
						 
						- 
						
						anti-thyroid 
						effects  
						- 
						
						anaemia 
						 
						- 
						
						elevated ESR (erythrocyte 
			sedimentation rate)  
						- 
						
						systemic lupus erythematosus 
						 
						- 
						
						multiple 
						sclerosis  
						- 
						
						ALS 
						(amyotrophic lateral sclerosis)  
						- 
						
						Raynaud’s 
						phenomenon  
						- 
						
						Sjorgren’s syndrome 
						 
						- 
						
						chronic diarrhoea 
						 
						- 
						
						night sweats 
						  
						- 
						
						low-grade 
						fevers  
					 
				 
				
				This long list of reactions shows just how much damage is done by 
			vaccines, particularly when potentiated by powerful "immuno-enhancers" 
			such as squalene and other adjuvants. Interestingly, vaccinators as 
			a rule consider such problems as mysterious and/or coincidental with 
			vaccines.  
				  
				
				Since the administration of a multitude of vaccines to the 
			participants (and prospective participants) in the Gulf War is 
			well-documented (in fact, veterans claim they were given many more 
			than were even recorded), this list of observed reactions further 
			incriminates the vaccines as causing such problems. 
			 
			
			 
			  
			
			
			 
			IMMUNOLOGY PRINCIPLES 
			- ANTIBODY RESPONSE 
			
			 
			To explain the action of adjuvants, we should look into immunology. 
			The theory of vaccine efficacy is based on the ability of vaccines 
			to evoke the formation of antibodies. This is of varying efficacy, 
			depending on the nature of the antigen(s) and the amount of 
			antigenic substance administered. 
			 
			However, the mechanisms for the diversity of immune reactions are 
			complex, and to this day are not quite known and understood. There 
			are numerous theories, the favored one being antibody response as 
			the sign of immunization (acquiring immunity). 
			 
			Specific immunity to a particular disease is generally considered to 
			be the result of two kinds of activity: the humoral antibody and the 
			cellular sensitivity. 
			 
			The ability to form antibodies develops partly in utero and partly 
			after birth in the neonatal period. In either case, immunological 
			competence - the ability to respond immunologically to an antigenic 
			stimulus - appears to originate with the thymic activity. 
			 
			The thymus initially consists largely of primitive cellular elements 
			which become peripheralised to the lymph nodes and spleen. These 
			cells give rise to lymphoid cells, resulting in the development of 
			immunological competence. The thymus may also exert a second 
			activity in producing a hormqne-lilce substance which is essential 
			for the maturation of immunological competence in lymphoid cells. 
			 
			
			  
			
			Such maturation also takes place by contact with thymus cells in the 
			thymus. 
			 
			Stimulation of the organism by antigen results in proliferation of 
			cells of the lymphoid series accompanied by the formation of 
			immunocytes, and this leads to the antibody production. Certain 
			lymphocytes and possibly reticulum cells may be transformed into 
			immunoblasts, which develop into immunologically active ("sensitised") 
			lymphocytes and plasmocytes (plasma cells). Antibody formation is 
			connected with plasma cells, while cellular immunity reactions are 
			mainly lymphocytic. 
			 
			None of the theories for antibody formation comprehends all the 
			biological and chemical data now available. However, several 
			principal theories have been considered at length. 
			 
			The so-called instructive theory holds that the antigen is brought 
			to the locus of antibody synthesis and there imposes in some way the 
			synthesis of the specific antibody with reactive sites which are 
			complementary to the antigen. 
			 
			The clonal selection theory, evolved by Burnett (1960), presupposes 
			that the information requisite to the synthesis of the antibody is 
			part of the genetics. While the body develops a wide range of clones 
			of cells necessary to cover all antigenic determinants by random 
			mutation during early embryonic life, those clones which are capable 
			of reacting with antigens of the body ("self’) are destroyed, 
			leaving only those cells which are not oriented to self 
			("non-self’).  
			
			  
			
			Upon stimulation by a foreign antigen, the clones of 
			the cells corresponding to the particular foreign antigen are 
			stimulated to proliferate and to produce the antibody. 
			 
			Other researchers demonstrated that there are at least four 
			different antigens formed by descendants of a single cloned cell. By 
			this mechanism, the information for antibody synthesis is contained 
			in the genetic material of each cell (DNA) but is normally 
			repressed. The antigen then assumes the role of a de-repressor and 
			initiates (provokes) the RNA synthesis for a particular messenger, 
			resulting in the corresponding antibody production.  
			
			  
			
			The antigen 
			would instruct the genetically predisposed capability of multipotential cells as to which antibody to produce and might also 
			command the cells to proliferate, resulting in clones of properly 
			instructed cells. 
			 
			There are two possible mechanisms for the elimination of antibodies 
			against self: immunological non-responsiveness and immunological 
			paralysis. There are several states of immunological 
			non-responsiveness; one is illustrated by the exposure of a fetus or 
			newborn to an antigen prior to the development of its ability to 
			recognize the antigen as non-self (immunological incompetence). 
			Immunological paralysis results from the injection of a very large 
			amount of antigen into immunologically competent individuals. 
			 
			
			  
			
			Nonspecific immunological suppression by cortisone, ACTH, nitrogen 
			mustards and irradiation is also well known. 
			 
			Cellular sensitivity, also known as delayed or cellular 
			hypersensitivity, depends on the development of immunologically 
			reactive or "sensitive" lymphocytes and possibly other cells which 
			react with the corresponding antigen to give a typical delayed-type 
			reaction after a period of several hours, days or even weeks. 
			 
			Cellular hypersensitivity depends on the original antigenic 
			stimulation and a latent period, and is specific in its response. 
			Delayed-type hypersensitivity is characteristic of the body’s 
			response to various infectious agents such as viruses, bacteria, 
			fungi, spirochetes and parasites. It is also characteristic of the 
			body’s response to various chemicals, such as mercury, endotoxins, 
			antibiotics, various drugs and many other substances foreign to the 
			body. 
			 
			The induction of a hypersensitivity reaction requires the presence 
			in the tissues of the whole organism or certain derivatives of it, 
			in addition to the specific antigen such as a lipid in addition to 
			tubercle bacillus protein.  
			
			  
			
			Sensitization to a non-infectious 
			substance must be mediated through the skin or mucous membranes 
			which probably provide further necessary co-factors. 
			 
			A delayed hypersensitivity reaction may be enhanced experimentally 
			by the employment of the antigen in a mineral oil adjuvant with 
			added Mycobacterium tuberculosis or by injection of the antigen 
			directly into the lymphatics. The delayed hypersensitivity response 
			is accompanied by mild to severe inflammation which may cause cell 
			injury and necrosis.  
			
			  
			
			The inflammatory response which occurs in 
			delayed-type hypersensitivity may not be protective, and in many 
			instances may even be harmful (e.g., rejection of grafts is directly 
			linked to delayed hypersensitivity). 
  
			
			  
			
			  
			
			 
			
			IMMUNO-PATHOLOGY OF HYPERSENSITIVITY REACTIONS 
			
			  
			
				
				Immediate Hypersensitivity This is the antibody-type reaction that is a secondary consequence 
			to the beneficial effect of the combination of an antibody with its 
			antigen.   
				
				 
				Arthus-type Reaction This reaction results from the precipitative union of a large amount 
			of antigen with a highly reactive antibody in the blood vessels, and 
			leads to vascular damage. The cascade of events includes spastic 
			contraction of the arterioles, endothelial damage, formation of 
			leukocyte thrombi, exudation of fluid and blood cells into the 
			tissues, and sometimes ischemic necrosis.  
				  
				
				Periarteritis nodosa 
			results from a similar antigen-antibody reaction and is 
				characterized by inflammation of the smaller arteries and 
			periarterial structures. it is accompanied by proliferation of the 
			intima and two types of occlusion:  
				
					
						- 
						
						by proliferation or 
			thrombosis  
						- 
						
						by the formation of nodules containing neutrophils and eosinophils 
						 
					 
				 
				
				 
				Anaphylaxis Injection of antigen and its combination with antibody may cause 
			release from the cells (especially mast-cell fixed basophils) of 
			physiologically active substances such as histamine, serotonin, 
			acetyicholine, slow-reacting substances (SRS) and heparin. 
				 
				  
				
				They act 
			on smooth muscle and blood vessels and cause anaphylactic 
			(hypersensitivity) shock, asthma attack, allergic oedema, rhinitis 
			or hay fever, and accumulation of fluid in the joints.   
				
				 
				Atopy Atopy is caused by the union of antigen 
				- usually pollens, dust, milk, 
			wheat and animal danders - with a peculiar type of antibody (reagin). 
				 
				  
				
				This reaction is relatively heat-labile and cannot be demonstrated 
			by in vitro procedure. It has a special affinity for the skin and 
			for familial predisposition to the disease.  
				  
				
				The reaction is 
			nevertheless similar to other immediate-type sensitivities, with the 
			release of histamine and its manifestation principally as asthma 
			(breathing paralysis), hay fever, urticaria, angioedema and 
			infantile eczema.   
				
				 
				Delayed Hypersensitivity The typical pathology of delayed hypersensitivity due to infectious 
			agents involves perivascular infiltration of lymphocytes and 
			histiocytes with the destruction of the antigen-containing 
			parenchyma in the infiltrated area.  
				  
				
				The visual manifestations may 
			vary from slight erythema and oedema to a violent reaction with 
			progressive tissue destruction and necrosis. Local reactions include 
			papular rose spots of typhoid fever, meningitis and a variety of 
			infectious diseases, and contact sensitivities to plant and chemical 
			substances manifesting as erythema, followed by papule and vesicle 
			formation with resultant tissue damage and desquamation. Systemic 
			reactions may accompany severe local reactions or may result from 
			inhalation of the allergenic substances.
  Humoral antibodies do not seem to play a role in delayed 
			hypersensitivity reaction. The reactivity is transferred only by 
			cells, presumably sensitised lymphocytes, and it is unlikely that 
			histamine or other physiologically active substances play a role in 
			the reaction.  
				  
				
				The reaction extends to any or all tissues where the 
			offending antigen may occur.   
				
				 
				Isoimmunological Disease This is the result of an immunological reaction of a member of the 
			same species to the tissue of another member of the same species. A 
			blood transfusion reaction in a person given an incompatible blood 
			type is a typical example.  
				  
				
				Another example is erythroblastosis 
			fetalis, which results from the transfer of antibodies against the 
			red blood cells of the fetus to the fetal circulation.  
				  
				
				Homograft 
			rejection of tissues or organs between nonisologous members of a 
			species is also immunologically based.   
				
				 
				Immunological Disease Resulting from Adsorption of Foreign 
			Substances Under certain circumstances, foreign substances such as medications 
			may combine with cells to render them antigenic.  
				  
				
				Subsequent exposure 
			to such a foreign substance results in lytic, agglutinative or other 
			types of cell-destructive activity. Such a reaction may involve red 
			blood cells (drug-induced anaemias), platelets (drug-induced 
			thrombocytopemc purpura), and leukocytosis (drug-induced 
			agranulocytosis).
  Bacteria or viruses may also alter cell surfaces by coating or by 
			unmasking antigens through enzymatic activity which may render them 
			vulnerable to immunological destruction.   
				
				 
				Autoimmune Disease Under certain circumstances, the body may respond immunologically to 
			its own components or to intrinsic substances which are related 
			antigenically to the host’s own tissues.  
				  
				
				The circulating antibody or 
				sensitized cells which are produced are then active in causing 
			cellular injury to the tissues or organs of the body which bear the 
			corresponding antigen. 
			 
			
			  
			
			Waksman (1962) proposed several mechanisms of 
			autoimmunization, such 
			as: 
			
				
					- 
					
					Vaccination with organ-specific antigens which are isolated from 
			the lymphatic channels and bloodstream and are not recognized as 
			self when brought into contact with the immunologic process. They 
			are represented in the central and peripheral nervous systems, lens, 
			uvea, testes, thyroid (thyroglobulin), kidneys and other organs.   
					 
					- 
					
					Vaccination against constituents of tissues which have been 
			altered antigenetically by various factors. These include myocardial 
			infarction, X-irradiation, enzymatic or other chemical alteration, 
			and changes induced by infectious disease agents or by drugs. 
			Erythrocytes, platelets and leucocytes are the most affected cells. 
			Various organs may also be affected.    
					- 
					
					Vaccination with heterologous antigens which are sufficiently 
			different to permit an immunological response but sufficiently alike 
			to react with autologous antigens.    
					- 
					
					Alteration of the immunological apparatus so as to result in the 
			failure of recognition of self. This occurs in neoplasia of the 
			lymphatic system and in experimental grafting of immunologically 
			competent heterologous lymphatic tissues under conditions which 
			suppress the host’s response to the graft and give rise to the 
			wasting "runt disease" or "homologous disease".   
					 
					- 
					
					Possible hereditary or other immunological abnormality. This is 
			represented by a hyper-reactivity to antigens or other aberrations 
			without apparent antigenic stimulation. Such mechanisms might be 
			related to certain forms of the "collagen diseases", such as 
			systemic lupus erythematosus in which there is an antibody against a 
			diversity of antigens.    
					- 
					
					Experimentally, Freund’s mineral oil adjuvant (usually with added mycobacteria) and certain bacteria or bacterial toxins may so alter 
			the host as to bring about a ready response to unaltered normal 
			homologous tissue. These "experimental autoallergies" include a wide 
			variety of organs and tissues, and are now being employed as model 
			systems for investigation of autoimmune phenomena.  
				 
			 
			
			Both humoral antibody and 
			sensitized cells may function in 
			autoimmune disease.  
			
			  
			
			Auto-antibodies seem to be involved in reactions 
			with cells which are easily accessible, such as the formed elements 
			of the blood (in haemolytic anaemia, leucopeni thrombocytopenia), 
			vascular endothelium, vascular basement membrane including the 
			glomerulus (in acute glomerulonephritis and ascites cells (neoplastic 
			immunity). 
			 
			Production of lesions in the solid vascularised tissues appears to 
			depend on delayed hypersensitivity reactions with sensitised 
			lymphoid cells (such as in allergic encephalomyeitis, thyroiditis, 
			subacute and chronic glomerulonephritis, orchitis, adrenalitis and 
			many other diseases). 
			 
			It is quite obvious now that the same autoimmune mechanisms are 
			responsible for the same diseases in human beings and that the 
			extent of such damage is enormous and keeps increasing with more and 
			more vaccines added to to "recommended" schedule. 
			 
			Indeed, vaccines such as the pertussis vaccine are actually used to 
			induce autoimmune diseases in laboratory animals, the best and most publicised example being the so-called 
			experimental allergic 
			encephalomyelitis (EAE).  
			
			  
			
			When, as expected, these unfortunate 
			animals develop EAE from the 
			
			pertussis vaccine, the causal link is 
			never disputed; yet when babies after vaccination with the same 
			vaccines develop the same symptoms of EAE as the laboratory animals, 
			the causal link to the administered vaccine is always disputed and 
			usually considered "coincidental". Lately, innocent parents and 
			other carers have been accused of causing the symptoms of vaccine 
			darn age by allegedly shaking their babies. 
			 
			Systemic lupus erythematosus is one of the innumerable recognized 
			side effects of a number of vaccinations. One of the best papers (if 
			not the best on this is by Ayvazian and Badger (1948), and it has 
			not lost any of its punch and relevance since it was published. They 
			describe three cases of nurses who were literally vaccinated to 
			death.  
			
			  
			
			The authors surveyed a group of 750 nurses who trained at a 
			large municipal hospital between 1932 and 1946, and detailed the 
			cases of three nurses who were vaccinated with a multitude of 
			vaccines over a period of time and developed and succumbed to 
			disseminated lupus erythematosus. 
			 
			Typically, these nurses were given the following tests and vaccines 
			in short succession:  
			
				
					- 
					
					the 
					
					Schick test  
					- 
					
					three days later, the 
					
					Dick 
			test  
					- 
					
					seven days later, 
					
					typhoid-paratyphoid vaccine 
					 
					- 
					
					seven days 
			later, another typhoid-paratyphoid vaccine (a double dose) 
					 
					- 
					
					seven 
			days later, the third typhoid-paratyphoid vaccine  
					- 
					
					seven days 
			later, the fourth typhoid-paratyphoid vaccine  
				 
			 
			
			Every time, the 
			recipient developed local erythema and/or fever and malaise, but it 
			did not deter the doctor from administering yet another series of 
			vaccines, starting only 14 days after the first lot of tests and 
			typhoid-paratyphoid vaccines. 
			 
			This time, after all these injections, one of the trainee nurses was 
			given her first injection of scarlet fever streptococcus toxin with 
			"no ill results". One week later, she was given the second injection 
			of streptococcus toxin, after which she developed joint pains and 
			fever. She did not report these reactions to the health office. Nine 
			days later, she returned and received the third injection of a 
			fourfold dose of streptococcus, after which she developed severe 
			arthralgia in the fingers and knees and a sore throat. 
			 
			She was hospitalized for five days and discharged with the diagnosis 
			"Dick-toxin reaction". Only five days later her inoculations were 
			continued, first in lower and then in gradually increasing doses so 
			that the series included a total of 10 instead of the usual seven 
			injections.  
			
			  
			
			Epinephrine was administered with each of these 
			injections of streptococcus toxin and toxin-antitoxin. 
			 
			Two months after the last lot, the trainee nurse was re-admitted to 
			the hospital with swelling and pain of the ankles and toes and 
			tenderness of the joints of both hands, which had been constant 
			since the first Dick test five months earlier. The diagnosis was 
			"rheumatic arthritis". She was given aspirin, but two weeks later 
			the pain came back and she developed chills and fever, sore throat 
			and cough.  
			
			  
			
			One month later, the trainee nurse was re-admitted to 
			hospital for two weeks, and during this admission a streptococcus 
			vaccine was started in small doses, but because of her severe 
			reaction "further vaccines were refused". The diagnosis after this 
			admission was "rheumatoid arthritis and infectious mononucleosis". 
			Four months later, the trainee nurse noticed skin eruptions over her 
			nose and both cheeks, and her saliva became foul. The skin and 
			cheeks, upper lips and the bridge of the nose were covered with 
			purplish red, mottled and indurated rash eruptions.  
			
			  
			
			Two months 
			later, the eruptions spread over much of the body. A year later, the 
			trainee nurse died, but not before developing severe symptoms of 
			high fever, tachycardia, diarrhea and showing abnormal blood tests. 
			 
			It was not enough that this unfortunate trainee nurse died; there 
			were another two cases reported, almost identical to the first case. 
			We shall never know bow many of the remaining 747 trainee nurses 
			developed less lethal, but still health-incapacitating reactions. 
			 
			If someone said that this type of "medical treatment’ had been given 
			to the inmates of the Nazi concentration camps, I would not be 
			surprised. However, this type of "medical treatment" was and is 
			being given with impunity to millions of babies, children, teenagers 
			and adults in so-called free and democratic countries as well as in 
			the Third World.  
			
			  
			
			Meanwhile, the health authorities refuse to accept 
			that vaccines cause such reactions and even deaths. 
  
			
			  
			
			  
			
			 
			VACCINATION - 
			A SAFETY WARNING 
			
			 
			The conclusions which follow the study of relevant medical and 
			immunological 
			literature dealing with vaccines and the adjuvants 
			used in vaccines is that the absolute safety of these substances can 
			never be guaranteed.  
			
			  
			
			According to Gupta et al. (1993), the toxicity 
			of adjuvants can be ascribed in part to the unintended stimulation 
			of various mechanisms of the immune response. That’s why the safety 
			and adjuvancy must be balanced to get the maximum immune stimulation 
			with minimum side effects. 
			 
			My conclusion is that such balance is impossible to achieve, even if 
			we fully understood the immune system and the full spectrum of 
			deleterious effects of foreign antigens and other toxic substances 
			such as vaccine and drug adjuvants and medications on the immune 
			system of humans, and particularly on the immature immune system of 
			babies and small children. Injecting any foreign substance straight 
			into the bloodstream will only cause anaphylactic (sensitization) 
			reactions.  
			
			  
			
			Nature, over thousands and thousands of years, has 
			developed effective immune responses; yet man, without respect for 
			nature, demonstrably causes more harm than good. 
			 
			Vaccination procedures are a highly politically motivated 
			non-science, whose practitioners are only interested in injecting 
			multitudes of vaccines without much interest or care as to their 
			effects. Data collection on reactions to vaccines is only paid lip 
			service, and the obvious ineffectiveness of vaccines to prevent 
			diseases is glossed over. 
			 
			The fact that natural infectious diseases have beneficial effect on 
			the maturation and development of the immune system is ignored or 
			deliberately suppressed. 
			 
			Consequently, parents of small children and any potential recipients 
			of vaccines and any orthodox medications should be wary of any 
			member of the medical establishment (which is little more than a 
			highly politicized business system) extolling the non-existent 
			virtues of vaccination.  
			
			  
			
			Even though Australian law requires doctors 
			to warn patients about all side-effects of all medications and 
			procedures of a material nature, whether the patient asks or not, 
			doctors as a rule do not uphold this important law. 
			
			  
			
			  
			
			  
			
			 
			References 
			(in alphabetical order) 
			
				
				• Aprile, M.A. and 
				Wardlaw, A.C., 1966. Aluminium compounds as adjuvants for 
				vaccines and toxoids in man: A review Can. J. Public Health 
				57:343. 
				• Asa, PB., Cao, Y. and Garry, RF., 2000. Antibodies to Squalene 
				in Gulf War Syndrome. Experimental Molecular Pathology 68:55 - 64. 
				• Ayvazian, L.F. and Badger, TL, 1948. Disseminated lupus 
				erythematosus occurring among student nurses. New England 
				Journal of Medicine 239(16):565 - 570. 
				•Bizzini, B., Carlotti, M. and Fattal-German, M., 1992. 
				Lnduction of various cytokines in mice and activation of the 
				complement system in rats as a part of the mechanism of action 
				of the Corynebacterium granulosum-derived P40 immunomodulator. 
				FEMS Microbiol. Immunol. 105:17 1. 
				• Burnett, F.M., 1960. Theories of immunity. Persp. Biol. Med 
				III:447 - 458. 
				• Butler, N.R., Wilson, B.D.R., Benson, P.F., Dudgeon, J.A. at 
				al, 1962. Response of infants to pertussis vaccine at one week 
				and to poliomyelitis, diphtheria and tetanus vaccine at six 
				months. Lancet ii:112. 
				• Chedid, L, 1985. Adjuvants of immunity. Ann. immunol. (Inst. 
				Pasteur) 136D:283. 
				• Coursaget, P., Yvonnet, B., Relyveld, E.H., Barres, JL. at 
				al., 1986. Simultaneous administration of diphtheria-tetanus-pertussis-polio 
				and hepatitis B vaccines in a simplified immunisalion programme: 
				immune response to diphtheria toxoid, tetanus toxoid, pertussis 
				and hepatitis B surface antigens. Infect, immunity 51:784. 
				• DeVries, P., Van Binnendijk. RS., Van der Marel, P., Van Wezel, 
				A.L. et al, 1988. Measles virus fusion protein presented in an 
				immune-stimulating complex (ISCOM) induces hemolysis-inhibiting 
				and fusioninhibiting antibodies, virus-specific T-cells and 
				protection in mice. J. Gen. Virol. 69:549. 
				• Dolin, P.J., Faal, H., Johnson, G.J., Minassian, D. at aL, 
				1997. Reduction of trachoma in a sub-Saharan village in absence 
				of a disease control programme. Lancet 349:1511 - 1512. 
				• Friedwald, W.F., 1944. Adjuvants in immunization with 
				influenza virus vaccines. J. Exp. Med 80:477 - 491. 
				• Glenny, A.T., Buttle; G.A.H. and Stevens, M.F., 1926. Rate of 
				disappearance of diphtheria toxoid injected into rabbits and 
				guinea pigs: toxoid precipitated with alum. J. Pathol. Bacteriol. 
				34:267. 
				• Grayston, J.T., Wang, S.P., Woolridge, R.L. and Alexander, 
				ER., 1964. Prevention of trachoma with vaccine. Arch. Environ. 
				Health 8:518 - 526. 
				• Gregoriadis, G., 1976. The carrier potential of liposomes in 
				biology and medicine (first of two pasts). New Eng. J. Med. 
				295:765. 
				• Gupta, R.K., Relyved, ER, Lindblad, EB., Bizzini, B. at al., 
				1993. Adjuvants - a balance between toxicity and adjuvanticity. 
				Vaccine 11(4). 
				• Henle, W. and Henle, G., 1945. Effect of adjuvants on 
				vaccination of human beings against influenza. Proc. Soc. Exp. 
				Biol., NY 59:179 - 181. 
				• Hilleman, M.R., 1966. Critical appraisal of emulsified oil 
				adjuvants applied to viral vaccine. Prog. in Med. Virology 
				8:131-182. 
				• Lovgren, K. and Morem, B., 1990. The ISCOM: An antigen 
				delivery system with built-in adjuvant. Mol. immunol. 28:285. 
				• McLaughlin, CA, Schwartzman, S.M., Homer, B.L., Jones, G.H. at 
				al., 1980. Regression of tumors in guinea pigs after treatment 
				with synthetic muramyl dipeptides and trehalose dimycolate. 
				Science 208:415. 
				• Miller, L.F., Peckinpaugh, R.O., Adander, T.R., Pierce, W.E. 
				at al, 1965. Epidemiology of prevention of acute respiratory 
				respiratory disease in naval recruits: II. Efficacy of adjuvant 
				and aqueous adenovirus vaccines in prevention of naval recruits 
				respiratory disease. Am. J. Public Health 55:47 - 59. 
				• Morein, B., Fossum, C., Lovgren, K. and Hoglund, S., 1990. The 
				ISCOM: a modern approach to vaccines. Semin. Virol. 1:49. 
				• Pittman, M., 1984. The concept of pertussis as a 
				toxin-mediated disease. Pediatric infectious Diseases 
				3(5):467 - 486. 
				• Salk, J.E., 1951. Use of adjuvants in studies on influenza 
				vaccination. 3. Degree of persistence of antibody in human 
				subjects two years after vaccination. JAMA 151:1169 - 1175. 
				• Salk, J.E., Lewis, L.J., Younger, J.S. and Bennett, B.L., 
				1953. The use of adjuvants to facilitate studies on the 
				immunologic classification of poliomyelitis viruses. Am. I. Hyg. 
				54:157 - 173. 
				• Wakaman, B.H., 1962. Auto-immunization and the lesions of 
				auto-immunity. Medicine 41:93 - 141. 
			 
			
			 |