Telethon Institute for Child Health Research, Centre for Child Health Research, 100 Roberts Road, Perth, WA 6008, Australia.
Vaccine. 2013 Feb 27;31(10):1393-9. doi: 10.1016/j.vaccine.2012.12.078. Epub 2013 Jan 9.
Recurrent acute otitis media (AOM), frequently caused by Streptococcus pneumoniae, is a major paediatric health problem. A reduced antibody response against pneumococcal polysaccharides may contribute to an increased susceptibility to AOM. Using a multiplex bead-based assay we measured IgG, IgG1 and IgG2 levels against 11 pneumococcal polysaccharides in serum samples from 166 children below 3 years of age with a history of at least 3 episodes of acute otitis media receiving ventilation tubes, and 61 healthy controls. Pneumococcal serotype specific IgG was also determined in 144 middle ear effusion samples. Pneumococcal serotype specific IgG, IgG1 and IgG2 levels were similar in children with or without AOM, except for IgG and IgG1 levels against serotype 5, which were significantly higher in children with a history of frequent AOM (IgG: 137.5 μg/ml vs. 84.0 μg/ml; p=0.02; IgG1: 24.5 μg/ml vs. 18.2 μg/ml; p=0.05). The age-related development of pneumococcal serotype-specific IgG, IgG1 and IgG2 levels was similar in children with or without a history of AOM. Pneumococcal serotype specific IgG was present in middle ear effusion and these levels correlated significantly with serum titres. Children with a history of frequent AOM receiving ventilation tubes do not have a deficient IgG, IgG1 or IgG2 response against pneumococcal polysaccharides, either induced by vaccination or due to natural exposure. The strong correlation between IgG levels in serum and the middle ear suggests parenteral pneumococcal conjugate vaccination induces antibodies in the middle ear which may therefore contribute to reducing the burden of AOM.
复发性急性中耳炎（AOM），常由肺炎链球菌引起，是儿童健康的主要问题。针对肺炎球菌多糖的抗体反应减弱可能导致对 AOM 的易感性增加。我们使用基于多重微球的检测方法，测量了 166 名 3 岁以下有至少 3 次急性中耳炎病史并接受通气管治疗的儿童和 61 名健康对照者血清样本中针对 11 种肺炎球菌多糖的 IgG、IgG1 和 IgG2 水平。还在 144 份中耳积液样本中测定了肺炎球菌血清型特异性 IgG。在有无 AOM 的儿童中，肺炎球菌血清型特异性 IgG、IgG1 和 IgG2 水平相似，除了针对血清型 5 的 IgG 和 IgG1 水平，有频繁 AOM 病史的儿童明显更高（IgG：137.5 μg/ml 比 84.0 μg/ml；p=0.02；IgG1：24.5 μg/ml 比 18.2 μg/ml；p=0.05）。有无 AOM 病史的儿童的肺炎球菌血清型特异性 IgG、IgG1 和 IgG2 水平的年龄相关性发育相似。肺炎球菌血清型特异性 IgG 存在于中耳积液中，且这些水平与血清滴度显著相关。接受通气管治疗的有频繁 AOM 病史的儿童对肺炎球菌多糖既没有针对疫苗诱导或自然暴露的缺陷 IgG、IgG1 或 IgG2 反应。血清 IgG 水平与中耳之间的强相关性表明，肺炎球菌结合疫苗的全身接种会在中耳诱导产生抗体，因此可能有助于减轻 AOM 的负担。
