儿童接触全氟化合物的血清疫苗抗体浓度。
Serum vaccine antibody concentrations in children exposed to perfluorinated compounds.
机构信息
Department of Environmental Health, Harvard School of Public Health, 401 Park Dr, EOME 3E-110, Boston, MA 02215, USA.
出版信息
JAMA. 2012 Jan 25;307(4):391-7. doi: 10.1001/jama.2011.2034.
CONTEXT
Perfluorinated compounds (PFCs) have emerged as important food contaminants. They cause immune suppression in a rodent model at serum concentrations similar to those occurring in the US population, but adverse health effects of PFC exposure are poorly understood.
OBJECTIVE
To determine whether PFC exposure is associated with antibody response to childhood vaccinations.
DESIGN, SETTING, AND PARTICIPANTS: Prospective study of a birth cohort from the National Hospital in the Faroe Islands. A total of 656 consecutive singleton births were recruited during 1997-2000, [corrected] and 587 participated in follow-up through 2008.
MAIN OUTCOME MEASURES
Serum antibody concentrations against tetanus and diphtheria toxoids at ages 5 and 7 years.
RESULTS
Similar to results of prior studies in the United States, the PFCs with the highest serum concentrations were perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA). Among PFCs in maternal pregnancy serum, PFOS showed the strongest negative correlations with antibody concentrations at age 5 years, for which a 2-fold greater concentration of exposure was associated with a difference of -39% (95% CI, -55% to -17%) in the diphtheria antibody concentration. PFCs in the child's serum at age 5 years showed uniformly negative associations with antibody levels, especially at age 7 years, except that the tetanus antibody level following PFOS exposure was not statistically significant. In a structural equation model, a 2-fold greater concentration of major PFCs in child serum was associated with a difference of -49% (95% CI, -67% to -23%) in the overall antibody concentration. A 2-fold increase in PFOS and PFOA concentrations at age 5 years was associated with odds ratios between 2.38 (95% CI, 0.89 to 6.35) and 4.20 (95% CI, 1.54 to 11.44) for falling below a clinically protective level of 0.1 IU/mL for tetanus and diphtheria antibodies at age 7 years.
CONCLUSION
Elevated exposures to PFCs were associated with reduced humoral immune response to routine childhood immunizations in children aged 5 and 7 years.
背景
全氟化合物（PFCs）已成为重要的食物污染物。它们在血清浓度类似于美国人群中发生的浓度下，在啮齿动物模型中引起免疫抑制，但 PFC 暴露的不良健康影响知之甚少。
目的
确定 PFC 暴露是否与儿童疫苗接种的抗体反应有关。
设计、地点和参与者：来自法罗群岛国家医院的出生队列的前瞻性研究。1997-2000 年间共招募了 656 例连续单胎出生，并在 2008 年通过随访有 587 例参与。
主要结局测量
5 岁和 7 岁时破伤风和白喉类毒素的血清抗体浓度。
结果
与美国先前研究的结果相似，血清浓度最高的 PFC 是全氟辛烷磺酸（PFOS）和全氟辛酸（PFOA）。在母亲妊娠血清中的 PFC 中，PFOS 与 5 岁时的抗体浓度呈最强的负相关，暴露浓度增加 2 倍与白喉抗体浓度差异 -39%（95%CI，-55%至-17%）相关。5 岁时儿童血清中的 PFC 与抗体水平呈一致的负相关，尤其是在 7 岁时，除了 PFOS 暴露后的破伤风抗体水平没有统计学意义。在结构方程模型中，儿童血清中主要 PFC 的浓度增加 2 倍与总抗体浓度的差异为 -49%（95%CI，-67%至-23%）相关。5 岁时 PFOS 和 PFOA 浓度增加 2 倍与破伤风和白喉抗体低于 7 岁时临床保护水平 0.1IU/mL 的比值比分别为 2.38（95%CI，0.89 至 6.35）和 4.20（95%CI，1.54 至 11.44）。
结论
PFC 暴露水平升高与 5 岁和 7 岁儿童常规儿童免疫接种的体液免疫反应降低有关。
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