Burton Robert L, Kim Han Wool, Lee Soyoung, Kim Hun, Seok Jee-Hyun, Lee Sang Heon, Balloch Anne, Licciardi Paul, Marimla Rachel, Bae Sejong, Nahm Moon H, Kim Kyung-Hyo
Department of Medicine, University of Alabama at Birmingham, Birmingham, AL.
Department of Pediatrics, Ewha Womans University College of Medicine.
Medicine (Baltimore). 2018 Apr;97(17):e0567. doi: 10.1097/MD.0000000000010567.
Pneumococcal conjugate vaccines (PCVs) have been very effective in reducing the disease burden caused by Streptococcus pneumoniae serotypes covered by the current vaccine formulations. However, the incidence of disease caused by serotypes not covered by the vaccine is increasing. Consequently, there are active efforts to develop new PCVs with additional serotypes in order to provide protection against the emergent serotypes. Due to costs and ethical issues associated with performing true vaccine efficacy studies, new PCVs are being licensed based on their immunogenicity, which may be assessed with 2 in vitro assays: enzyme-linked immunosorbent assay (ELISA) for quantitating antibody level and opsonophagocytic assay (OPA) for assessing protective function. While a standardized ELISA has been developed, OPA results from different laboratories can be quite disparate, even among laboratories utilizing the same platform. In order to harmonize OPA data, a recent international collaboration assigned opsonic indices to the US Food and Drug Administration (US FDA) reference serum, 007sp, as well as a panel of US FDA calibration sera. However, due to a low number of aliquots, the availability of these calibration sera is extremely limited. Because calibration sera are critical to establish the performance characteristics of an OPA, a second calibration serum panel was created, comprised of 20 sera collected from adults immunized with the 23-valent polysaccharide vaccine, with 150 to 500 aliquots prepared for each serum. In order to establish consensus OPA values of the 20 sera for the 13 serotypes in 13-valent PCV, the sera were tested by 4 laboratories in an international collaborative OPA study. The 007sp results of 1 laboratory deviated significantly from those obtained by the other laboratories, as well as from previously assigned values. Due to these discrepancies, the consensus values for the calibration sera were determined based on the data from the remaining laboratories. Thus, we were able to create a panel of sera with consensus opsonic values that could be used by outside laboratories to calibrate pneumococcal OPAs. Our results also confirmed findings of a previous study that normalization of OPA results significantly reduces interlaboratory variation, with normalization based on 007sp reducing variation by 43% to 74%, depending on serotype.
肺炎球菌结合疫苗(PCV)在减轻由当前疫苗配方所涵盖的肺炎链球菌血清型引起的疾病负担方面非常有效。然而,由疫苗未涵盖的血清型引起的疾病发病率正在上升。因此,人们正在积极努力研发包含更多血清型的新型PCV,以便为新出现的血清型提供保护。由于进行真正的疫苗效力研究存在成本和伦理问题,新型PCV是基于其免疫原性获得许可的,免疫原性可通过两种体外试验进行评估:用于定量抗体水平的酶联免疫吸附测定(ELISA)和用于评估保护功能的调理吞噬测定(OPA)。虽然已经开发出标准化的ELISA,但不同实验室的OPA结果可能差异很大,即使是在使用相同平台的实验室之间。为了统一OPA数据,最近的一项国际合作给美国食品药品监督管理局(US FDA)的参考血清007sp以及一组US FDA校准血清指定了调理指数。然而,由于等分试样数量较少,这些校准血清的可用性极其有限。由于校准血清对于确定OPA的性能特征至关重要,因此创建了第二个校准血清组,由从接种23价多糖疫苗的成年人中收集的20份血清组成,每份血清制备了150至500个等分试样。为了确定13价PCV中13种血清型的20份血清的OPA共识值,这些血清在一项国际合作的OPA研究中由4个实验室进行了检测。1个实验室的007sp结果与其他实验室获得的结果以及先前指定的值有显著偏差。由于这些差异,校准血清的共识值是根据其余实验室的数据确定的。因此,我们能够创建一组具有共识调理值的血清,外部实验室可使用这些血清来校准肺炎球菌OPA。我们的结果还证实了先前一项研究的发现,即OPA结果的标准化显著降低了实验室间的差异,基于007sp的标准化根据血清型不同可将差异降低43%至74%。