title: Acellular and "low" pertussis vaccines: adverse events and the role of mutations.
abstract: OBJECTIVE
  to discuss the current PAHO recommendation that does not support the substitution of traditional cellular DTP vaccine by acellular DTP, and the role of mutations, in humans, as the main cause of rare adverse events, such as epileptic-like convulsions, triggered by pertussis vaccine.
  the main components related to toxic effects of cellular pertussis vaccines are the lipopolysaccharide of bacterial cell wall and pertussis toxin. The removal of part of lipopolysaccharide layer has allowed the creation of a safer cellular pertussis vaccine, with costs comparable to the traditional cellular vaccine, and which may be a substitute for the acellular vaccine.
  
  
  CONCLUSIONS
  The new methodology introduced by Instituto Butantan allows for the development of a new safer pertussis vaccine with low LPS content (Plow), and the use of the lipopolysaccharide obtained in the process in the production of monophosphoryl lipid A. This component has shown potent adjuvant effect when administered together with influenza inactivated vaccine, making possible to reduce the antigen dose, enhancing the production capacity and lowering costs.
authors: Diretora da Divisão Bioindustrial, Instituto Butantan, Av. Vital Brasil 1500, Butantã, São Paulo, SP, Brazil. hisa@butantan.gov.br
authors: Hisako G
authors: HG
authors: Higashi
authors: Expedito
authors: E
authors: Luna
authors: Alexander R
authors: AR
authors: Precioso
authors: Marluce
authors: M
authors: Vilela
authors: Flávia S
authors: FS
authors: Kubrusly
authors: Waldely O
authors: WO
authors: Dias
authors: Isaias
authors: I
authors: Raw
mesh_terms: D003362:Cost-Benefit Analysis; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000009:adverse effects* / Q000235:genetics / Q000276:immunology; D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines / Q000009:adverse effects* / Q000235:genetics / Q000276:immunology; D006801:Humans; D008070:Lipopolysaccharides / Q000009:adverse effects / Q000276:immunology*; D009154:Mutation; D014944:World Health Organization
chemical_list: D015721:Diphtheria-Tetanus-Pertussis Vaccine; D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines; D008070:Lipopolysaccharides