Dashefsky B, Wald E, Guerra N, Byers C
University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh, PA 15213.
Pediatrics. 1990 Apr;85(4 Pt 2):682-9.
In 1985, the first capsular polysaccharide (polyribosylribitol-phosphate [PRP]) vaccine for Haemophilus influenzae type b was licensed and recommended for routine use in children between 24 and 60 months of age. In the United States, approximately 75% to 90% of invasive disease due to H influenzae type b occurs in infants younger than 24 months, a population for whom H influenzae type b polysaccharide vaccine is inadequately immunogenic and protective. In an effort to enhance the immunogenicity of H influenzae type b polysaccharide vaccine for children in the most susceptible age groups, conjugate vaccines have been developed in which the capsular PRP of H influenzae type b has been bound to a variety of carrier proteins, thereby conferring the vaccines with thymic-dependent attributes. One such conjugate vaccine, in which the carrier protein is diphtheria toxoid (PRP-D), was licensed in 1987 and has been recommended since 1988 for routine use in children 18 months of age and older. A second conjugate vaccine, in which an oligosaccharide derivative of H influenzae type b capsular PRP is coupled to CRM, a nontoxic mutant diphtheria toxin (oligo-CRM), was licensed in 1988 and is a sanctioned alternative to PRP-D. Another investigational conjugate vaccine, in which the polysaccharide is linked to the outer membrane protein of Neisseria meningitidis group B (PRP-OMPC), has been demonstrated to be both safe and immunogenic when administered in a two-dose schedule to 2- to 6-month-old infants. However, anti-PRP antibody levels decline significantly during the ensuing 10 to 15 months; they rise significantly in response to booster doses of either PRP or PRP-OMPC administered 10 to 15 months after the initial priming doses of PRP-OMPC.(ABSTRACT TRUNCATED AT 250 WORDS)
1985年，第一种用于b型流感嗜血杆菌的荚膜多糖（多聚核糖基核糖醇磷酸[PRP]）疫苗获得许可，并被推荐用于24至60个月大儿童的常规接种。在美国，约75%至90%的b型流感嗜血杆菌侵袭性疾病发生在24个月以下的婴儿中，而b型流感嗜血杆菌多糖疫苗对这一年龄段人群的免疫原性和保护作用不足。为提高b型流感嗜血杆菌多糖疫苗对最易感年龄组儿童的免疫原性，人们研发了结合疫苗，其中b型流感嗜血杆菌的荚膜PRP与多种载体蛋白结合，从而使疫苗具有胸腺依赖性特性。一种这样的结合疫苗，其载体蛋白为白喉类毒素（PRP-D），于1987年获得许可，自1988年起被推荐用于18个月及以上儿童的常规接种。第二种结合疫苗，其中b型流感嗜血杆菌荚膜PRP的寡糖衍生物与CRM（一种无毒的白喉毒素突变体）偶联（寡糖-CRM），于1988年获得许可，是PRP-D的一种认可替代方案。另一种研究性结合疫苗，其中多糖与B群脑膜炎奈瑟菌的外膜蛋白相连（PRP-OMPC），已证明在对2至6个月大婴儿按两剂方案接种时既安全又具有免疫原性。然而，抗PRP抗体水平在随后的10至15个月内显著下降；在最初接种PRP-OMPC的起始剂量10至15个月后接种PRP或PRP-OMPC加强剂量时，抗体水平会显著上升。（摘要截选至250词）
