13价肺炎球菌结合疫苗在有基础疾病儿童中的免疫原性。
Immunogenicity of 13-valent pneumococcal conjugate vaccine among children with underlying medical conditions.
作者信息
Jallow Sabelle, Madhi Shabir A, Madimabe Richard, Sipambo Nosisa, Violari Avy, Kala Udai, Petersen Karen, Naidoo Sanushka, Verwey Charl, Moore David P, Nunes Marta C
机构信息
Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa; Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa; National Institute for Communicable Diseases: A Division of National Health Laboratory Service, Centre for Vaccines and Immunology, Johannesburg, South Africa.
Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa; Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa.
出版信息
Vaccine. 2017 Aug 3;35(34):4321-4329. doi: 10.1016/j.vaccine.2017.06.081. Epub 2017 Jul 5.
BACKGROUND
Streptococcus pneumoniae is a leading cause of vaccine-preventable disease in children under 5years. Immunocompromised children and those with underlying diseases are at increased risk of severe complications from vaccine-preventable infections. We studied the humoral immune response to the 13-valent pneumococcal conjugate vaccine (PCV13) in children with HIV-infection, kidney or lung disease and compared this to the response in healthy control children.
METHODS
Children aged 12-71months with underlying conditions including HIV-infection and those with kidney and lung diseases (at-risk children), and a healthy control group were vaccinated with PCV13. The at-risk children received two doses of PCV13 and the controls received one dose. Serotype-specific antibodies for all PCV13 serotypes were measured by a luminex-based enzyme immunoassay at baseline and post-vaccination.
RESULTS
After the first PCV13 dose, the fold-increase in serotype-specific antibody geometric mean concentrations (GMCs) from baseline and the percentage of participants with ≥4-fold-increase in antibody concentrations was similar between the control and at-risk children. GMCs were, however, lower for three of the 13 serotypes in HIV-infected children, higher for serotype 6B in children with kidney disease and higher for serotypes 6B and 14 in children with lung disease. After second vaccine dose HIV-infected children had an increase in GMCs from post-first dose for nine serotypes but the percentage of participants with ≥4-fold-increase from baseline was similar post-second dose compared to post-first dose except for serotypes 6A and 19F. In children with kidney or lung diseases the immune responses after second vaccine dose were similar to post-first dose. Attenuated responses were observed for serotypes 3 and 19A in all study-groups, which was especially pronounced in the at-risk groups.
CONCLUSION
All study-groups mounted an immune response to PCV13, with the at-risk groups having responses that were mostly similar to the control children.
背景
肺炎链球菌是5岁以下儿童疫苗可预防疾病的主要病因。免疫功能低下的儿童和患有基础疾病的儿童因疫苗可预防感染而发生严重并发症的风险增加。我们研究了感染HIV、患有肾脏或肺部疾病的儿童对13价肺炎球菌结合疫苗（PCV13）的体液免疫反应，并将其与健康对照儿童的反应进行比较。
方法
对年龄在12 - 71个月、患有包括HIV感染以及肾脏和肺部疾病等基础疾病的儿童（高危儿童）和一个健康对照组接种PCV13。高危儿童接种两剂PCV13，对照组接种一剂。在基线和接种疫苗后，通过基于微珠的酶免疫测定法测量所有PCV13血清型的血清型特异性抗体。
结果
在接种第一剂PCV13后，对照儿童和高危儿童血清型特异性抗体几何平均浓度（GMCs）较基线的增加倍数以及抗体浓度增加≥4倍的参与者百分比相似。然而，HIV感染儿童中13种血清型中的3种血清型的GMCs较低，肾病儿童中6B血清型的GMCs较高，肺病儿童中6B和14血清型的GMCs较高。在接种第二剂疫苗后，HIV感染儿童9种血清型的GMCs较第一剂接种后有所增加，但与第一剂接种后相比，除6A和19F血清型外，第二剂接种后抗体浓度增加≥4倍的参与者百分比相似。在患有肾脏或肺部疾病的儿童中，第二剂疫苗接种后的免疫反应与第一剂接种后相似。在所有研究组中均观察到3型和19A型血清型的免疫反应减弱，在高危组中尤为明显。
结论
所有研究组均对PCV13产生了免疫反应，高危组的反应大多与对照儿童相似。
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