Coovadia H M, Kiepiela P, Wesley A G
S Afr Med J. 1984 Jun 9;65(23):918-21.
The age-related sequential immune response to natural measles was investigated in order to establish the role of immunodeficiency in the high infant mortality from infectious diseases. There was no difference in lymphocyte transformation, complement-fixing antibody titres, serum IgG, IgM, IgA, C3 and factor B levels, total haemolytic complement and the alternative pathway of complement over a 6-week period after onset of the rash in those younger than 12 months (group A) compared with children older than 12 months (group B). The absolute number of peripheral blood lymphocytes, comprising T, B and null cells, was higher on different days in group A compared with group B. Throughout the 6 weeks group A had higher haemagglutination inhibition antibody levels and lower serum C4 levels than Group B. The inhibition of leucocyte migration to measles antigen was similar in the two groups, except on day 28 when it was significantly higher in group B. There were 5 deaths, all in infants younger than 15 months of age. Most immunological reactions studied were not age-dependent, while those differences detected in the younger age group involved factors known to indicate a good prognosis. Therefore, the high mortality rate reported for measles in infants is unlikely to be due to immunodeficiency in this age group.
为了确定免疫缺陷在婴儿因传染病导致的高死亡率中所起的作用，对与年龄相关的自然麻疹序贯免疫反应进行了研究。在皮疹出现后的6周内，12个月以下的婴儿（A组）与12个月以上的儿童（B组）相比，淋巴细胞转化、补体结合抗体滴度、血清IgG、IgM、IgA、C3和B因子水平、总溶血补体以及补体替代途径均无差异。A组外周血淋巴细胞（包括T细胞、B细胞和裸细胞）的绝对数量在不同日期均高于B组。在整个6周内，A组的血凝抑制抗体水平高于B组，血清C4水平低于B组。两组对麻疹抗原的白细胞迁移抑制作用相似，但在第28天，B组的抑制作用明显更高。有5例死亡，均为15个月以下的婴儿。所研究的大多数免疫反应与年龄无关，而在较年轻年龄组中检测到的差异涉及已知表明预后良好的因素。因此，婴儿麻疹报告的高死亡率不太可能是由于该年龄组的免疫缺陷。
