进一步研究细胞性而非细胞性百日咳博德特氏菌联合接种后破伤风和白喉的 IgE 反应。

Further investigations of the IgE response to tetanus and diphtheria following covaccination with acellular rather than cellular Bordetella pertussis.

机构信息

Amsterdam and Landsteiner Laboratory, Department of Immunopathology, Academic Medical Center, Sanquin Research, University of Amsterdam, Amsterdam, The Netherlands.

Department of Pediatric Pneumology and Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany.

出版信息

Pediatr Allergy Immunol. 2019 Dec;30(8):841-847. doi: 10.1111/pai.13113.

DOI:10.1111/pai.13113

PMID:31419322

Abstract

BACKGROUND

It has previously been shown in an uncontrolled study that the IgE response to vaccine antigens is downregulated by co-vaccination with cellular Bordetella pertussis vaccine.

METHODS

In the present study, we compared in a controlled trial the humoral immune response to diphtheria toxoid (D) and tetanus toxoid (T) in relation to co-vaccinated cellular or acellular B pertussis vaccine. IgE, IgG4, and IgG to D and T were analyzed at 2, 7, and 12 months of age in sera of children vaccinated with D and T (DT, N = 68), cellular (DTPw, N = 68), 2- or 5-component acellular B pertussis vaccine (DTPa2, N = 64; DTPa5, N = 65).

RESULTS

One month after vaccination, D-IgE was detected in 10% sera of DTPw-vaccinated children, whereas vaccination in the absence of whole-cell pertussis resulted in 50%-60% IgE positivity. Six months after vaccination, the IgE antibody levels were found to be more persistent than the IgG antibodies. These diphtheria findings were mirrored by those for tetanus. Only minor differences between vaccine groups were found with regard to D-IgG and T-IgG. No immediate-type allergic reactions were observed.

CONCLUSION

Cellular (but not acellular) B pertussis vaccine downregulates IgE to co-vaccinated antigens in infants. We assume that the absence of immediate-type allergic reactions is due to the high levels of IgG antibodies competing with IgE antibodies.

摘要

背景

先前的一项非对照研究表明，细胞百日咳疫苗与疫苗抗原共同接种可下调对疫苗抗原的 IgE 应答。

方法

在本研究中，我们通过对照试验比较了在婴儿中同时接种细胞型或无细胞型百日咳疫苗与全细胞型百日咳疫苗时，对白喉类毒素（D）和破伤风类毒素（T）的体液免疫应答。在接种 D 和 T（DT，N=68）、细胞型（DTPw，N=68）、2 或 5 组分无细胞型百日咳疫苗（DTPa2，N=64；DTPa5，N=65）的儿童血清中，于 2、7 和 12 月龄时分析 IgE、IgG4 和 IgG 对 D 和 T 的应答。

结果

接种 DTPw 疫苗的儿童中，1 个月后有 10%的血清中可检测到 D-IgE，而全细胞百日咳疫苗缺失时，IgE 阳性率为 50%-60%。接种 6 个月后，发现 IgE 抗体水平比 IgG 抗体更持久。这些白喉发现与破伤风的发现相似。关于 D-IgG 和 T-IgG，各组之间仅发现了微小差异。未观察到即刻型过敏反应。