Chen Mee-Yew, Kirkwood Carl D, Bines Julie, Cowley Daniel, Pavlic Daniel, Lee Katherine J, Orsini Francesca, Watts Emma, Barnes Graeme, Danchin Margaret
a Department of Women's and Children's Health , Dunedin School of Medicine, University of Otago , Dunedin , New Zealand.
b RV3 Rotavirus Vaccine Program, Murdoch Childrens Research Institute , Parkville , Victoria , Australia.
Hum Vaccin Immunother. 2017 May 4;13(5):1126-1135. doi: 10.1080/21645515.2016.1274474. Epub 2017 Jan 6.
Maternal antibodies, acquired passively via placenta and/or breast milk, may contribute to the reduced efficacy of oral rotavirus vaccines observed in children in developing countries. This study aimed to investigate the effect of rotavirus specific maternal antibodies on the serum IgA response or stool excretion of vaccine virus after any dose of an oral rotavirus vaccine, RV3-BB, in parallel to a Phase IIa clinical trial conducted at Dunedin Hospital, New Zealand. At the time of the study rotavirus vaccines had not been introduced in New Zealand and the burden of rotavirus disease was evident.
Rotavirus specific IgG and serum neutralizing antibody (SNA) levels in cord blood and IgA levels in colostrum and breast milk samples collected ∼4 weeks, ∼20 weeks and ∼28 weeks after birth were measured. Infants were randomized to receive the first dose of vaccine at 0-5 d (neonatal schedule) or 8 weeks (infant schedule). Breast feeding was with-held for 30 minutes before and after vaccine administration. The relationship between rotavirus specific IgG and SNA levels in cord blood and IgA in colostrum and breast milk at the time of first active dose of RV3-BB vaccine and level of IgA response and stool excretion after 3 doses of vaccine was assessed using linear and logistic regression.
Forty infants received 3 doses of RV3-BB rotavirus vaccine and were included in the analysis of the neonatal and infant groups. Rotavirus specific IgA in colostrum (neonatal schedule group) and breast milk at 4 weeks (infant schedule group) was identified in 14/21 (67%) and 14/17 (82%) of infants respectively. There was little evidence of an association between IgA in colostrum or breast milk IgA at 4 weeks, or between cord IgG or SNA level, and IgA response or stool excretion after 3 doses of RV3-BB, or after one dose (neonatal schedule) (all p>0.05).
The level of IgA in colostrum or breast milk and level of placental IgG and SNA did not impact on the serum IgA response or stool excretion following 3 doses of RV3-BB Rotavirus Vaccine administered using either a neonatal or infant schedule in New Zealand infants.
通过胎盘和/或母乳被动获得的母体抗体，可能是发展中国家儿童口服轮状病毒疫苗效力降低的原因之一。本研究旨在平行于在新西兰达尼丁医院进行的一项IIa期临床试验，调查轮状病毒特异性母体抗体对口服轮状病毒疫苗RV3-BB任何一剂后血清IgA反应或疫苗病毒粪便排泄的影响。在研究期间，新西兰尚未引入轮状病毒疫苗，轮状病毒疾病负担明显。
测量出生后约4周、约20周和约28周采集的脐带血中轮状病毒特异性IgG和血清中和抗体（SNA）水平，以及初乳和母乳样本中的IgA水平。婴儿被随机分为在0-5天（新生儿方案）或8周（婴儿方案）接受第一剂疫苗。在疫苗接种前后30分钟停止母乳喂养。使用线性和逻辑回归评估在首次接种RV3-BB疫苗活性剂量时脐带血中轮状病毒特异性IgG和SNA水平以及初乳和母乳中IgA水平与3剂疫苗后IgA反应水平和粪便排泄之间的关系。
40名婴儿接受了3剂RV3-BB轮状病毒疫苗，并纳入新生儿组和婴儿组的分析。初乳（新生儿方案组）和4周时母乳（婴儿方案组）中的轮状病毒特异性IgA分别在14/21（67%）和14/17（82%）的婴儿中被检测到。几乎没有证据表明初乳或4周时母乳中的IgA，或脐带IgG或SNA水平与3剂RV3-BB后或一剂（新生儿方案）后的IgA反应或粪便排泄之间存在关联（所有p>0.05）。
在新西兰婴儿中，无论是采用新生儿方案还是婴儿方案接种3剂RV3-BB轮状病毒疫苗后，初乳或母乳中的IgA水平以及胎盘IgG和SNA水平均不影响血清IgA反应或粪便排泄。
