Collins Andrea M, Batrawy Sherouk El, Gordon Stephen B, Ferreira Daniela M
Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK.
Vaccine. 2013 Aug 2;31(35):3469-72. doi: 10.1016/j.vaccine.2013.04.062. Epub 2013 May 10.
PspA and pneumolysin (Ply) are important protein vaccine candidates. HIV infection is associated with increased susceptibility to pneumococcal pneumonia and concomitantly high pneumococcal carriage rates. Pneumococcal exposure is immunizing at the mucosa in healthy adults and so we wished to determine if the increased pneumococcal exposure in HIV-infected adults would be associated with altered pneumococcal specific antibody responses. We measured serum and bronchoalveolar lavage (BAL) fluid immunoglobulin (Ig)G and IgA to PspA and Ply in HIV-infected and healthy age-matched adults. Naturally generated anti-Ply and anti-PspA IgG levels but not IgA were significantly increased in HIV-infected subjects in BAL independent of the hyperglobulinaemia commonly associated with HIV. There was therefore no evidence of a defect in mucosal responses to pneumococcal protein antigens among HIV-infected adults. With regard to future vaccination strategies, simply increasing mucosal anti-pneumococcal protein Ig levels, without addressing functional protective response, is not likely to be effective in preventing pneumococcal pneumonia in HIV-infected individuals.
肺炎球菌表面蛋白A（PspA）和肺炎溶血素（Ply）是重要的蛋白质疫苗候选物。HIV感染与肺炎球菌肺炎易感性增加以及随之而来的高肺炎球菌携带率相关。肺炎球菌暴露可在健康成年人的黏膜处产生免疫作用，因此我们希望确定HIV感染成年人中增加的肺炎球菌暴露是否与肺炎球菌特异性抗体反应改变有关。我们检测了年龄匹配的HIV感染成年人和健康成年人血清及支气管肺泡灌洗（BAL）液中针对PspA和Ply的免疫球蛋白（Ig）G和IgA。在HIV感染受试者的BAL中，天然产生的抗Ply和抗PspA IgG水平显著升高，但IgA未升高，这与通常与HIV相关的高球蛋白血症无关。因此，没有证据表明HIV感染成年人对肺炎球菌蛋白抗原的黏膜反应存在缺陷。关于未来的疫苗接种策略，仅仅增加黏膜抗肺炎球菌蛋白Ig水平，而不解决功能性保护反应，不太可能有效预防HIV感染个体的肺炎球菌肺炎。
