Department of Paediatrics, The University of Melbourne, Royal Children's Hospital Melbourne, Parkville, Australia.
Vaccine. 2013 Jun 26;31(30):3098-103. doi: 10.1016/j.vaccine.2013.03.059. Epub 2013 Apr 10.
Bacille Calmette-Guérin (BCG) is one of the most commonly administered vaccines worldwide. In addition to protection against tuberculosis (TB), evidence suggests that BCG immunisation has a number of additional beneficial non-specific immunological effects. These include a reduction in overall infant and child mortality attributable to causes other than TB in high-mortality regions. The antibody response to immunisations provides an opportunity to investigate the influence of BCG on the immune response to unrelated antigens. This study compared the antibody response to routine immunisations in BCG-immunised and non-BCG-immunised infants. BCG-immunised infants were recruited from a related study in which BCG was given at birth and non-BCG-immunised infants were recruited from immunisation clinics. All infants received their routine immunisations according to the Australian National Immunisation Program. Concentrations of antibodies against pneumococcal (anti-Pn Ps), Haemophilus influenzae type B (anti-Hib), tetanus toxoid (anti-TT) and hepatitis B surface (anti-HBs) antigen were measured four weeks after the last (six month) set of infant immunisations. A total of 127 parents agreed for their infants to take part in the study of which 108 were included in the final analysis (56 BCG-immunised and 52 non-BCG-immunised). The geometric mean concentration (GMC) of anti-Pn Ps IgG for all serotypes, anti-Hib IgG and anti-TT IgG were higher in the BCG-immunised group than the non-BCG-immunised group. This difference reached statistical significance for serotype 9V (p<0.01) and 18C (p=0.04). The GMC of anti-HBs IgG was lower in the BCG-immunised group than the non-BCG-immunised group (p=0.03). The majority of participants in both groups had antibody levels above the protective threshold. BCG immunisation at birth influences the antibody response to routine immunisations administered later in infancy. This has important implications for the introduction of both pneumococcal conjugate and novel TB vaccines in resource-limited countries.
卡介苗（BCG）是全球应用最广泛的疫苗之一。除了预防结核病（TB）外，有证据表明，BCG 免疫接种具有许多额外的有益的非特异性免疫作用。这些作用包括在高死亡率地区，降低因 TB 以外的其他原因导致的婴儿和儿童总体死亡率。接种疫苗后的抗体反应为研究 BCG 对与无关抗原的免疫反应的影响提供了机会。本研究比较了 BCG 免疫和非 BCG 免疫婴儿常规免疫接种后的抗体反应。BCG 免疫婴儿是从一项相关研究中招募的，该研究在出生时给予 BCG，而非 BCG 免疫婴儿是从免疫接种诊所招募的。所有婴儿均根据澳大利亚国家免疫计划接受常规免疫接种。在最后一组（六个月）婴儿免疫接种四周后，测量了针对肺炎球菌（anti-Pn Ps）、流感嗜血杆菌 b 型（anti-Hib）、破伤风类毒素（anti-TT）和乙型肝炎表面抗原（anti-HBs）的抗体浓度。共有 127 位家长同意让他们的婴儿参加这项研究，其中 108 位家长最终参与了研究（BCG 免疫组 56 位，非 BCG 免疫组 52 位）。所有血清型的抗 Pn Ps IgG、抗 Hib IgG 和抗 TT IgG 的几何平均浓度（GMC）在 BCG 免疫组中均高于非 BCG 免疫组。9V 血清型（p<0.01）和 18C 血清型（p=0.04）的差异具有统计学意义。BCG 免疫组的抗 HBs IgG 的 GMC 低于非 BCG 免疫组（p=0.03）。两组中的大多数参与者的抗体水平均高于保护阈值。出生时接种 BCG 会影响婴儿后期常规免疫接种后的抗体反应。这对资源有限的国家引入肺炎球菌结合疫苗和新型 TB 疫苗具有重要意义。
