Clark Carolyn E, Fay Michael P, Chico Martha E, Sandoval Carlos A, Vaca Maritza G, Boyd Alexis, Cooper Philip J, Nutman Thomas B
Laboratory of Parasitic Diseases.
Biostatistics Research Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.
J Infect Dis. 2016 Jun 15;213(12):1996-2004. doi: 10.1093/infdis/jiw066. Epub 2016 Feb 16.
Many studies have documented lower vaccine efficacy among children in low-income countries, compared with their counterparts in high-income countries. This disparity is especially apparent with respect to oral vaccines such as rotavirus and oral polio vaccines. One potential contributing factor is the presence of maternal antenatal helminth infections, which can modulate the infant's developing immune system.
Using a multiplex immunoassay, we tested plasma immunoglobulin A (IgA) or immunoglobulin G (IgG) levels specific for antigens in 9 routinely administered childhood vaccines among 1639 children aged approximately 13 months enrolled in the ECUAVIDA (Ecuador Life) birth cohort study in Ecuador. We compared vaccine responses in 712 children of mothers who tested positive for helminth infections in the last trimester of pregnancy to responses in 927 children of mothers without helminth infection.
Plasma IgA levels specific for antigens in rotavirus vaccine and oral polio vaccine containing poliovirus serotypes 1 and 3 were all significantly higher in children of helminth-infected mothers, compared with children of uninfected mothers. Plasma IgG levels specific for diphtheria, tetanus, pertussis, measles, rubella, and Haemophilus influenzae type b vaccine antigens were comparable between the 2 groups.
Antenatal maternal helminth infections were not associated with reduced antibody responses to infant vaccines, but rather with modestly increased IgA responses to oral vaccines.
许多研究表明,与高收入国家的儿童相比,低收入国家儿童的疫苗效力较低。这种差异在轮状病毒和口服脊髓灰质炎疫苗等口服疫苗方面尤为明显。一个潜在的促成因素是母亲产前感染蠕虫,这可能会调节婴儿正在发育的免疫系统。
我们在厄瓜多尔参加ECUAVIDA(厄瓜多尔生命)出生队列研究的1639名年龄约13个月的儿童中,使用多重免疫测定法检测了9种常规接种的儿童疫苗抗原特异性的血浆免疫球蛋白A(IgA)或免疫球蛋白G(IgG)水平。我们比较了妊娠晚期蠕虫感染检测呈阳性的母亲的712名儿童与未感染蠕虫的母亲的927名儿童的疫苗反应。
与未感染母亲的孩子相比,感染蠕虫母亲的孩子中,轮状病毒疫苗和含有脊髓灰质炎病毒1型和3型的口服脊髓灰质炎疫苗抗原特异性的血浆IgA水平均显著更高。两组之间白喉、破伤风、百日咳、麻疹、风疹和b型流感嗜血杆菌疫苗抗原特异性的血浆IgG水平相当。
产前母亲感染蠕虫与婴儿疫苗抗体反应降低无关,而是与口服疫苗的IgA反应适度增加有关。