Laboratory of Pediatric Infectious Diseases, Radboud Center for Infectious Diseases, Radboud University Medical Center, 6500 HB, Nijmegen, The Netherlands.
Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee 37232.
Cold Spring Harb Perspect Biol. 2017 Dec 1;9(12):a029553. doi: 10.1101/cshperspect.a029553.
Memory responses seen after whole-cell pertussis (wP) and acellular pertussis (aP) vaccine priming are different and reflect better long-term protection against pertussis disease seen with the whole-cell vaccines. Although acellular vaccines generate higher levels of antigen-specific IgG to the antigens included in the aP vaccines, there are many more pertussis antigens included in whole-cell vaccines. Acellular vaccine priming is associated with skewing of the immune response to a more Th2-like response, whereas whole-cell priming is associated with a Th1/Th17 response. Repeated booster doses of acellular vaccine in children primed with acellular vaccine has been shown to result in progressively shorter duration of protection against disease. This may be explained by the generation of higher levels of antigen-specific IgG4, which does not bind complement and leads to a suboptimal inflammatory response and impaired phagocytosis and antimicrobial defense. In contrast, whole-cell priming followed by aP vaccine boosters results in better opsonization, phagocytosis, and complement mediated killing through the preferential induction of IgG1.
全细胞百日咳（wP）和无细胞百日咳（aP）疫苗初免后观察到的记忆应答不同，反映了全细胞疫苗对百日咳疾病的更好的长期保护作用。虽然无细胞疫苗能产生更高水平的针对 aP 疫苗中包含的抗原的特异性 IgG，但全细胞疫苗中包含的百日咳抗原更多。无细胞疫苗初免与免疫应答向更偏向 Th2 样应答的倾斜有关，而全细胞初免与 Th1/Th17 应答有关。在无细胞疫苗初免的儿童中重复加强接种无细胞疫苗已被证明会导致对疾病的保护作用持续时间逐渐缩短。这可能是由于产生了更高水平的抗原特异性 IgG4 所致，该 IgG4 不结合补体，导致炎症反应不佳，吞噬作用和抗菌防御受损。相比之下，全细胞初免后加强接种 aP 疫苗会通过优先诱导 IgG1 导致更好的调理作用、吞噬作用和补体介导的杀伤作用。
