Healy C Mary, Munoz Flor M, Rench Marcia A, Halasa Natasha B, Edwards Kathryn M, Baker Carol J
Section of Infectious Diseases, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
J Infect Dis. 2004 Jul 15;190(2):335-40. doi: 10.1086/421033. Epub 2004 Jun 14.
Passively acquired maternal antibodies protect infants from many pathogens. With increasing reports of infant pertussis, we evaluated pertussis antibodies in maternal-infant paired sera from 1999-2000.
Antibodies to pertussis toxin (PT), filamentous hemagglutinin (FHA), and fimbrial proteins (FIM) were measured by validated IgG-specific enzyme-linked immunosorbant assay (ELISA) in 64 maternal-umbilical cord serum pairs and in 61 of 64 infant sera. Geometric mean concentrations (GMCs) of pertussis antibodies and cord : maternal GMC ratios were calculated.
Mean maternal age and gestation were 29.7 years (range, 19-42) and 39.3 weeks (range, 35.6-40.9), and 81% of mothers were white. GMCs of maternal antibodies at delivery (ELISA units/mL) were 2.4 for PT, 6.9 for FHA, and 13 for FIM. Cord GMCs were 169%, 178%, and 157% of maternal delivery values for PT, FHA, and FIM, respectively, demonstrating active placental transfer (P<.001). Pertussis-specific IgG values for each antigen decayed to below the threshold of detection by age 2 months.
Despite efficient placental transfer, low maternal pertussis antibody levels and their rapid decay in infant sera leave infants with little humoral protection against pertussis. These data support the rationale for maternal or neonatal immunization, with acellular pertussis vaccines, to prevent life-threatening pertussis in early infancy.
被动获得的母体抗体可保护婴儿免受多种病原体侵害。随着婴儿百日咳报告的增加，我们评估了1999 - 2000年母婴配对血清中的百日咳抗体。
采用经过验证的IgG特异性酶联免疫吸附测定（ELISA）法，检测了64对母婴血清（母亲血清和脐带血血清）以及64份婴儿血清中的61份，以测定针对百日咳毒素（PT）、丝状血凝素（FHA）和菌毛蛋白（FIM）的抗体。计算了百日咳抗体的几何平均浓度（GMCs）以及脐带血与母亲血清的GMC比值。
母亲的平均年龄和孕周分别为29.7岁（范围19 - 42岁）和39.3周（范围35.6 - 40.9周），81%的母亲为白人。分娩时母体抗体的GMCs（ELISA单位/毫升），PT为2.4，FHA为6.9，FIM为13。脐带血GMCs分别为母体分娩时PT、FHA和FIM值的169%、178%和157%，表明存在活跃的胎盘转运（P<0.001）。每种抗原的百日咳特异性IgG值在2个月龄时均降至检测阈值以下。
尽管胎盘转运效率较高，但母体百日咳抗体水平较低且在婴儿血清中迅速衰减，使得婴儿几乎没有针对百日咳的体液免疫保护。这些数据支持了使用无细胞百日咳疫苗对母亲或新生儿进行免疫接种以预防婴儿早期危及生命的百日咳的理论依据。
