肺炎球菌结合疫苗不会在复发性急性中耳炎患儿中诱导持续的黏膜IgA反应。

Pneumococcal conjugate vaccination does not induce a persisting mucosal IgA response in children with recurrent acute otitis media.

作者信息

Bogaert D, Veenhoven R H, Ramdin R, Luijendijk I H T, Rijkers G T, Sanders E A M, de Groot R, Hermans P W M

机构信息

Laboratory of Pediatrics, Department of Pediatrics, University Medical Center Rotterdam, Erasmus MC-Sophia Rotterdam, Room Ee 1500, Dr. Molewaterplein 50, 3015 GE Rotterdam, The Netherlands.

出版信息

Vaccine. 2005 Apr 8;23(20):2607-13. doi: 10.1016/j.vaccine.2004.11.033.

DOI:10.1016/j.vaccine.2004.11.033

PMID:15780443

Abstract

AIM

In a prospective controlled study in young children with a history of recurrent acute otitis media, we analyzed the salivary IgA and IgG antibody titers upon vaccination with a 7-valent pneumococcal conjugate vaccine (PCV) given once or twice, followed by a 23-valent polysaccharide booster vaccination.

METHODS

Salivary IgA and IgG antibody concentrations to vaccine serotype 6B, 14, 18C and 19F were measured by enzyme immunoassay in 38 samples of children vaccinated with PCV and 45 control samples. In the PCV group, 12 samples were taken prior to vaccination, 12 samples 4 weeks after the polysaccharide booster (8 months after the first conjugate vaccination) and 14 samples 7 months after the last vaccination (14 months after the first conjugate vaccination). In the control group 15 children were sampled at each of these three time points.

RESULTS

We observed an increase in salivary IgG antibody concentrations against serotype 6B, 14, and 18C 14 months after the primary vaccination in children vaccinated with PCV twice, although this was significant for serotype 14 only. There was no increase in salivary IgG antibody in children vaccinate with PCV once nor in control children. IgA antibody titers increased significantly after 8 and after 14 months in both the pneumococcal vaccine recipients and the controls. However, the observed increase in mean antibody titers was significantly higher in control children compared to the PCV group.

CONCLUSION

We suggest that repeated pneumococcal conjugate vaccination is necessary to induce an increase in salivary IgG antibodies and effectuate clearance of S. pneumoniae from the nasopharyngeal mucosa of children with recurrent acute otitis media. We hypothesize that the increase in salivary IgA is caused by the local boosting of the mucosal immune response by carriage and recurrent infections, which occurs less often in the PCV group compared to the control children.

摘要

目的

在一项针对有复发性急性中耳炎病史的幼儿的前瞻性对照研究中，我们分析了接种一剂或两剂7价肺炎球菌结合疫苗（PCV）后再接种一剂23价多糖加强疫苗时唾液中IgA和IgG抗体滴度。

方法

通过酶免疫测定法测量了38例接种PCV疫苗儿童的样本和45例对照样本中针对疫苗血清型6B、14、18C和19F的唾液IgA和IgG抗体浓度。在PCV组中，12个样本在接种疫苗前采集，12个样本在多糖加强疫苗接种后4周（首次结合疫苗接种后8个月）采集，14个样本在最后一次接种后7个月（首次结合疫苗接种后14个月）采集。在对照组中，在这三个时间点各采集15名儿童的样本。

结果

我们观察到，在接种两剂PCV的儿童中，初次接种疫苗14个月后，针对血清型6B、14和18C的唾液IgG抗体浓度有所增加，不过仅血清型14的增加具有统计学意义。接种一剂PCV的儿童和对照儿童的唾液IgG抗体均未增加。肺炎球菌疫苗接种者和对照儿童在8个月和14个月后IgA抗体滴度均显著增加。然而，与PCV组相比，对照儿童中观察到的平均抗体滴度增加显著更高。