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犬咬伤病例中狂犬病暴露后预防接种一年后的免疫评估。

Evaluation of one year immunity following rabies post-exposure prophylaxis in dog bite cases.

作者信息

Ya Nisa, Auerswald Heidi, Touch Sothy, In Saraden, Yun Chanvannak, Thai Pisey, Sann Sotheary, Heng Borita, Leng Chanthy, Duong Veasna, Peng Yik Sing, Ly Sowath, Cantaert Tineke

机构信息

Immunology Unit, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia.

Virology Unit, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia.

出版信息

NPJ Vaccines. 2024 Nov 27;9(1):237. doi: 10.1038/s41541-024-01030-8.

Abstract

Rabies remains a global health threat despite being preventable with post-exposure prophylaxis (PEP). This study assessed one-year humoral and T cell immunity in PEP recipients of the Insitut Pasteur du Cambodge (IPC) regimen, recommended by WHO. We analyzed rabies virus (RABV) neutralizing antibodies (nAbs) and T cell responses at baseline, 7 and 14 days, 6 and 12 months after PEP. A total of 148 patients were included, with 78 bitten by confirmed RABV-positive dogs receiving PEP and equine rabies immunoglobulins (eRIG), and 70 bitten by RABV-negative dogs receiving only PEP. Fourteen days after PEP, all but two individuals seroconverted for nAbs ( ≥ 0.5 IU/mL) with 87% maintaining this response even after 12 months. Interleukin-4 (IL-4) and interferon-gamma (IFN-γ)-secreting T cells were significantly elevated after 14 days and sustained for one year. No differences were observed between the RABV-exposed and -unexposed groups. This study demonstrates robust one-year immunity after IPC PEP.

摘要

尽管暴露后预防(PEP)可预防狂犬病,但狂犬病仍然是一种全球健康威胁。本研究评估了世界卫生组织推荐的柬埔寨巴斯德研究所(IPC)方案的PEP接受者的一年体液免疫和T细胞免疫。我们分析了PEP后基线、第7天和第14天、第6个月和第12个月时的狂犬病病毒(RABV)中和抗体(nAbs)和T细胞反应。总共纳入了148例患者,其中78例被确诊为RABV阳性犬咬伤并接受了PEP和马狂犬病免疫球蛋白(eRIG),70例被RABV阴性犬咬伤仅接受了PEP。PEP后14天,除两人外,所有个体的nAbs均发生血清转化(≥0.5 IU/mL),即使在12个月后仍有87%的个体维持这种反应。分泌白细胞介素-4(IL-4)和干扰素-γ(IFN-γ)的T细胞在14天后显著升高并持续了一年。在暴露于RABV和未暴露的组之间未观察到差异。本研究证明了IPC PEP后有强大的一年免疫力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/772e/11603308/17aa7c5dd63a/41541_2024_1030_Fig1_HTML.jpg

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