Sly P D, McFarlane P, Mermelstein N, Cripps A W, Roberton D M
Department of Thoracic Medicine, Royal Children's Hospital, Parkville, Victoria, Australia.
Aust Paediatr J. 1988 Apr;24(2):122-7. doi: 10.1111/j.1440-1754.1988.tb00303.x.
Serum IgG, IgA and IgM antibody and salivary IgA antibody concentrations to non-capsular Haemophilus influenzae antigens were measured in 13 children with H. influenzae type b meningitis and in 15 children with epiglottitis. Most had detectable serum IgG and IgM antibody at presentation but significantly fewer patients with meningitis had serum IgA antibody at presentation (P less than 0.05). Serum antibody concentrations had risen significantly by 3 weeks after presentation in patients with epiglottitis only. Convalescent serum IgG antibody concentrations against these antigens were higher in younger children with epiglottitis. Salivary IgA antibody to H. influenzae was detectable at presentation in all children with epiglottitis and in 12 of 13 with meningitis. Salivary antibody concentrations did not differ significantly between the two patient groups at presentation, although patients with meningitis had higher salivary IgA antibody concentrations than 10 children of similar age with bronchiolitis (P less than 0.02). There was no association between the presence of salivary antibody and low concentrations of convalescent serum antibody. The rise in convalescent serum antibody concentrations to non-capsular H. influenzae antigens only in children with epiglottitis is similar to findings for antibody to capsular polysaccharide. However, this rise was greater for IgG in younger patients, and the low titre of convalescent serum antibody in patients with meningitis was not associated with higher titres of IgA antibody in secretions as described by others for polysaccharide antibody. These findings suggest that the poor serum antibody response to these antigens in patients with meningitis is independent of age and is not due to mucosal induction of systemic tolerance.(ABSTRACT TRUNCATED AT 250 WORDS)
检测了13例b型流感嗜血杆菌脑膜炎患儿和15例会厌炎患儿针对非荚膜型流感嗜血杆菌抗原的血清IgG、IgA和IgM抗体以及唾液IgA抗体浓度。大多数患儿在就诊时可检测到血清IgG和IgM抗体，但脑膜炎患儿就诊时血清IgA抗体阳性的明显较少（P<0.05）。仅会厌炎患儿在就诊后3周血清抗体浓度显著升高。患会厌炎的年幼儿童针对这些抗原的恢复期血清IgG抗体浓度较高。所有会厌炎患儿以及13例脑膜炎患儿中的12例在就诊时可检测到针对流感嗜血杆菌的唾液IgA抗体。就诊时两组患儿的唾液抗体浓度无显著差异，不过脑膜炎患儿的唾液IgA抗体浓度高于10例患细支气管炎的同龄儿童（P<0.02）。唾液抗体的存在与恢复期血清抗体低浓度之间无关联。仅会厌炎患儿针对非荚膜型流感嗜血杆菌抗原的恢复期血清抗体浓度升高与针对荚膜多糖抗体的研究结果相似。然而，年幼儿童中IgG的升高幅度更大，脑膜炎患儿恢复期血清抗体滴度低与其他人所描述的多糖抗体分泌型IgA抗体高滴度无关。这些发现表明，脑膜炎患儿对这些抗原的血清抗体反应不佳与年龄无关，并非由于黏膜诱导全身耐受所致。（摘要截短于250词）
