Becker-Dreps Sylvia, Vilchez Samuel, Bucardo Filemon, Twitchell Erica, Choi Wan Suk, Hudgens Michael G, Perez Johann, Yuan Lijuan
From the *Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; †Department of Microbiology and Parasitology, National Autonomous University of Nicaragua-León, León, Nicaragua; ‡Department of Biomedical Sciences and Pathobiology, Virginia Polytechnic Institute and State University, Blacksburg, Virginia; and §Department of Biostatistics, UNC-Gillings School of Global Public Health, Chapel Hill, North Carolina.
Pediatr Infect Dis J. 2017 Apr;36(4):412-416. doi: 10.1097/INF.0000000000001457.
Environmental enteropathy (EE) is a common intestinal condition among children living in low- and middle-income countries and is associated with diminished enteric immunity to gastrointestinal pathogens, and possibly to oral vaccine antigens. The goal of this study was to examine associations between biomarkers of EE and immunogenicity to the pentavalent rotavirus vaccine (RV5).
Infants were recruited 1 day before their first RV5 immunization in León, Nicaragua, from public health rosters. Infants provided a preimmunization blood and stool sample, and a second blood sample 1 month after receipt of RV5. We measured immunoglobin A (IgA) seroconversion to the first dose of RV5 and concentrations of 4 previously identified fecal biomarkers of EE (alpha-1 antitrypsin, neopterin, myeloperoxidase and calprotectin). We then assessed associations between concentrations of these biomarkers, both individually and as combined scores, and seroconversion to the first dose of RV5.
Of the 43 enrolled infants, 24 (56%) seroconverted after the first dose of RV5. As compared with infants who seroconverted, those who did not seroconvert had higher median concentrations of both myeloperoxidase (3.1 vs. 1.1 µg/mL, P = 0.002) and calprotectin (199.1 vs. 156.2 µg/mL, P = 0.03). Further, those who did not seroconvert had a higher median combined score of the 4 biomarkers as compared with those who seroconverted (6.5 vs. 4.5, P = 0.017).
We found an association between biomarkers of EE and seroconversion to the first dose of RV5. It is possible that interventions that prevent or ameliorate EE may also improve oral rotavirus vaccine response.
环境性肠病（EE）是低收入和中等收入国家儿童中常见的肠道疾病，与肠道对胃肠道病原体以及可能对口服疫苗抗原的免疫力下降有关。本研究的目的是检查EE生物标志物与五价轮状病毒疫苗（RV5）免疫原性之间的关联。
在尼加拉瓜莱昂，从公共卫生名册中招募婴儿，在其首次接种RV5疫苗前1天入组。婴儿提供免疫前血液和粪便样本，并在接种RV5疫苗1个月后提供第二份血液样本。我们测量了对第一剂RV5的免疫球蛋白A（IgA）血清转化以及4种先前确定的EE粪便生物标志物（α-1抗胰蛋白酶、新蝶呤、髓过氧化物酶和钙卫蛋白）的浓度。然后，我们评估了这些生物标志物的浓度（单独以及作为综合评分）与对第一剂RV5血清转化之间的关联。
在43名入组婴儿中，24名（56%）在第一剂RV5接种后发生血清转化。与发生血清转化的婴儿相比，未发生血清转化的婴儿髓过氧化物酶（3.1对1.1µg/mL，P = 0.002）和钙卫蛋白（199.1对156.2µg/mL，P = 0.03）的中位数浓度更高。此外，与发生血清转化的婴儿相比，未发生血清转化的婴儿4种生物标志物的综合评分中位数更高（6.5对4.5，P = 0.017）。
我们发现EE生物标志物与对第一剂RV5的血清转化之间存在关联。预防或改善EE的干预措施也可能改善口服轮状病毒疫苗的反应。
