Tables for estimating the mean of distribution of logarithms of titers based on data with a pooled serum sample

Adverse neuropsychiatric effects of antimalarial drugs

INTRODUCTION

Antimalarial drugs are the primary weapon to treat parasite infection, save lives, and curtail further transmission. Accumulating data have indicated that at least some antimalarial drugs may contribute to severe neurological and/or psychiatric side effects which further complicates their use and limits the pool of available medications.

AREAS COVERED

In this review article, we summarize published scientific studies in search of evidence of the neuropsychiatric effects that may be attributed to the commonly used antimalarial drugs administered alone or in combination. Each individual drug was used as a search term in addition to keywords such as neuropsychiatric, adverse events, and neurotoxicity.

EXPERT OPINION

Accumulating data based on published reports over several decades have suggested that among the major commonly used antimalarial drugs, only mefloquine exhibited clear indications of serious neurological and/or psychiatric side effects. A more systematic approach to assess the neuropsychiatric adverse effects of new or repurposed antimalarial drugs on their safety, tolerability and efficacy phases of clinical studies and in post-marketing surveillance, is needed to ensure that these life-saving tools remain available and can be prescribed with appropriate caution and medical judgment.

Experimental clioquinol intoxication in rats: abnormalities in optic nerves and small nerve cells of dorsal root ganglia

Pathological abnormalities in the central (CNS) and peripheral nervous system (PNS) were produced in rats by daily administration of 300-400 mg/kg clioquinol for 7-40 days. The changes comprised axonal degeneration of optic nerve fibers and mitochondrial swellings in small nerve cells of dorsal root ganglia. There were occasional myelin splittings in the spinal nerve roots. No apparent changes were observed in the spinal cord or peripheral nerves. Similar changes were occasionally encountered to a lesser extent in control rats by restricting the diet and water to maintain the body weight comparable to the ranges of experimental animals. It seemed that not only clioquinol intoxication but nutritional deficiency also contributed, in part, to the production of these CNS and PNS abnormalities. The possibility of the presence of peripheral neuropathy in subacute myelooptic neuropathy is discussed.

Standardization of the national reference anti-HBs immunoglobulin by radioimmunoassay

The method for assaying potency of anti-HBs immunoglobulin (HBIG) developed in our Department was applied to the standardization of the Japanese national reference HBIG preparation which is specified in the Minimum Requirements for Biological Products. The method was studied for utility in routine anti-HBs determination. The reference HBIG preparation proved to be satisfactorily stable.

The subacute neurotoxicity of excess pyridoxine HCl and clioquinol (5-chloro-7-iodo-8-hydroxyquinoline) in beagle dogs. II. Pathology

The lesions caused by excess oral pyridoxine hydrochloride (150 mg/kg body weight/day) and clioquinol (200 mg/kg body weight/day), given individually and in combination to adult Beagle dogs, were evaluated. The experimental period was 100 to 112 days, except that four dogs in each of the clioquinol and combined-treatment groups were killed early because of severe debilitation or neurologic disease, and one dog given both compounds died on the third day of compound administration. Degenerative neurologic lesions had distribution specific for the compound given. Pyridoxine-treated dogs had lesions limited to tracts and nerves with neuronal bodies of their nerve fibers in the spinal and trigeminal ganglia. Clioquinol-treated dogs had neurologic lesions limited to the central nervous system. The most lesions were in the rostral dorsal funiculus and distal aspects of the optic nerve fibers, but minimal to mild degenerative changes also occurred in distal aspects of the corticospinal and spinocerebellar tracts. Dogs given both pyridoxine hydrochloride and clioquinol had a combination of the lesions in dogs given pyridoxine or clioquinol individually. Several dogs given clioquinol or pyridoxine plus clioquinol had extraneural lesions, including myocardial degeneration and thyroidal alterations.

Effects of adjuvants on the immunogenicity of Habu-venom toxoid in the monkey and the guinea pig

Incorporation of aluminum adjuvant as large an amount as 1 mg/ml (as Al) in immunization was required to produce high antibody titers against Habu-venom toxoid. The adjuvanticity of aluminum hydroxide was superior to that of aluminum phosphate. When used in combination with poly-L-lysine, a smaller amount of aluminum was needed to produce the same level of antibody titer as that produced with aluminum alone.