Granoff D M, Rathore M H, Holmes S J, Granoff P D, Lucas A H
Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine, St Louis Children's Hospital, MO 63110.
Vaccine. 1993;11 Suppl 1:S46-51. doi: 10.1016/0264-410x(93)90160-y.
The anticapsular antibody responses to some Haemophilus influenzae type b (Hib) conjugate vaccines may be enhanced by prior or simultaneous administration of the carrier protein used in the conjugate. Currently, there are two Hib conjugate vaccines licensed in the USA for use in infants beginning at 2 months of age: Hib polysaccharide coupled to an outer membrane protein complex of Neisseria meningitidis (PRP-OMPC), and Hib oligosaccharides conjugated to CRM197, a non-toxic mutant diphtheria toxin (HbOC). The PRP-OMPC conjugate vaccine is immunogenic in infant monkeys and infant humans in the absence of carrier priming or additional carrier vaccination. The mechanism responsible for this immunogenicity is unknown but may relate to the adjuvanticity of the OMPC carrier. In contrast, data from infant rhesus monkeys and infant humans suggest that there may be a need for vaccination with diphtheria toxoid in order to maximize anti-PRP antibody responses to the HbOC conjugate. In addition, immunization with HbOC alone appears to be insufficient to elicit an antibody response to diphtheria toxoid. Thus, the need for additional vaccination with diphtheria toxoid in order to generate consistent anti-PRP antibody responses to HbOC may be a result of failure of the CRM197 protein carrier to elicit T-cell help. In infants in whom diphtheria-tetanus-pertussis (DTP) vaccination is deferred because of medical contraindications, vaccination with the PRP-OMPC conjugate would appear to be preferable to HbOC because of the ability of the former to elicit antibody responses in the absence of diphtheria toxoid vaccination.
对某些b型流感嗜血杆菌（Hib）结合疫苗的抗荚膜抗体反应，可能会因预先或同时给予结合物中使用的载体蛋白而增强。目前，美国有两种获得许可的Hib结合疫苗可用于2月龄开始的婴儿：与脑膜炎奈瑟菌外膜蛋白复合物偶联的Hib多糖（PRP - OMPC），以及与无毒突变白喉毒素CRM197偶联的Hib寡糖（HbOC）。在没有载体启动或额外载体疫苗接种的情况下，PRP - OMPC结合疫苗在幼猴和婴儿中具有免疫原性。负责这种免疫原性的机制尚不清楚，但可能与OMPC载体的佐剂作用有关。相比之下，来自恒河猴幼崽和婴儿的数据表明，可能需要接种白喉类毒素，以最大化对HbOC结合物的抗PRP抗体反应。此外，单独接种HbOC似乎不足以引发对白喉类毒素的抗体反应。因此，为了对HbOC产生一致的抗PRP抗体反应而需要额外接种白喉类毒素，可能是CRM197蛋白载体未能引发T细胞辅助的结果。对于因医学禁忌而推迟接种白喉 - 破伤风 - 百日咳（DTP）疫苗的婴儿，接种PRP - OMPC结合疫苗似乎比HbOC更可取，因为前者在没有接种白喉类毒素的情况下能够引发抗体反应。
