急性中耳炎患儿对肺炎球菌蛋白肺炎球菌表面黏附素A和肺炎溶血素的抗体反应。
Antibody response to the pneumococcal proteins pneumococcal surface adhesin A and pneumolysin in children with acute otitis media.
作者信息
Rapola S, Kilpi T, Lahdenkari M, Mäkelä P H, Käyhty H
机构信息
National Public Health Institute, Helsinki, Finland.
出版信息
Pediatr Infect Dis J. 2001 May;20(5):482-7. doi: 10.1097/00006454-200105000-00003.
BACKGROUND
Pneumococcal surface adhesin A (PsaA) and pneumolysin (Ply) are common to virtually all Streptococcus pneumoniae isolates, and they are immunogenic and protective against pneumococcal challenge in experimental animals. We have recently shown production of antibodies to PsaA and Ply in young children, but data on the immune response to these antigens during culture-confirmed pneumococcal infection are lacking.
OBJECTIVES
To evaluate whether young children respond to S. pneumoniae by producing antibodies to PsaA and Ply during acute otitis media (AOM).
SUBJECTS AND METHODS
A cohort of 329 children was followed prospectively from the age of 2 months to the age of 2 years. Paired sera were obtained during episodes of AOM and used to measure antibodies to PsaA and Ply by enzyme-linked immunosorbent assay. S. pneumoniae cultured from the middle ear fluid was taken as evidence of pneumococcal AOM. The presence of S. pneumoniae in the nasopharyngeal aspirate collected in connection of AOM or any other respiratory infection or in the nasopharyngeal swab collected at scheduled visits was taken to indicate pneumococcal carriage and thus a history of previous contact with S. pneumoniae.
RESULTS
Children with previous pneumococcal contacts had high anti-PsaA and anti-Ply concentrations in the acute phase sera regardless of the nature (AOM or carriage) of the current pneumococcal contact. Of the children with no previous pneumococcal contact, those with current pneumococcal AOM had lower antibody concentrations than those with current pneumococcal carriage only. Anti-PsaA and anti-Ply responses were found in children with current pneumococcal contact. The antibody response was strongly associated with low acute phase antibody concentration, but not significantly with age and the nature of the current pneumococcal contact.
CONCLUSIONS
We showed that infants are capable of developing a specific antibody response to the pneumococcal proteins PsaA and Ply during AOM.
背景
肺炎球菌表面黏附素A（PsaA）和肺炎球菌溶血素（Ply）几乎存在于所有肺炎链球菌分离株中，具有免疫原性，且在实验动物中对肺炎球菌攻击具有保护作用。我们最近发现幼儿体内可产生针对PsaA和Ply的抗体，但缺乏关于培养确诊的肺炎球菌感染期间对这些抗原免疫反应的数据。
目的
评估幼儿在急性中耳炎（AOM）期间是否通过产生针对PsaA和Ply的抗体来应对肺炎链球菌感染。
对象与方法
对329名儿童进行前瞻性随访，从2个月大至2岁。在AOM发作期间采集配对血清，通过酶联免疫吸附测定法检测针对PsaA和Ply的抗体。从中耳液培养出的肺炎链球菌作为肺炎球菌性AOM的证据。在AOM或任何其他呼吸道感染时采集的鼻咽抽吸物中或在定期就诊时采集的鼻咽拭子中检测到肺炎链球菌，表明存在肺炎球菌携带，即既往有肺炎链球菌接触史。
结果
既往有肺炎球菌接触史的儿童，无论当前肺炎球菌接触的性质（AOM或携带）如何，急性期血清中抗PsaA和抗Ply浓度均较高。在既往无肺炎球菌接触史的儿童中，当前患有肺炎球菌性AOM的儿童抗体浓度低于仅当前有肺炎球菌携带的儿童。在当前有肺炎球菌接触的儿童中发现了抗PsaA和抗Ply反应。抗体反应与急性期低抗体浓度密切相关，但与年龄和当前肺炎球菌接触的性质无显著关联。
结论
我们发现婴儿在AOM期间能够对肺炎球菌蛋白PsaA和Ply产生特异性抗体反应。
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