anti-tetanus immunoglobulin (Tetglob)

Adult Seroprotection Gaps Against Diphtheria and Tetanus in Urban China: Repeated Cross-Sectional Serosurveillance in Pudong, Shanghai, 2017-2025.

Cheng Wanran W, Li Juan J, Yang Tian T, Bai Yu Y et al.

Background: Adult susceptibility to diphtheria and tetanus may increase as vaccine-induced immunity wanes, yet repeated population-based serosurveillance data in China are limited. Methods: We analyzed annual serosurveys conducted in Pudong New Area, Shanghai, China, from 2017 to 2025 among healthy adults aged 20-49 years. Diphtheria and tetanus IgG concentrations were measured by ELISA. Seroprotection was defined as antibody concentration ≥0.1 IU/mL. Antibody concentrations were further categorized as <0.01, 0.01-<0.1, 0.1-<1.0, and ≥1.0 IU/mL, and geometric mean concentrations (GMCs) were calculated. Multivariable logistic regression models were fitted to assess factors associated with non-protection, including survey year, age group, and household registration. Sensitivity analyses excluding the 2018 survey year were conducted. Results: A total of 2376 serum samples were included. Overall seroprotection was 21.46% for diphtheria and 13.80% for tetanus. The proportion protected against both antigens was 9.05%, while 73.78% showed concurrent non-protection against both antigens. The overall GMC was 0.032 IU/mL (95% CI: 0.030-0.034) for diphtheria and 0.018 IU/mL (95% CI: 0.017-0.019) for tetanus. Concentrations ≥1.0 IU/mL were uncommon for both antigens. Adults aged 40-49 years had higher odds of non-protection than those aged 20-29 years for diphtheria (OR: 2.43, 95% CI: 1.85-3.21) and tetanus (OR: 2.94, 95% CI: 2.11-4.13). Non-local residents also had higher odds of non-protection than local residents for diphtheria (OR: 1.55, 95% CI: 1.24-1.93) and tetanus (OR: 2.81, 95% CI: 2.15-3.69). Seroprotection varied across survey years, with a marked nadir in 2018. Sensitivity analyses excluding 2018 attenuated most year-specific associations, whereas age- and residence-related differences persisted. Conclusions: Healthy adults aged 20-49 years in Pudong showed low seroprotection and low GMCs against both diphtheria and tetanus, with a high proportion concurrently non-protected against both antigens. These findings highlight a persistent adult immunity gap and support further evaluation of adult booster strategies and enhanced serosurveillance.

SARS-CoV-2 mRNA Vaccination Induces Neutralizing Antibodies and Type I IFN Changes in People Living With HIV.

Frasca Federica F, Maddaloni Luca L, D'Auria Alessandra A, Fracella Matteo M et al.

This study examined changes in anti-Spike (anti-S) antibodies (Abs) and type I interferon (IFN-I) following the BNT162b2 vaccine in people living with HIV (PLWH) and analyzed the impact of demographic and immunological factors. In total, 75 PLWH and 28 healthy donors were followed at baseline (T0), at the second dose (T1), after the second dose (T2), and more than 1 year later (T3). Anti-S Abs were assessed by chemiluminescence and vesicular stomatitis virus (VSV)-based pseudo virus-neutralization assay, while IFN-α2, IFN-β, and IFN-ω mRNA levels were measured by RT-Real Time PCR. PLWH showed an increase in anti-S Immunoglobulin G (IgG) levels comparable to healthy donors (p < 0.001) and an induction of anti-S neutralizing Abs (p < 0.014 for T2 vs. T3). Age, gender, CD4+ T cell count, exposure to combined antiretroviral therapy (cART) and IFN-I levels at T0 did not affect the anti-S IgG production. IFN-I gene expression showed temporal changes, with a decrease at T2 (p < 0.01) and a subsequent increase at T3 (p < 0.001, for IFN-α2 and IFN-ω). A multivariable model revealed no overall change in the IFN-I response over time, except for IFN-β, which was lower at T3 than at T1 (p = 0.032). CD4+ T cell count was positively correlated with the IFN-I response (p < 0.05). These results suggest that mRNA vaccination can elicit an effective anti-S response and modulate the IFN-β gene expression in PLWH, with CD4+ T cell count being a key determinant of vaccine-induced changes in IFN.

Diagnostic pitfall: NSAID-induced membranous nephropathy with PLA2R positivity, IgG1-predominant deposits, C1q positivity, and concurrent acute interstitial nephritis-A case report.

Li Jingzhen J, Zhang Qianqian Q, Chen Zhengyue Z, Qiu Yingyin Y et al.

Serum anti-phospholipase A2 receptor (PLA2R) antibody is widely used to diagnose primary membranous nephropathy (MN), but PLA2R positivity also occurs in secondary MN, especially nonsteroidal anti-inflammatory drug (NSAID)-induced MN, leading to a common diagnostic pitfall. We report a 71-year-old female with long-term unsupervised NSAID administration for polymyalgia rheumatica, presenting with recurrent nephrotic syndrome and acute kidney injury. Initial laboratory tests revealed severe hypoalbuminemia (15.7 g/L), elevated serum creatinine (3.98 mg/dL), massive proteinuria (10.24 g/24 h), and positive anti-PLA2R antibody (39.69 U/mL). The etiology of her first nephrotic episode remained unclear, and renal biopsy during disease relapse finally confirmed NSAID-induced secondary MN. Pathological examination demonstrated PLA2R-positive MN with immunoglobulin G1 (IgG1)-predominant immune deposits, moderate (2+) glomerular complement component 1q (C1q) deposition, and concomitant severe acute interstitial nephritis. The patient achieved clinical remission after NSAID discontinuation and treatment with intravenous methylprednisolone combined with rituximab, but disease relapse occurred after inadvertent NSAID re-exposure. This case highlights that PLA2R positivity does not exclude drug-induced secondary MN. IgG subclass profiling and C1q staining are critical complementary biomarkers for precise differential diagnosis and can effectively prevent the common diagnostic pitfall of attributing PLA2R positivity exclusively to primary MN. Permanent NSAID discontinuation remains the cornerstone of disease management.

Management of Refractory Eosinophilic Fasciitis Using Biologic Therapies, Janus Kinase Inhibitors, and Intravenous Immunoglobulin: A Systematic Review.

Mitwalli Mohammed M, Waked Jihad Abou Ali JAA, Sood Siddhartha S, Abduelmula Abrahim A et al.