Department of Pediatrics, The Warren Alpert Medical School of Brown University, Providence, RI, United States; Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea.
Department of Pediatrics, The Warren Alpert Medical School of Brown University, Providence, RI, United States.
Int J Infect Dis. 2020 Mar;92:261-268. doi: 10.1016/j.ijid.2019.12.021.
Geographic region can be an important source of variation in the immune response to pneumococcal conjugate vaccines (PCV). The aim of this study was to collate data from available PCV clinical trials in order to characterize the differences in antibody responses in different countries.
A systematic review and meta-analysis was conducted to examine the difference in antibody responses after primary series of PCVs in infants, associated with geographic regions, compared with each other and with the different PCVs using random-effects models.
A total of 69 trials were included. Studies conducted in the Western Pacific Region (WPR) showed higher geometric mean concentrations (GMC) compared to studies conducted in Europe. The pooled GMC for serotype 4 after three doses of PCV7 in the WPR was 5.19 μg/ml (95% confidence interval 4.85-5.53 μg/ml), while for studies conducted in Europe this was 2.01 μg/ml (95% confidence interval 1.88-2.14 μg/ml). The IgG GMC ratios among the WPR versus European regions ranged from 1.51 to 2.87 for PCV7, 1.69 to 3.22 for PCV10, and 1.49 to 3.08 for PCV13.
Studies conducted in the WPR generally showed greater antibody responses than the studies conducted in Europe. Indications of differences among geographic regions highlight the fact that further research is needed to compare the biological factors contributing to immune responses, which may affect vaccination schedules.
地理位置可能是肺炎球菌结合疫苗（PCV）免疫反应产生差异的一个重要来源。本研究旨在整理现有 PCV 临床试验数据，以描述不同国家/地区抗体反应的差异。
系统回顾和荟萃分析考察了与彼此相比以及与不同 PCV 相比，婴儿 PCV 基础系列接种后，不同地理位置之间的抗体反应差异，采用随机效应模型。
共纳入 69 项研究。与欧洲相比，在西太平洋地区（WPR）进行的研究显示出更高的几何平均浓度（GMC）。在 WPR 中，PCV7 接种三剂后的血清型 4 总 GMC 为 5.19μg/ml（95%置信区间 4.85-5.53μg/ml），而在欧洲进行的研究中，这一数值为 2.01μg/ml（95%置信区间 1.88-2.14μg/ml）。WPR 与欧洲地区相比，PCV7 的 IgG GMC 比值范围为 1.51-2.87，PCV10 为 1.69-3.22，PCV13 为 1.49-3.08。
与在欧洲进行的研究相比，在 WPR 进行的研究通常显示出更大的抗体反应。地理位置之间存在差异的迹象表明，需要进一步研究以比较影响疫苗接种计划的免疫反应的生物学因素。
