Department of Medicine, University of Washington, Seattle, WA, USA.
Department of Global Health, George Washington University Milliken School of Public Health, Washington, DC, USA.
J Clin Virol. 2017 Oct;95:90-95. doi: 10.1016/j.jcv.2017.08.017. Epub 2017 Sep 2.
Respiratory syncytial virus (RSV) is the most important viral cause of pneumonia in children. RSV-specific antibody (ab) protects infants from disease, and may be increased by a potential strategy of maternal RSV vaccination.
To describe the effect of RSV antibody on RSV infection risk in infants in a resource-limited setting.
In a prospective study in Nepal, women were enrolled during pregnancy and maternal and infant cord blood were collected at birth. Weekly surveillance for respiratory illness was performed from birth to 180days. Nasal swabs were tested for RSV by PCR and serum was tested using an RSV antibody microneutralization assay. Antibody concentrations at time of RSV infection were estimated based on a decay rate of 0.026 log/day.
Cord:maternal RSV antibody transfer ratio was 1.03 (0.88-1.19), with RSV antibody concentration of log 11.3 and log 11.7 in 310 paired maternal and infant samples, respectively. Cord blood RSV antibody was log 12.1 versus 11.6 in those with or without RSV infection (P=0.86). Among infants with RSV infection, estimated RSV antibody concentration at time of infection did not differ in infants with upper (n=8; log 10.7) versus lower respiratory tract infection (n=21; log 9.8; P=0.37). Cord blood RSV antibody concentrations did not correlate with age at primary RSV infection (R=0.11; P=0.57).
Transplacental transfer of RSV antibody from mother to the fetus was highly efficient in mother-infant pairs in rural Nepal, though higher antibody concentrations were not protective against earlier or more severe RSV infection in infants.
呼吸道合胞病毒（RSV）是导致儿童肺炎的最重要的病毒病原体。RSV 特异性抗体（ab）可保护婴儿免受疾病侵害，并且可能通过潜在的母体 RSV 疫苗接种策略增加。
描述在资源有限的环境中 RSV 抗体对婴儿 RSV 感染风险的影响。
在尼泊尔的一项前瞻性研究中，在妊娠期间招募了女性，并在出生时采集了母婴脐带血。从出生到 180 天，每周对呼吸道疾病进行监测。通过 PCR 检测鼻拭子中的 RSV，并使用 RSV 抗体微量中和测定法检测血清。根据 RSV 感染时的抗体浓度衰减率为 0.026 log/天来估计 RSV 感染时的抗体浓度。
脐带：母婴 RSV 抗体转移比为 1.03（0.88-1.19），在 310 对母婴样本中，RSV 抗体浓度分别为 log 11.3 和 log 11.7。与未感染 RSV 的婴儿相比，有 RSV 感染的婴儿的脐带血 RSV 抗体分别为 log 12.1 和 log 11.6（P=0.86）。在 RSV 感染的婴儿中，上呼吸道（n=8；log 10.7）与下呼吸道感染（n=21；log 9.8；P=0.37）的婴儿感染时的估计 RSV 抗体浓度没有差异。脐带血 RSV 抗体浓度与 RSV 初次感染时的年龄无相关性（R=0.11；P=0.57）。
在尼泊尔农村的母婴对中，RSV 抗体从母体向胎儿的胎盘转移非常有效，尽管较高的抗体浓度并不能预防婴儿更早或更严重的 RSV 感染。
