Jertborn M, Svennerholm A M, Holmgren J
J Clin Microbiol. 1986 Aug;24(2):203-9. doi: 10.1128/jcm.24.2.203-209.1986.
The possibility that antibody responses in serum, saliva, or breast milk samples to oral vaccines or enteric infections may reflect the intestinal immune response was evaluated in Bangladeshi volunteers orally immunized with a cholera B subunit-whole-cell vaccine (B + WCV) and in patients convalescing from enterotoxin-induced diarrheal disease. Two peroral doses of B + WCV induced antitoxin and antibacterial antibody responses in the intestinal fluids of 76 and 92%, respectively, of the volunteers and in serum samples in 90 and 69% of those tested. These responses were comparable to those obtained after cholera or enterotoxigenic Escherichia coli disease. Whereas immunoglobulin A (IgA) antitoxin titer increases in saliva (44%) and breast milk (29%) specimens after vaccination were less frequent than in intestinal fluid (76%), antitoxin responses in saliva and breast milk occurred in 80 to 90% of the patients after disease. Also, antilipopolysaccharide (anti-LPS) titer increases in extraintestinal body fluids were found more frequently after disease than after vaccination. A comparison of the frequency and magnitude of antibody response in different body fluids with those in intestinal lavage fluid revealed no extraintestinal antibody that directly reflected the intestinal immunity. However, comparison of vibriocidal and IgG antitoxin antibodies in serum specimens with antitoxin and anti-LPS IgA responses in intestinal fluids after the vaccination of volunteers showed a sensitivity of 70 to 90% and a predictive accuracy of about 80% for the serum analyses reflecting the intestinal immune responses. Furthermore, antitoxin and anti-LPS antibody responses in saliva and breast milk samples seemed to be useful proxy indicators of a gut mucosal response of these antibodies after enterotoxin-induced diarrheal disease showing sensitivity vales of 70 to 90% and predictive accuracy vales of 70 to 100%.
在口服霍乱B亚单位-全细胞疫苗（B+WCV）的孟加拉国志愿者以及从肠毒素诱导的腹泻病中康复的患者中，评估了血清、唾液或母乳样本中针对口服疫苗或肠道感染的抗体反应是否可能反映肠道免疫反应。两剂口服B+WCV分别在76%和92%的志愿者的肠液中以及在90%和69%接受检测的志愿者的血清样本中诱导了抗毒素和抗菌抗体反应。这些反应与霍乱或产肠毒素大肠杆菌疾病后获得的反应相当。虽然接种疫苗后唾液（44%）和母乳（29%）样本中免疫球蛋白A（IgA）抗毒素滴度升高的频率低于肠液（76%），但疾病后80%至90%的患者唾液和母乳中出现了抗毒素反应。此外，疾病后在肠外体液中脂多糖（LPS）抗体滴度升高的情况比接种疫苗后更常见。比较不同体液与肠灌洗液中抗体反应的频率和强度发现，没有肠外抗体能直接反映肠道免疫力。然而，在志愿者接种疫苗后，将血清样本中的杀弧菌和IgG抗毒素抗体与肠液中的抗毒素和抗LPS IgA反应进行比较，血清分析反映肠道免疫反应的敏感性为70%至90%，预测准确性约为80%。此外，唾液和母乳样本中的抗毒素和抗LPS抗体反应似乎是肠毒素诱导的腹泻病后这些抗体肠道黏膜反应的有用替代指标，敏感性值为70%至90%，预测准确性值为70%至100%。
