Rosales S V, Lascolea L J, Ogra P L
J Immunol. 1984 Mar;132(3):1517-21.
Groups of patients with different forms of infection with Haemophilus influenzae type B (Hib), namely meningitis, epiglottitis, arthritis, and periorbital cellulitis, were evaluated for the appearance of serum IgG, IgA, IgM, and nasopharyngeal secretory (NPS) IgA (SIgA) antibody response to Hib capsular antigen at various intervals after the onset of clinical illness, by using an indirect enzyme-linked immunosorbent assay. The serum immune response was characterized by its predictable absence in infants under 23 mo of age, and in those with meningitis who, regardless of age, had high levels of circulating antigen. On the other hand, antibody response was frequently detected in the serum of older infants. Significantly, however, the appearance of SIgA antibody was demonstrated in virtually all patients with Hib infections under 23 mo of age. In addition, a positive correlation was observed between the concentration of antigen NPS, the level of SIgA activity in the NPS, and the absence of antibody response in the serum. These observations are strikingly similar to the development of systemic hyporesponsiveness (oral tolerance) observed after oral administration of certain infectious or nonreplicating antigens in experimental animals. It is suggested that similar mechanisms may underlie the immunologic abnormalities observed in the serum antibody response in infants with Hib meningitis.
采用间接酶联免疫吸附测定法，对感染不同形式B型流感嗜血杆菌（Hib）的患者群体，即脑膜炎、会厌炎、关节炎和眶周蜂窝织炎患者，在临床疾病发作后的不同时间间隔，评估其血清IgG、IgA、IgM以及鼻咽分泌物（NPS）IgA（SIgA）对Hib荚膜抗原的抗体反应。血清免疫反应的特征是，在23个月龄以下的婴儿以及患有脑膜炎的患者中可预测地缺乏，而患有脑膜炎的患者无论年龄大小，循环抗原水平都很高。另一方面，在年龄较大的婴儿血清中经常检测到抗体反应。然而，值得注意的是，在几乎所有23个月龄以下的Hib感染患者中都证实了SIgA抗体的出现。此外，还观察到抗原NPS的浓度、NPS中SIgA活性水平与血清中抗体反应的缺乏之间存在正相关。这些观察结果与在实验动物口服某些感染性或非复制性抗原后观察到的全身低反应性（口服耐受）的发展惊人地相似。有人提出，类似的机制可能是Hib脑膜炎婴儿血清抗体反应中观察到的免疫异常的基础。
