Parkkali T, Käyhty H, Anttila M, Ruutu T, Wuorimaa T, Soininen A, Volin L, Ruutu P
Division of Haematology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland.
Bone Marrow Transplant. 1999 Sep;24(6):671-8. doi: 10.1038/sj.bmt.1701967.
In a randomized study, 20 adult allogeneic BMT recipients were vaccinated at 6 months and 22 at 18 months after BMT with Haemophilus influenzae type b (Hib)-diphtheria toxoid conjugate vaccine (PRP-D), and 23 recipients at 8 months and 21 at 20 months with pneumococcal polysaccharide (Pnc PS) vaccine. IgG1 and IgG2 subclasses of Pnc PS and Hib antibodies and avidities of Pnc PS IgG antibodies were determined by EIA in sera from patients with at least a two-fold total antibody response to Pnc type 3, 6B, 19F or PRP-D. The Pnc PS vaccine induced predominantly IgG1 Pnc 3 antibody production. Anti-Pnc 6B and 19F responses were mainly IgG2. The time of the Pnc PS vaccination, at 8 or 20 months after BMT, did not influence the IgG subclass response pattern. The PRP-D vaccine induced predominantly IgG2 anti-Hib production in the patients vaccinated at 6 months after BMT. The patients vaccinated at 18 months produced IgG1 and IgG2 antibodies more evenly. The same patient was able to produce predominantly IgG1 subclass antibodies to one antigen, Pnc 3, 6B, 19F or Hib, and IgG2 antibodies to another. The avidities of anti-Pnc 6B and 19F 1 month after vaccination were similar to those before vaccination, anti-Pnc 3 avidity was lower than before vaccination but matured in 15 months. The IgG subclass distribution and avidity were similar in the patients with and without chronic GVHD. In conclusion, the IgG response to Pnc type 3 was predominantly IgG1 as in infants and IgG2 to PRP-D, Pnc 6B, and 19F as in adults. Early vaccination after BMT or the presence of chronic GVHD did not impair the quality of response to Pnc PS and PRP-D vaccines.
在一项随机研究中，20名成年异基因骨髓移植受者在骨髓移植后6个月接种b型流感嗜血杆菌（Hib）-白喉类毒素结合疫苗（PRP-D），22名在18个月时接种；23名受者在8个月时接种肺炎球菌多糖（Pnc PS）疫苗，21名在20个月时接种。对至少对3型、6B型、19F型肺炎球菌或PRP-D产生两倍总抗体反应的患者血清，通过酶免疫分析（EIA）测定Pnc PS和Hib抗体的IgG1和IgG2亚类以及Pnc PS IgG抗体的亲和力。Pnc PS疫苗主要诱导产生IgG1 Pnc 3抗体。抗Pnc 6B和19F反应主要为IgG2。骨髓移植后8个月或20个月接种Pnc PS疫苗的时间，不影响IgG亚类反应模式。PRP-D疫苗在骨髓移植后6个月接种的患者中主要诱导产生IgG2抗Hib抗体。在18个月时接种的患者产生IgG1和IgG2抗体更为均匀。同一患者能够针对一种抗原（Pnc 3、6B、19F或Hib）主要产生IgG1亚类抗体，而针对另一种抗原产生IgG2抗体。接种疫苗1个月后，抗Pnc 6B和19F的亲和力与接种前相似，抗Pnc 3的亲和力低于接种前，但在15个月时成熟。有或无慢性移植物抗宿主病（GVHD）的患者中，IgG亚类分布和亲和力相似。总之，对3型肺炎球菌的IgG反应主要为IgG1，如同婴儿；对PRP-D、Pnc 6B和19F的反应主要为IgG2，如同成人。骨髓移植后早期接种疫苗或存在慢性GVHD并不损害对Pnc PS和PRP-D疫苗的反应质量。
