老年成人中肺炎球菌结合多糖疫苗与游离多糖疫苗的比较：结合疫苗可引发更好的抗菌免疫反应和免疫记忆。

Comparison of pneumococcal conjugate polysaccharide and free polysaccharide vaccines in elderly adults: conjugate vaccine elicits improved antibacterial immune responses and immunological memory.

作者信息

de Roux Andrés, Schmöle-Thoma B, Siber G R, Hackell J G, Kuhnke A, Ahlers N, Baker S A, Razmpour A, Emini E A, Fernsten P D, Gruber W C, Lockhart S, Burkhardt O, Welte T, Lode H M

机构信息

Center for Respiratory Medicine at the Charlottenburg Castle, Charité Universitätsmedizin Berlin, Berlin, Germany.

出版信息

Clin Infect Dis. 2008 Apr 1;46(7):1015-23. doi: 10.1086/529142.

DOI:10.1086/529142

PMID:18444818

Abstract

BACKGROUND

High functional antibody responses, establishment of immunologic memory, and unambiguous efficacy in infants suggest that an initial dose of conjugated pneumococcal polysaccharide (PnC) vaccine may be of value in a comprehensive adult immunization strategy.

METHODS

We compared the immunogenicity and safety of 7-valent PnC vaccine (7vPnC) with that of 23-valent pneumococcal polysaccharide vaccine (PPV) in adults >/=70 years of age who had not been previously vaccinated with a pneumococcal vaccine. One year later, 7vPnC recipients received a booster dose of either 7vPnC (the 7vPnC/7vPnC group) or PPV (the 7vPnC/PPV group), and PPV recipients received a booster dose of 7vPnC (the PPV/7vPnC group). Immune responses were compared for each of the 7 serotypes common to both vaccines.

RESULTS

Antipolysaccharide enzyme-linked immunosorbent assay antibody concentrations and opsonophagocytic assay titers to the initial dose of 7vPnC were significantly greater than those to the initial dose of PPV for 6 and 5 of 7 serotypes, respectively (P < .01 and P < .05, respectively). 7vPnC/7vPnC induced antibody responses that were similar to those after the first 7vPnC inoculation, and 7vPnC/PPV induced antibody responses that were similar to or greater than antibody responses after administration of PPV alone; PPV/7vPnC induced significantly lower antibacterial responses, compared with those induced by 7vPnC alone, for all serotypes (P < .05).

CONCLUSION

In adults, an initial dose of 7vPnC is likely to elicit higher and potentially more effective levels of antipneumococcal antibodies than is PPV. In contrast with PPV, for which the induction of hyporesponsiveness was observed when used as a priming dose, 7vPnC elicits an immunological state that permits subsequent administration of 7vPnC or PPV to maintain functional antipolysaccharide antibody levels.

摘要

背景

婴儿体内高效的功能性抗体反应、免疫记忆的建立以及明确的疗效表明，在全面的成人免疫策略中，首剂结合肺炎球菌多糖（PnC）疫苗可能具有价值。

方法

我们比较了7价PnC疫苗（7vPnC）与23价肺炎球菌多糖疫苗（PPV）在年龄≥70岁且此前未接种过肺炎球菌疫苗的成年人中的免疫原性和安全性。一年后，7vPnC接种者接受一剂7vPnC加强针（7vPnC/7vPnC组）或PPV加强针（7vPnC/PPV组），PPV接种者接受一剂7vPnC加强针（PPV/7vPnC组）。比较了两种疫苗共有的7种血清型中每种血清型的免疫反应。

结果

对于7种血清型中的6种和5种，7vPnC首剂的抗多糖酶联免疫吸附测定抗体浓度和吞噬调理活性测定滴度分别显著高于PPV首剂（分别为P <.01和P <.05）。7vPnC/7vPnC诱导的抗体反应与首次接种7vPnC后的反应相似，7vPnC/PPV诱导的抗体反应与单独接种PPV后的反应相似或更强；对于所有血清型，PPV/7vPnC诱导的抗菌反应显著低于单独使用7vPnC诱导的反应（P <.05）。