Vaccines are an indispensable weapon in the battle to
prevent disease, both in humans and animals. Provision and protection of the
vaccine supply is so essential that no possible pathogen is beyond
suspicion. So it is with nanobacteria (NB), a potential infectious agent so
new that science is still debating its existence as a "living organism". We
analysed 6 veterinary vaccines and 3 inactivated human polio vaccines
produced in cell culture for NB. We report that 3 of 6
European veterinary vaccines contained NB. Of the 3 distinct lots of
polio vaccine from European manufacturers, 2 lots from manufacturer-1 were
NB-positive and 1 lot from manufacturer-2 was NB-negative. These results
suggest that not all lots of vaccine contain detectable NB. The
public health risk, if any, from nanobacteria is yet to be defined, but
nanobacteria have been found in kidney stones, liver and kidney cyst fluids,
and implicated in kidney stone formation.
In the early 1990s, Drs. Olavi Kajander and Neva
Ciftcioglu, University of Kuopio, Finland discovered a minute self
replicating agent, which was named "nanobacteria", in fetal bovine
serum (FBS) that mediates mineral (calcium phosphate) formation under
conditions found in blood and urine. NB was subsequently found to
contaminate cell cultures widely used in research and to pass through
filters commonly used to sterilize vaccines. Several vaccines are produced
in mammalian cell cultures that were initially or are currently cultured in
media supplemented with FBS. Thus, the question arose, "Could the NB found
in some batches of FBS contaminate some vaccines"?
To detect nanobacteria in these 9 vaccines, the Kuopio
University team cultured the vaccines in routine tissue culture medium
known by prior testing to be free of NB and examined the original
vaccines and cultured vaccines by electron microscopy, and
immunologic tests for NB antigens (immunofluorescent staining, dot blot
assay and ELISA). NB were found 3 of 6 vet vaccine products and 2 of 3 human
vaccine products prepared using FBS. A second question arose, "Even if NB
are present in the culture broth, why were they not removed during the
purification and sterilizing steps of vaccine production"?
Cell culture mediated viral vaccine production requires
the use of cells to propagate large amounts of virus, which is then filtered
to remove contaminates and cells present in the propagation step. The
viruses passing through the filters are then further processed and
inactivated prior to use. NB are in the same size range as certain large
viruses, and may adhere to viruses thus escaping purification steps using
filtration. NB are also resistant to many disinfecting chemicals and
antibiotics. NB can exist intracellularly and grow in the absence of FBS. At
this time it is not known if FBS added to the production cell lines or NB in
the cells lines themselves are the source of NB contamination in these
cases.
The Center for Biologics Evaluation and Research (CBER)
and the U.S. Food and Drug Administration (FDA) learned earlier this
year that some vaccines were manufactured with bovinederived materials
obtained from countries where bovine spongiform encephalopathy (BSE;
mad cow disease) is prevalent or where a substantial risk for BSE exists.
Creutzfeldt-Jakob disease (vCJD), the human equivalent of BSE, has been
attributed to, among other possibilities, eating beef products from cattle
infected with the prion agent of BSE. Although there is no evidence to date
that cases of vCJD are related to the use of vaccines, interestingly a
vaccine lot was withdrawn because of being exposed to FBS from the country
where high risk for this prion disease exists.
The study summarised in the first paragraph will be
presented in the 101st ASM Meeting in Orlando in May 21, 2001
(1.00-2.30pm). The Kuopio teams message to the scientific society in this
presentation will be: More research is needed to understand nanobacteria and
their role in human and animal diseases. To err on the side of safety is no
vice; just as prions and viruses were viewed with scepticism before they
were completely characterised, so concepts of nanobacteria (and the
scientists who study them) will be knocked around until more is known about
NB. Vaccines should be regarded as safe and essential to human health in the
modern age until they are proven otherwise.
Related Literature:
NB have been linked to kidney stones (Ciftcioglu et
al., Kidney International 56:1893-8,1999),
as a kidney stone causative agent (Garcia Cuerpo et
al., Arch Esp Urol 53:291-303, 2000), and
in polycystic kidney disease (Hjelle et al, Kidney
International 57: 2360-2374, 2000).
For a recent review of nanobacteria, (Kajander,
Ciftcioglu, Miller-Hjelle, Hjelle. Current Opinions in Nephrology and
Hypertension 2001 in press).