title: Rapid induction of protective tolerance to potential terrorist agents: a systematic review of low- and ultra-low dose research.
abstract: OBJECTIVE
  To systematically review the literature on the ability of low-dose (LD) and ultra-low-dose (ULD) toxin exposure to prevent and treat biological and chemical threats.
  
  
  METHODS
  Laboratory research articles on protection or treatment from LD or ULD exposure for the 13 high-risk chemical and biological warfare threats were collected and systematically evaluated for quantity and scientific quality using pre-defined methodological criteria.
  
  
  RESULTS
  Over 2600 articles were screened. Only five studies met the inclusion criteria examining stimulation and protective effects of LD- or ULD-exposures to the 13 pre-identified biological and chemical agents. The quality evaluation (QE) of these studies was above average with a mean QE score of 70.6% of maximum. Two articles of fair to good quality reported both protective and treatment efficacy from exposure of animals or humans to LD- and ULD-exposures to toxins of risk in biochemical warfare.
  
  
  CONCLUSIONS
  There is little research on agents of biological and chemical warfare investigating the possible use of LD- and ULD-toxins for protection and treatment. The existing literature is generally of good quality and indicates that rapid induction of protective tolerance is a feasible but under-investigated approach to bioterrorist or biowarfare defense. In our opinion, further research into the role of induced protection with LD- and ULD-toxic agents is needed.
authors.affiliation: Food and Drug Administration, Rockville, MD, USA.
authors.forename: A L
authors.initials: AL
authors.lastname: Szeto
authors.forename: F
authors.initials: F
authors.lastname: Rollwagen
authors.forename: W B
authors.initials: WB
authors.lastname: Jonas
mesh_terms: D001694:Biological Warfare / Q000517:prevention & control; D023482:Bioterrorism / Q000517:prevention & control; D002618:Chemical Warfare / Q000517:prevention & control; D002619:Chemical Warfare Agents / Q000378:metabolism*; D004189:Disaster Planning / Q000379:methods; D006705:Homeopathy / Q000379:methods*; D006801:Humans; D020011:Protective Agents / Q000627:therapeutic use*; D012107:Research Design
chemical_list: D002619:Chemical Warfare Agents; D020011:Protective Agents