Department of Paediatrics, The University of Melbourne, Parkville, Australia; Infectious Diseases Research Group, Murdoch Children's Research Institute, Parkville, Australia; Infectious Diseases Unit, The Royal Children's Hospital Melbourne, Parkville, Australia; Department of Pediatrics, Fribourg Hospital HFR and Faculty of Science and Medicine, University of Fribourg, Switzerland.
Department of Paediatrics, The University of Melbourne, Parkville, Australia; Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Parkville, Australia.
Vaccine. 2019 Jun 19;37(28):3735-3744. doi: 10.1016/j.vaccine.2019.03.016. Epub 2019 May 29.
Bacillus Calmette-Guérin vaccine (BCG), one of the most widely used vaccines, does not only provide protection against tuberculosis and other mycobacterial infections, but also has non-specific (heterologous) immunomodulatory effects. In participants in a randomised trial, we investigated the effect of neonatal BCG immunisation on antibody responses to routine infant vaccines given in the first year of life.
Antibodies against antigens in the diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b (Hib), and the 13-valent pneumococcal conjugate vaccines were measured in 91 (45 BCG-vaccinated, 46 BCG-naïve) infants one month after, and in 310 (169 BCG-vaccinated, 141 BCG-naïve) infants seven months after immunisation at 6 weeks, 4 and 6 months of age. In addition, antibodies against meningococcus C, Hib, measles, mumps, and rubella were measured in 147 (78 BCG-vaccinated, 69 BCG-naïve) infants one month after immunisation at 12 months of age. The seroprotection rates for each vaccine and the geometric mean concentrations (GMC) of antibodies were compared in BCG-vaccinated and BCG-naïve infants.
At 7 months of age, seroprotection rates were high in both BCG-vaccinated and BCG-naïve infants. At 13 months of age, seroprotection rates were lower than at 7 months of age, particularly for pertussis and a number of pneumococcal antigens, with generally higher rates for the latter in BCG-vaccinated infants. Although not statistically significant, antibody responses in BCG-vaccinated infants were consistently higher against diphtheria, tetanus, and pneumococcal antigens at both 7 and 13 months of age, and against measles and mumps at 13 months of age, but were lower against Hib one month after immunisation at both 7 and 13 months of age.
The immunomodulatory effect of BCG on antibody responses to heterologous vaccines adds to the evidence that BCG immunisation at birth has broad heterologous effects on the infant immune system.
卡介苗（BCG）是使用最广泛的疫苗之一，不仅能预防结核病和其他分枝杆菌感染，还具有非特异性（异源）免疫调节作用。在一项随机试验中，我们研究了新生儿 BCG 免疫接种对婴儿在生命的第一年中接受的常规疫苗的抗体反应的影响。
在 91 名（45 名 BCG 接种，46 名 BCG 未接种）婴儿接种疫苗后一个月，以及 310 名（169 名 BCG 接种，141 名 BCG 未接种）婴儿在 6 周、4 个月和 6 个月大时接种疫苗 7 个月后，测量了对白喉、破伤风、百日咳、脊髓灰质炎、流感嗜血杆菌 b（Hib）和 13 价肺炎球菌结合疫苗抗原的抗体。此外，在 147 名（78 名 BCG 接种，69 名 BCG 未接种）婴儿在 12 个月大时接种疫苗后一个月，测量了对脑膜炎球菌 C、Hib、麻疹、腮腺炎和风疹的抗体。比较了 BCG 接种和 BCG 未接种婴儿的每种疫苗的血清保护率和抗体几何平均浓度（GMC）。
在 7 个月大时，BCG 接种和未接种婴儿的血清保护率均很高。在 13 个月大时，血清保护率低于 7 个月大时，特别是对百日咳和一些肺炎球菌抗原，BCG 接种婴儿的保护率通常更高。尽管没有统计学意义，但在 7 个月和 13 个月大时，BCG 接种婴儿的抗白喉、破伤风和肺炎球菌抗原的抗体反应均始终较高，而在 13 个月大时，抗麻疹和腮腺炎的抗体反应也较高，但在 7 个月和 13 个月大时，Hib 的抗体反应在接种疫苗后一个月较低。
BCG 对异源疫苗的抗体反应的免疫调节作用增加了证据，即出生时的 BCG 免疫接种对婴儿免疫系统具有广泛的异源作用。
