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Principi N, Bianchini S, Esposito S. Pertussis Epidemiology in Children: The Role of Maternal Immunization. Vaccines (Basel) 2024; 12:1030. [PMID: 39340060 PMCID: PMC11436108 DOI: 10.3390/vaccines12091030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2024] [Revised: 08/30/2024] [Accepted: 09/04/2024] [Indexed: 09/30/2024] Open
Abstract
In the last twelve months, a significant global increase in pertussis cases has been observed, particularly among infants under three months of age. This age group is at the highest risk for severe disease, hospitalization, and death. Maternal immunization with the Tdap vaccine during pregnancy has been recommended to protect newborns by transferring maternal antibodies transplacentally. This review examines the current epidemiology of pertussis, the importance of preventing it in young children, and the effectiveness of maternal immunization. Despite the proven benefits of maternal vaccination, which has been found effective in pertussis prevention in up to 90% of cases, coverage remains suboptimal in many countries. Factors contributing to low vaccination rates include vaccine hesitancy due to low trust in health authority assessments, safety concerns, practical barriers to vaccine access, and the impact of the COVID-19 pandemic, which disrupted routine vaccination services. The recent increase in pertussis cases may also be influenced by the natural cyclic nature of the disease, increased Bordetella pertussis (Bp) activity in older children and adults, and the genetic divergence of circulating Bp strains from vaccine antigens. Given the high efficacy of maternal vaccination in preventing pertussis in infants, increasing coverage rates is crucial. Efforts to improve vaccine uptake should address barriers to access and vaccine hesitancy, ensuring consistent immune protection for the youngest and most vulnerable populations. Enhanced maternal vaccination could significantly reduce the incidence of whooping cough in infants, decreasing related hospitalizations and deaths.
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Affiliation(s)
| | - Sonia Bianchini
- Pediatric Unit, ASST Santi Carlo e Paolo, 20153 Milan, Italy
| | - Susanna Esposito
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy
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Briga M, Goult E, Brett TS, Rohani P, Domenech de Cellès M. Maternal pertussis immunization and the blunting of routine vaccine effectiveness: a meta-analysis and modeling study. Nat Commun 2024; 15:921. [PMID: 38297003 PMCID: PMC10830464 DOI: 10.1038/s41467-024-44943-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 01/10/2024] [Indexed: 02/02/2024] Open
Abstract
A key goal of pertussis control is to protect infants too young to be vaccinated, the age group most vulnerable to this highly contagious respiratory infection. In the last decade, maternal immunization has been deployed in many countries, successfully reducing pertussis in this age group. Because of immunological blunting, however, this strategy may erode the effectiveness of primary vaccination at later ages. Here, we systematically reviewed the literature on the relative risk (RR) of pertussis after primary immunization of infants born to vaccinated vs. unvaccinated mothers. The four studies identified had ≤6 years of follow-up and large statistical uncertainty (meta-analysis weighted mean RR: 0.71, 95% CI: 0.38-1.32). To interpret this evidence, we designed a new mathematical model with explicit blunting mechanisms and evaluated maternal immunization's short- and long-term impact on pertussis transmission dynamics. We show that transient dynamics can mask blunting for at least a decade after rolling out maternal immunization. Hence, the current epidemiological evidence may be insufficient to rule out modest reductions in the effectiveness of primary vaccination. Irrespective of this potential collateral cost, we predict that maternal immunization will remain effective at protecting unvaccinated newborns, supporting current public health recommendations.
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Affiliation(s)
- Michael Briga
- Infectious Disease Epidemiology Group, Max Planck Institute for Infection Biology, Berlin, Germany.
| | - Elizabeth Goult
- Infectious Disease Epidemiology Group, Max Planck Institute for Infection Biology, Berlin, Germany
| | - Tobias S Brett
- Odum School of Ecology, University of Georgia, Athens, GA, 30602, USA
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602, USA
| | - Pejman Rohani
- Odum School of Ecology, University of Georgia, Athens, GA, 30602, USA
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602, USA
- Center of Ecology of Infectious Diseases, University of Georgia, Athens, GA, 30602, USA
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Abu-Raya B, Esser MJ, Nakabembe E, Reiné J, Amaral K, Diks AM, Imede E, Way SS, Harandi AM, Gorringe A, Le Doare K, Halperin SA, Berkowska MA, Sadarangani M. Antibody and B-cell Immune Responses Against Bordetella Pertussis Following Infection and Immunization. J Mol Biol 2023; 435:168344. [PMID: 37926426 DOI: 10.1016/j.jmb.2023.168344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/27/2023] [Accepted: 10/31/2023] [Indexed: 11/07/2023]
Abstract
Neither immunization nor recovery from natural infection provides life-long protection against Bordetella pertussis. Replacement of a whole-cell pertussis (wP) vaccine with an acellular pertussis (aP) vaccine, mutations in B. pertussis strains, and better diagnostic techniques, contribute to resurgence of number of cases especially in young infants. Development of new immunization strategies relies on a comprehensive understanding of immune system responses to infection and immunization and how triggering these immune components would ensure protective immunity. In this review, we assess how B cells, and their secretory products, antibodies, respond to B. pertussis infection, current and novel vaccines and highlight similarities and differences in these responses. We first focus on antibody-mediated immunity. We discuss antibody (sub)classes, elaborate on antibody avidity, ability to neutralize pertussis toxin, and summarize different effector functions, i.e. ability to activate complement, promote phagocytosis and activate NK cells. We then discuss challenges and opportunities in studying B-cell immunity. We highlight shared and unique aspects of B-cell and plasma cell responses to infection and immunization, and discuss how responses to novel immunization strategies better resemble those triggered by a natural infection (i.e., by triggering responses in mucosa and production of IgA). With this comprehensive review, we aim to shed some new light on the role of B cells and antibodies in the pertussis immunity to guide new vaccine development.
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Affiliation(s)
- Bahaa Abu-Raya
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, BC, Canada; Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
| | - Mirjam J Esser
- Department of Pediatrics, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Eve Nakabembe
- Centre for Neonatal and Paediatric Infectious Diseases Research, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK; Department of Obstetrics and Gynaecology, Makerere University College of Health Sciences, Upper Mulago Hill Road, Kampala, P.O. Box 7072, Uganda
| | - Jesús Reiné
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Oxford Vaccine Group, University of Oxford, Oxford, United Kingdom
| | - Kyle Amaral
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, BC, Canada; Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Annieck M Diks
- Department of Immunology, Leiden University Medical Center, Albinusdreef 2, Leiden ZA 2333, the Netherlands
| | - Esther Imede
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Sing Sing Way
- Department of Pediatrics, Division of Infectious Diseases, Center for Inflammation and Tolerance, Cincinnati Children's Hospital Medical Center, University of Cincinnati School of Medicine, Cincinnati, OH, USA
| | - Ali M Harandi
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, BC, Canada; Department of Microbiology and Immunology, University of Gothenburg, Gothenburg, Sweden
| | - Andrew Gorringe
- UK Health Security Agency, Porton Down, Salisbury SP4 0JG, UK
| | - Kirsty Le Doare
- Centre for Neonatal and Paediatric Infectious Diseases Research, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK; Makerere University-Johns Hopkins University Research Collaboration, MU-JHU, Upper Mulago Hill, Kampala, P.O. Box 23491, Uganda
| | - Scott A Halperin
- Canadian Center for Vaccinology, Departments of Pediatrics and Microbiology and Immunology, Dalhousie University, Izaak Walton Killam Health Centre, and Nova Scotia Health Authority, Halifax, NS, Canada
| | - Magdalena A Berkowska
- Medical Microbiology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Manish Sadarangani
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, BC, Canada; Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
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Knuutila A, Dalby T, Ahvenainen N, Barkoff AM, Jørgensen CS, Fuursted K, Mertsola J, He Q. Antibody avidity to pertussis toxin after acellular pertussis vaccination and infection. Emerg Microbes Infect 2023; 12:e2174782. [PMID: 36715361 PMCID: PMC9936998 DOI: 10.1080/22221751.2023.2174782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Pertussis toxin (PT) is a unique virulence factor of Bordetella pertussis, and therefore a key component of acellular pertussis vaccines. Although immunity after infection seems to persist longer than after vaccination, the exact mechanisms are not fully known. In this study the overall binding strength (avidity) of anti-PT IgG antibodies was compared after acellular booster vaccination and infection, as a parameter to evaluate long-lasting protection.Danish and Finnish serum samples from a total of 134 serologically confirmed patients and 112 children who received acellular booster vaccines were included in this study. The concentration of anti-PT IgG was first determined by ELISA, followed by two separate ELISAs to evaluate antibody avidity: either with a dilution series of urea as a bond-breaking agent of antibody and antigen binding and a constant anti-PT IgG concentration between the samples or with a constant dilution ratio of sera and detergent. In addition to urea, the use of diethylamine and ammonium thiocyanate as disruptive agents were first compared between each other.A strong Spearman correlation (R > 0.801) was noted between avidity and concentration of anti-PT IgG antibodies if a constant serum dilution method was used, and avidity was noted to be higher in patients in comparison to vaccinees in Denmark, but not in Finland. However, no correlation between antibody concentration and avidity was found if a constant anti-PT IgG concentration was used (R = -0.157). With this method, avidity after vaccination was significantly higher in comparison to that after infection in both Danish and Finnish subjects (p < 0.01). A shorter time since the latest booster vaccination was found to affect avidity positively on the next PT-antigen exposure with either vaccination or infection.
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Affiliation(s)
- Aapo Knuutila
- Institute of Biomedicine, University of Turku, Turku, Finland
| | - Tine Dalby
- Statens Serum Institut, Copenhagen, Denmark
| | | | | | | | | | - Jussi Mertsola
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland
| | - Qiushui He
- Institute of Biomedicine, University of Turku, Turku, Finland,InFLAMES Research Flagship Center, University of Turku, Turku, Finland, Qiushui He
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Kayatani AKK, Bobbili N, Megnekou R, Matsunaga M, Leke RFG, Taylor DW. Are high avidity antibodies to Plasmodium falciparum antigens preferentially transferred across the placenta of premature and term babies? Placenta 2023; 140:11-19. [PMID: 37515848 PMCID: PMC10528449 DOI: 10.1016/j.placenta.2023.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/05/2023] [Accepted: 07/18/2023] [Indexed: 07/31/2023]
Abstract
INTRODUCTION Transplacental transport of maternal IgG via the neonatal Fc receptor (FcRn) provides babies with passive immunity. Several factors are reported to influence transport, including the avidity of antibodies (Abs) for their cognate antigens. Unfortunately, information on the role of antibody (Ab) avidity is limited. This study investigated if i) antibodies (Abs) with high avidity for 6 Plasmodium falciparum antigens and tetanus toxoid (TTx) were preferentially transferred to premature and term Cameroonian babies and ii) if Ab avidity was increased in babies whose mothers had placental malaria (PM), implicating the involvement of immune complexes. METHODS Total IgG (mg/ml) and Abs to malarial antigens (AMA1, EBA-175, MSP1-42, MSP2, MSP3, DBL5 of VAR2CSA) and TTx were measured in paired mother-cord samples obtained from premature and term deliveries in Cameroon. Half the women had PM at delivery. Avidity Indices (AIs) were determined by treating antigen-bound-Abs with different molar concentrations of NH4SCN and calculating 50% endpoints. RESULTS Total IgG and antigen-specific Abs increased in cord blood with gestational age; however, AIs did not. AIs in paired maternal-cord blood samples were strongly associated for all antigens (r = 0.77-0.96). However, no significant different in AIs was found between paired mother-cord blood samples for any of the antigens (p values > 0.05). Similarly, Ab avidity was not increased in cord blood of babies whose mothers had PM or hypergammaglobulinemia. DISCUSSION Overall, there was no evidence that higher avidity Abs to any of the malarial antigens or TTx were preferentially transferred to Cameroonian babies.
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Affiliation(s)
- Alexander K K Kayatani
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, 651 Ilalo Street, Bioscience Building, Room 320, Honolulu, HI, 96813, USA.
| | - Naveen Bobbili
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, 651 Ilalo Street, Bioscience Building, Room 320, Honolulu, HI, 96813, USA.
| | - Rosette Megnekou
- The Biotechnology Center, University of Yaoundé 1, BP 3851, Messa, Yaoundé, Cameroon.
| | - Masako Matsunaga
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, 651 Ilalo Street, Medical Education Building, Room 411, Honolulu, HI, 96813, USA.
| | - Rose F G Leke
- The Biotechnology Center, University of Yaoundé 1, BP 3851, Messa, Yaoundé, Cameroon.
| | - Diane Wallace Taylor
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, 651 Ilalo Street, Bioscience Building, Room 320, Honolulu, HI, 96813, USA.
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Sartoretti J, Fontannaz P, Martinez de Tejada B, Othenin-Girard V, Chilin A, Lemaître B, Blanchard-Rohner G, Siegrist CA, Eberhardt CS. Influence of Timing of Maternal Pertussis Immunization on the Avidity of Transferred Antibodies in Term and Preterm Neonates. Clin Infect Dis 2023; 77:645-648. [PMID: 37073575 PMCID: PMC10444006 DOI: 10.1093/cid/ciad227] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 04/05/2023] [Accepted: 04/12/2023] [Indexed: 04/20/2023] Open
Abstract
The timing of maternal pertussis vaccination influences the titers of cord-blood anti-pertussis antibodies. Whether it affects their avidity is unknown. We demonstrate in 298 term and 72 preterm neonates that antibody avidity is independent of the timing of maternal vaccination, whether comparing second with third trimester or intervals before birth.
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Affiliation(s)
- Julie Sartoretti
- Center for Vaccinology and Neonatal Immunology, Department of Pathology-Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of General Pediatrics, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland
- Department for Pediatrics, Gynecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Paola Fontannaz
- Center for Vaccinology and Neonatal Immunology, Department of Pathology-Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Begoña Martinez de Tejada
- Department for Pediatrics, Gynecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Obstetrics, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Véronique Othenin-Girard
- Department for Pediatrics, Gynecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Antonina Chilin
- Division of Obstetrics, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Barbara Lemaître
- Division of Laboratory Medicine, Department of Diagnostics and of Medical Specialties, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Géraldine Blanchard-Rohner
- Center for Vaccinology and Neonatal Immunology, Department of Pathology-Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of General Pediatrics, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland
- Department for Pediatrics, Gynecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Claire-Anne Siegrist
- Center for Vaccinology and Neonatal Immunology, Department of Pathology-Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of General Pediatrics, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland
- Department for Pediatrics, Gynecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Center for Vaccinology, University Hospitals of Geneva, Geneva, Switzerland
| | - Christiane Sigrid Eberhardt
- Center for Vaccinology and Neonatal Immunology, Department of Pathology-Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department for Pediatrics, Gynecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Center for Vaccinology, University Hospitals of Geneva, Geneva, Switzerland
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Knuutila A, Barkoff AM, Ivaska L, Tenhu E, Teräsjärvi J, van Gageldonk P, Buisman A, Mertsola J, He Q. Effect of Immunization During Pregnancy and Pre-existing Immunity on Diphtheria-Tetanus-Acellular Pertussis Vaccine Responses in Infants. Emerg Microbes Infect 2023; 12:2204146. [PMID: 37060181 PMCID: PMC10161941 DOI: 10.1080/22221751.2023.2204146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
Immunization during pregnancy (IP) against pertussis is recommended in many countries to protect infants. Although maternal antibodies can influence the infants' antibody responses to primary vaccinations, their effect on the development of functional antibodies and B cells remain poorly studied. We investigated the maternal immune response to IP and the effect of IP and pre-existing antibodieson infants' primary vaccine responses in an open-label, non-randomized trial. Forty-seven mothers received tetanus-diphtheria-acellular pertussis (Tdap) vaccine during pregnancy, and 22 mothers were included as controls. Sixty-nine infants received primary doses of DTaP at three and five months of age. Geometric mean concentrations of antibodies to pertussis toxin, filamentous haemagglutinin, pertactin, diphtheria, and tetanus toxins, pertussis toxin neutralizing antibodies (PTNAs), and plasma and memory B-cell frequencies were studied at delivery, and at three, five and six months. Levels of antibodies, PTNAs, and frequencies of memory B-cells were significantly increased at delivery and up to six months after in mothers with IP compared to those without IP (all p < 0.05, except for PT-specific memory B-cells). In vaccinated pregnant women, high pre-existing antibody levels were positively correlated with higher antibody responses after IP. IP blunted the infants' antibody and plasma B-cell responses to all vaccine antigens, except for tetanus toxin. This blunting effect was the strongest in infants with high concentrations of maternal antibodies. In conclusion, IP resulted in significantly higher concentrations of antibodies in infants up to three months of age (all p < 0.05); but was associated with blunting of various infants' vaccine responses.
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Affiliation(s)
- Aapo Knuutila
- Institute of Biomedicine, Centre for Infections and Immunity, University of Turku, Turku, Finland
| | - Alex-Mikael Barkoff
- Institute of Biomedicine, Centre for Infections and Immunity, University of Turku, Turku, Finland
| | - Lauri Ivaska
- Department of Paediatric and Adolescent Medicine, Turku University Hospital, and University of Turku, Turku, Finland
- InFLAMES Research Flagship Center, University of Turku, Turku, Finland
| | - Elina Tenhu
- Institute of Biomedicine, Centre for Infections and Immunity, University of Turku, Turku, Finland
| | - Johanna Teräsjärvi
- Institute of Biomedicine, Centre for Infections and Immunity, University of Turku, Turku, Finland
| | - Pieter van Gageldonk
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, Bilthoven, the Netherlands
| | - Annemarie Buisman
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, Bilthoven, the Netherlands
| | - Jussi Mertsola
- Department of Paediatric and Adolescent Medicine, Turku University Hospital, and University of Turku, Turku, Finland
- InFLAMES Research Flagship Center, University of Turku, Turku, Finland
| | - Qiushui He
- Institute of Biomedicine, Centre for Infections and Immunity, University of Turku, Turku, Finland
- InFLAMES Research Flagship Center, University of Turku, Turku, Finland
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Barkoff AM, Knuutila A, Mertsola J, He Q. Evaluation of Anti-PT Antibody Response after Pertussis Vaccination and Infection: The Importance of Both Quantity and Quality. Toxins (Basel) 2021; 13:toxins13080508. [PMID: 34437379 PMCID: PMC8402585 DOI: 10.3390/toxins13080508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/15/2021] [Accepted: 07/20/2021] [Indexed: 11/21/2022] Open
Abstract
Pertussis toxin (PT) is considered the main virulence factor causing whooping cough or pertussis. The protein is widely studied and its composition was revealed and sequenced already during the 1980s. The human immune system creates a good response against PT when measured in quantity. However, the serum anti-PT antibodies wane rapidly, and only a small amount of these antibodies are found a few years after vaccination/infection. Therefore, multiple approaches to study the functionality (quality) of these antibodies, e.g., avidity, neutralizing capacity, and epitope specificity, have been investigated. In addition, the long-term B cell memory (Bmem) to PT is crucial for good protection throughout life. In this review, we summarize the findings from functional PT antibody and Bmem studies. These results are discussed in line with the quantity of serum anti-PT antibodies. PT neutralizing antibodies and anti-PT antibodies with proper avidity are crucial for good protection against the disease, and certain epitopes have been identified to have multiple functions in the protection. Although PT-specific Bmem responses are detectable at least five years after vaccination, long-term surveillance is lacking. Variation of the natural boosting of circulating Bordetella pertussis in communities is an important confounding factor in these memory studies.
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Affiliation(s)
- Alex-Mikael Barkoff
- Research Center for Infection and Immunity, Institute of Biomedicine, University of Turku, 20520 Turku, Finland; (A.-M.B.); (A.K.); (J.M.)
| | - Aapo Knuutila
- Research Center for Infection and Immunity, Institute of Biomedicine, University of Turku, 20520 Turku, Finland; (A.-M.B.); (A.K.); (J.M.)
| | - Jussi Mertsola
- Research Center for Infection and Immunity, Institute of Biomedicine, University of Turku, 20520 Turku, Finland; (A.-M.B.); (A.K.); (J.M.)
- Department of Paediatrics and Adolescent Medicine, Turku University Hospital, 20520 Turku, Finland
| | - Qiushui He
- Research Center for Infection and Immunity, Institute of Biomedicine, University of Turku, 20520 Turku, Finland; (A.-M.B.); (A.K.); (J.M.)
- InFLAMES Research Flagship Center, University of Turku, 20520 Turku, Finland
- Correspondence: ; Tel.: +358-40-472-2255
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Vaz-de-Lima LR, Sato APS, Pawloski LC, Fernandes EG, Rajam G, Sato HK, Patel D, Li H, de Castilho EA, Tondella ML, Schiffer J. Effect of maternal Tdap on infant antibody response to a primary vaccination series with whole cell pertussis vaccine in São Paulo, Brazil. Vaccine X 2021; 7:100087. [PMID: 33817624 PMCID: PMC8010450 DOI: 10.1016/j.jvacx.2021.100087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 02/04/2021] [Accepted: 02/12/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Maternal Tetanus, diphtheria, and acellular pertussis (Tdap) vaccination provides antibody transfer to newborn infants and may affect their antibody response to the primary vaccination series. This study aimed to assess the effect of Tdap vaccination during pregnancy on infant antibody response to the whole cell pertussis (DTwP) primary series. METHODS Plasma from 318 pregnant women (243 Tdap-vaccinated and 75 unvaccinated) and their infants (cord blood) was collected at delivery; infant blood was again collected at 2 and 7 months, before and after their primary DTwP series. Anti-pertussis toxin (PT), pertactin (PRN), filamentous hemagglutinin (FHA), fimbriae 2/3 (FIM) and adenylate cyclase toxin (ACT) IgG antibodies were quantified by a microsphere-based multiplex antibody capture assay and anti-PT neutralizing antibodies by the Real Time Cell analysis system. RESULTS Infant geometric mean concentrations (GMCs) of IgG anti-Tdap antigens were significantly higher (p < 0.001) among the Tdap-vaccinated (PT: 57.22 IU/mL; PRN: 464.86 IU/mL; FHA: 424.0 IU/mL), versus the unvaccinated group (4 IU/mL, 15.43 IU/mL, 31.99 IU/mL, respectively) at delivery. Anti-FIM and ACT GMCs were similar between the two groups. At 2 months of age, anti-PT, PRN, and FHA GMCs remained higher (p < 0.001) in the Tdap-vaccinated group (12.64 IU/mL; 108.76 IU/mL; 87.41 IU/mL, respectively) than the unvaccinated group (1.02 IU/mL; 4.46 IU/mL; 6.89 IU/mL). However, at 7 months, after receiving the third DTwP dose, the anti-PT GMC was higher (p = 0.016) in the unvaccinated group (7.91 IU/mL) compared to the vaccinated group (2.27 IU/mL), but without differences for anti-PRN, FHA, FIM and ACT GMCs. CONCLUSION Elevated antibody levels suggest that maternal Tdap vaccination might protect infants until 2 months of age. Reduced anti-PT levels at 7 months indicate potential blunting of immune response in infants. Surveillance would help determine if blunting alters vaccine immunity and impacts pertussis prevention in infants.
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Affiliation(s)
- Lourdes R.A. Vaz-de-Lima
- Centro de Imunologia, Instituto Adolfo Lutz, Coordenadoria de Controle de Doenças da Secretaria de Estado da Saúde, São Paulo, Brazil
| | - Ana Paula S. Sato
- Departmento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo – USP, Brazil
| | - Lucia C. Pawloski
- Division of Bacterial Diseases, NCIRD, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Eder G. Fernandes
- Divisão de Imunização, Centro de Vigilância Epidemiológica Prof. Alexandre Vranjac, Coordenadoria de Controle de Doenças da Secretaria de Estado da Saúde SP, Brazil
| | - Gowrisankar Rajam
- Division of Bacterial Diseases, NCIRD, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Helena K. Sato
- Divisão de Imunização, Centro de Vigilância Epidemiológica Prof. Alexandre Vranjac, Coordenadoria de Controle de Doenças da Secretaria de Estado da Saúde SP, Brazil
| | - Divya Patel
- Division of Bacterial Diseases, NCIRD, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Han Li
- Division of Bacterial Diseases, NCIRD, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Maria Lucia Tondella
- Division of Bacterial Diseases, NCIRD, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jarad Schiffer
- Division of Bacterial Diseases, NCIRD, Centers for Disease Control and Prevention, Atlanta, GA, USA
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10
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Abu-Raya B, Giles ML, Kollmann TR, Sadarangani M. Profiling avidity of antibodies elicited by vaccination using enzyme-linked immunosorbent assay-based elution - Insights into a novel experimental and analytical approach. Vaccine 2020; 38:5389-5392. [PMID: 32620372 DOI: 10.1016/j.vaccine.2020.06.060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/14/2020] [Accepted: 06/19/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Bahaa Abu-Raya
- Vaccine Evaluation Center, BC Children's Hospital, University of British Columbia, Vancouver, Canada; Division of Infectious Diseases, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
| | - Michelle L Giles
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia
| | - Tobias R Kollmann
- Division of Infectious Diseases, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada; Telethon Kids Institute, Perth, Australia
| | - Manish Sadarangani
- Vaccine Evaluation Center, BC Children's Hospital, University of British Columbia, Vancouver, Canada; Division of Infectious Diseases, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
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11
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Patel CD, Backes IM, Taylor SA, Jiang Y, Marchant A, Pesola JM, Coen DM, Knipe DM, Ackerman ME, Leib DA. Maternal immunization confers protection against neonatal herpes simplex mortality and behavioral morbidity. Sci Transl Med 2020; 11:11/487/eaau6039. [PMID: 30971454 DOI: 10.1126/scitranslmed.aau6039] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 11/30/2018] [Accepted: 01/15/2019] [Indexed: 12/11/2022]
Abstract
Neonatal herpes simplex virus (nHSV) infections cause devastating morbidity and mortality in infants. Most nHSV cases are associated with primary maternal infection, consistent with the hypothesis that maternal immunity is protective. In humans, we found HSV-specific neutralizing antibodies in newborns of immune mothers, indicating that placentally transferred HSV-specific antibody is protective. Using a murine model, we showed that passive administration of HSV-specific antibody to dams prevented disseminated infection and mortality in pups. Maternal immunization with an HSV-2 replication-defective vaccine candidate, dl5-29, led to transfer of HSV-specific antibodies into neonatal circulation that protected against nHSV neurological disease and death. Furthermore, we observed considerable anxiety-like behavior in adult mice that had been infected with low doses of HSV as neonates, despite a notable lack of signs of infection. This phenotype suggests that nHSV infection can have an unsuspected and permanent impact on behavior. These behavioral sequelae of nHSV were prevented by maternal immunization with dl5-29, demonstrating an unexpected benefit of immunization. These findings also support the general concept that maternal immunization can prevent neurotropic neonatal infections and associated morbidity and mortality.
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Affiliation(s)
- Chaya D Patel
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Lebanon, NH 03756, USA.,Guarini School of Graduate and Advanced Studies at Dartmouth, Hanover, NH 03755, USA
| | - Iara M Backes
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Lebanon, NH 03756, USA.,Thayer School of Engineering, Dartmouth College, Hanover, NH 03755, USA
| | - Sean A Taylor
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Lebanon, NH 03756, USA
| | - Yike Jiang
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Lebanon, NH 03756, USA
| | - Arnaud Marchant
- Institute for Medical Immunology, Université libre de Bruxelles, Charleroi B-6041, Belgium
| | - Jean M Pesola
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA 02115, USA
| | - Donald M Coen
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA 02115, USA
| | - David M Knipe
- Department of Microbiology and Immunobiology, Harvard Medical School, Boston, MA 02115, USA
| | | | - David A Leib
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Lebanon, NH 03756, USA.
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12
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Gestal MC, Johnson HM, Harvill ET. Immunomodulation as a Novel Strategy for Prevention and Treatment of Bordetella spp. Infections. Front Immunol 2019; 10:2869. [PMID: 31921136 PMCID: PMC6923730 DOI: 10.3389/fimmu.2019.02869] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 11/22/2019] [Indexed: 12/13/2022] Open
Abstract
Well-adapted pathogens have evolved to survive the many challenges of a robust immune response. Defending against all host antimicrobials simultaneously would be exceedingly difficult, if not impossible, so many co-evolved organisms utilize immunomodulatory tools to subvert, distract, and/or evade the host immune response. Bordetella spp. present many examples of the diversity of immunomodulators and an exceptional experimental system in which to study them. Recent advances in this experimental system suggest strategies for interventions that tweak immunity to disrupt bacterial immunomodulation, engaging more effective host immunity to better prevent and treat infections. Here we review advances in the understanding of respiratory pathogens, with special focus on Bordetella spp., and prospects for the use of immune-stimulatory interventions in the prevention and treatment of infection.
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Affiliation(s)
- Monica C Gestal
- Department of Infectious Diseases, College of Veterinary Sciences, University of Georgia, Athens, GA, United States
| | - Hannah M Johnson
- Department of Infectious Diseases, College of Veterinary Sciences, University of Georgia, Athens, GA, United States
| | - Eric T Harvill
- Department of Infectious Diseases, College of Veterinary Sciences, University of Georgia, Athens, GA, United States
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13
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Switzer C, D'Heilly C, Macina D. Immunological and Clinical Benefits of Maternal Immunization Against Pertussis: A Systematic Review. Infect Dis Ther 2019; 8:499-541. [PMID: 31535327 PMCID: PMC6856250 DOI: 10.1007/s40121-019-00264-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Indexed: 11/17/2022] Open
Abstract
Infants are vulnerable to pertussis infection particularly before initiation of pertussis vaccination. Maternal pertussis vaccination during pregnancy has been introduced in a number of countries in order to confer on young infants indirect protection from the disease through transplacental transfer of maternal antibodies. We reviewed the evidence on the immunogenicity and efficacy of maternal pertussis vaccination during pregnancy. A systematic search of PubMed/MEDLINE, EMBASE, Scopus, Cochrane Database of Systematic Reviews, ProQuest, and Science Direct was undertaken to identify studies published between January 1995 and December 2018. This review was not specific to any particular pertussis vaccine but included applicable data on available pertussis vaccines administered to pregnant women. The search identified 40 publications for inclusion in this review. Vaccination during pregnancy elicited robust maternal immune responses against all vaccine antigens and resulted in high placental transfer of pertussis antibodies to the infant that persisted well beyond delivery. Vaccination during the second or early third trimesters was considered ideal for antibody quantity and functionality. Although blunting of immune responses to some antigens in the primary immunization series was documented in neonates born to women vaccinated during pregnancy, there was no apparent adverse effect on vaccine efficacy. Multiple studies conducted in diverse settings have confirmed the effectiveness of maternal pertussis vaccination during pregnancy in preventing pertussis in infants prior to receipt of their first primary vaccine dose and beyond. These findings collectively underscore the value of maternal pertussis vaccination during pregnancy in protecting vulnerable infants too young to be vaccinated.Funding Sanofi Pasteur.Plain Language Summary Plain language summary available for this article.
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Affiliation(s)
| | | | - Denis Macina
- Sanofi Pasteur, Vaccines Epidemiology and Modeling, Lyon, France.
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14
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Perrett KP, Halperin SA, Nolan T, Carmona Martínez A, Martinón-Torres F, García-Sicilia J, Virta M, Vanderkooi OG, Zuccotti GV, Manzoni P, Kostanyan L, Meyer N, Ceregido MA, Cheuvart B, Kuriyakose SO, Stranak Z, Merino Arribas JM, Cilleruelo Ortega MJ, Miranda-Valdivieso M, Arias Novas B, Ramos Amador JT, Omeñaca F, Baca M, Marchisio PG, Mesaros N. Impact of tetanus-diphtheria-acellular pertussis immunization during pregnancy on subsequent infant immunization seroresponses: follow-up from a large randomized placebo-controlled trial. Vaccine 2019; 38:2105-2114. [PMID: 31776027 DOI: 10.1016/j.vaccine.2019.10.104] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 10/30/2019] [Accepted: 10/31/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Pertussis immunization during pregnancy results in high pertussis antibody concentrations in young infants but may interfere with infant immune responses to post-natal immunization. METHODS This phase IV, multi-country, open-label study assessed the immunogenicity and safety of infant primary vaccination with DTaP-HepB-IPV/Hib and 13-valent pneumococcal conjugate vaccine (PCV13). Enrolled infants (6-14 weeks old) were born to mothers who were randomized to receive reduced-antigen-content diphtheria-tetanus-three-component acellular pertussis vaccine (Tdap group) or placebo (control group) during pregnancy (270/7-366/7 weeks' gestation) with crossover immunization postpartum. All infants received 2 or 3 DTaP-HepB-IPV/Hib and PCV13 doses according to national schedules. Immunogenicity was assessed in infants pre- and 1 month post-primary vaccination. The primary objective was to assess seroprotection/vaccine response rates for DTaP-HepB-IPV/Hib antigens 1 month post-primary vaccination. RESULTS 601 infants (Tdap group: 296; control group: 305) were vaccinated. One month post-priming, seroprotection rates were 100% (diphtheria; tetanus), ≥98.5% (hepatitis B), ≥95.9% (polio) and ≥94.5% (Hib) in both groups. Vaccine response rates for pertussis antigens were significantly lower in infants whose mothers received pregnancy Tdap (37.5-77.1%) versus placebo (90.0-99.2%). Solicited and unsolicited adverse event rates were similar between groups. Serious adverse events occurred in 2.4% (Tdap group) and 5.6% (control group) of infants, none were vaccination-related. CONCLUSIONS Pertussis antibodies transferred during pregnancy may decrease the risk of pertussis infection in the first months of life but interfere with the infant's ability to produce pertussis antibodies, the clinical significance of which remains unknown. Safety and reactogenicity results were consistent with previous experience. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov: NCT02422264.
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Affiliation(s)
- Kirsten P Perrett
- Murdoch Children's Research Institute and Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
| | - Scott A Halperin
- Dalhousie University, Canadian Center for Vaccinology, Halifax, Canada.
| | - Terry Nolan
- Murdoch Children's Research Institute and Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
| | | | - Federico Martinón-Torres
- Translational Pediatrics and Infectious Diseases, Pediatrics Department, Hospital Clínico Universitario de Santiago de Compostela and Genetics, Vaccines and Pediatrics Research Group, University of Santiago de Compostela, Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago de Compostela, Spain.
| | | | - Miia Virta
- Tampere Vaccine Research Center, Tampere University, Tampere, Finland.
| | - Otto G Vanderkooi
- Alberta Children's Hospital, University of Calgary, Alberta, Calgary, Canada.
| | | | - Paolo Manzoni
- Ospedale Ostetrico Ginecologico Sant'Anna, Turin, Italy and Department of Maternal-Infant -Pediatric Health, Hospital "Degli Infermi", Biella, Italy
| | | | | | | | | | | | - Zbynek Stranak
- Institute for the Care of Mother and Child, Prague, Czech Republic.
| | | | | | | | | | | | | | - Manuel Baca
- Hospital Quiron Malaga, Andalucia, Malaga, Spain.
| | - Paola Giovanna Marchisio
- Unità Pediatrica di Cure Altamente Intensive, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Lombardia, Milano, Italy.
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15
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Abu-Raya B, Giles ML, Kollmann TR, Sadarangani M. The Effect of Timing of Tetanus-Diphtheria-Acellular Pertussis Vaccine Administration in Pregnancy on the Avidity of Pertussis Antibodies. Front Immunol 2019; 10:2423. [PMID: 31681310 PMCID: PMC6798090 DOI: 10.3389/fimmu.2019.02423] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 09/27/2019] [Indexed: 11/15/2022] Open
Abstract
Background: Optimal timing of gestational tetanus-diphtheria-acellular pertussis (Tdap) vaccination is not well-defined. No well-established specific anti-pertussis antibody level correlates with protection, suggesting the importance of antibody quality such as avidity. We aimed to determine the effect of timing of vaccination with Tdap in pregnancy on the avidity of cord anti-pertussis toxin (PT) immunoglobulin G (IgG). Methods: Prospective study of newborns in a tertiary hospital (Melbourne, Australia) born to women vaccinated with Tdap in pregnancy. Ammonium thiocyanate was used as a bond-breaking agent to measure the avidity of anti-PT IgG using concentrations between 0.25 M (to measure low avidity antibodies) and 3 M (to measure very high avidity antibodies). Anti-PT IgG levels achieved at each ammonium thiocyanate concentration in cord samples of women vaccinated during 28–32 weeks gestation (WG) vs. 33–36 WG, and women vaccinated 5–12 vs. 1–4 weeks prior to delivery were compared using t-tests. Results: Newborns of women vaccinated with Tdap during 28–32 WG (n = 43) had statistically significant higher concentrations of medium and high avidity anti-PT IgG compared with newborns of women vaccinated during 33–36 WG (n = 47), 11.6 IU/ml (95% CI, 8.8–15.2) IU/ml vs. 6.7 IU/ml (95% CI, 5.2–8.6) and 10.1 IU/ml (95% CI, 7.4–13.8) vs. 5.7 (95% CI, 3.6–8.9) IU/ml (p = 0.007 and p = 0.035), respectively. Newborns of women vaccinated 5–12 weeks before delivery (n = 64) had statistically significant higher concentrations of high and very high avidity anti-PT IgG compared with newborns of women vaccinated within 4 weeks before delivery (n = 25), 10.3 IU/mL (95% CI, 7.9–13.4) vs. 3.3 IU/mL (95% CI, 1.7–6.4), 12.6 IU/mL (95% CI, 9.4–16.9) vs. 4.3 IU/mL (95% CI, 2.2–8.5) (all p < 0.03), respectively. Conclusions: Quantification of levels of anti-PT IgG with different avidities demonstrated that pertussis vaccination 5–12 weeks before delivery was associated with higher anti-PT IgG avidity compared with vaccination within 4 weeks before delivery. Pertussis vaccination during 28–32 WG was associated with higher anti-PT IgG avidity compared with vaccination during 33–36 WG, supporting vaccination at 28–32 over 33–36 WG for optimal protection against pertussis in infancy.
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Affiliation(s)
- Bahaa Abu-Raya
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, BC, Canada.,Division of Infectious Diseases, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Michelle L Giles
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, VIC, Australia
| | - Tobias R Kollmann
- Division of Infectious Diseases, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Manish Sadarangani
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, BC, Canada.,Division of Infectious Diseases, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
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16
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Age-related differences in antibody avidities to pertussis toxin and filamentous hemagglutinin in a healthy Japanese population. Vaccine 2019; 37:2463-2469. [PMID: 30930008 DOI: 10.1016/j.vaccine.2019.03.055] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 03/21/2019] [Accepted: 03/22/2019] [Indexed: 02/06/2023]
Abstract
To gain insights into the current Japanese pertussis immunization schedule, we examined the distributions of antibody titers and avidities to pertussis toxin (PT) and filamentous hemagglutinin (FHA) in 460 Japanese healthy subjects (aged 1-60 years) based on age category. Our avidity enzyme-linked immunosorbent assays revealed that young children aged 1-2 years, which corresponded to ages after receiving primary and/or booster pertussis vaccinations, had relatively high-avidity anti-PT IgG (mean avidity index [AI], 40.5%) compared with other age groups (AI, 26.5-31.9%); however, they had relatively low-avidity anti-FHA IgG (AI, 41.8%). In contrast, children aged 3-6 years had both low-avidity anti-PT IgG (AI, 26.5%) and low-avidity anti-FHA IgG (AI, 40.4%). A significant age-related difference in anti-PT IgG avidity was observed between children aged 1-2 years and 3-6 years (P < 0.05); however, the difference in anti-FHA IgG avidity was not significant. The anti-PT IgG avidity was positively correlated with the antibody titer, especially among children aged 1-15 years (rs = 0.508-0.685; P < 0.01), indicating that the avidity of vaccine-induced anti-PT IgG decreases with decreasing IgG antibody titer to PT. Our findings strongly suggest that vaccine-induced anti-PT IgG avidity rapidly wanes after vaccination, but this is not observed for anti-FHA IgG avidity. Because children aged 3-6 years have both low-quantity and low-quality antibodies against PT, an additional booster vaccination with acellular pertussis vaccines is required for such children in Japan.
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17
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Chekanova TA, Shpynov SN, Tarasevich IV. AVIDITY OF IGG TO RICKETTSIA PROWAZEKII AS AN ADDITIONAL CRITERION FOR THE SEROLOGICAL DIFFERENTIAL DIAGNOSIS OF THE EPIDEMIC TYPH AND ITS RECRUDESCENT FORM - BRILL-ZINSSER DISEASE. JOURNAL OF MICROBIOLOGY EPIDEMIOLOGY IMMUNOBIOLOGY 2018. [DOI: 10.36233/0372-9311-2018-5-73-80] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Aim: to investigate the diagnostic significance of avidity index (AI) for IgG toR. prowazekii with the determination of specific G and M class antibodies. Materials and methods. IgG/IgM to R. prowazekii, their titers and AI of IgG were measured in ELISA in 112 serum samples (47 sera from typhus-vaccinated individuals and 65 samples from patients and/or convalescents of epidemic typhus and/or Brill-Zinsser disease, including 18 sera collected during Lipetsk epidemic typhus outbreak in 1998).Results. Methodological approaches for estimation of AI for IgG toR. prowazekii have been determined. The initial period (or acute) of epidemic typhus we serologically detected in 8 cases by identifying of IgM toR. prowazekii only in two sera and IgM as well as IgG toR. prowazekii with low or medium values of AI in 6 samples. In 19 samples from patients we indicated Brill-Zinsser disease due to the presence in them specific IgM and IgG to R. prowazekii with high values AI. In 2 sera from vaccinated persons was established a low AI of IgG at significant diagnostic titers. Conclusion. AI of IgG to R. prowazekii has high prognostic information for differential diagnosis of epidemic typhus and Brill-Zinsser disease.
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Affiliation(s)
- T. A. Chekanova
- Gamaleya National Research Centre of Epidemiology and Microbiology
| | - S. N. Shpynov
- Gamaleya National Research Centre of Epidemiology and Microbiology
| | - I. V. Tarasevich
- Gamaleya National Research Centre of Epidemiology and Microbiology
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18
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Campbell H, Gupta S, Dolan GP, Kapadia SJ, Kumar Singh A, Andrews N, Amirthalingam G. Review of vaccination in pregnancy to prevent pertussis in early infancy. J Med Microbiol 2018; 67:1426-1456. [PMID: 30222536 DOI: 10.1099/jmm.0.000829] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Maternal pertussis vaccination has been introduced in several countries to protect infants from birth until routine infant vaccination takes place. This review assesses existing evidence on the effectiveness and safety of immunization in pregnancy. The search was finalized in April 2017 and was based on searches using several databases. The selection criteria included any experimental or observational study reporting on the immunogenicity, effectiveness or safety of vaccination with a pertussis-containing vaccine in pregnant women and their infants. Following de-duplication and exclusions, we identified 8395 studies, which were reduced to 46 for inclusion. The overall risk of bias was low, with the exception of some early studies and pharmacovigilance safety data. The evidence demonstrates efficient transplacental transfer of maternal antibodies in infants whose mothers were vaccinated with Tdap or Tdap/IPV in pregnancy, with good evidence that this protects against disease in young infants. Safety studies covering more than 150 000 women vaccinated mostly in the late second or third trimesters are generally consistent and provide reassurance of no significant increased risk of recognized maternal conditions or of adverse events (including congenital anomalies) in infants born to vaccinated women. The clinical significance of reduced seroconversion to pertussis following routine immunization is not yet clear, but no increased risk of pertussis in infants whose mothers were vaccinated in pregnancy was found following primary immunizations in North American and English studies. Most post-booster studies suggest that any blunting effect is short-lived and that longer-term protection in infants from active immunization is not compromised.
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Affiliation(s)
- Helen Campbell
- 1Department of Immunisation, Hepatitis and Blood Safety, Public Health England, London, UK
| | - Saurabh Gupta
- 2Public Health, Epidemiology and Biostatistics, Ambition Health Private Limited, Gurgaon, India
- 3National Technical Advisory Group on Immunization Secretariat, National Institute of Health and Family Welfare, New Delhi, India
| | - Gayle P Dolan
- 4North East PHE Centre, Public Health England, Newcastle upon Tyne, UK
| | - Smita J Kapadia
- 5Health Protection Team, Public Health England, East of England, Harlow, UK
| | - Awnish Kumar Singh
- 3National Technical Advisory Group on Immunization Secretariat, National Institute of Health and Family Welfare, New Delhi, India
| | - Nick Andrews
- 6Department of Statistics Modelling and Economics, Public Health England, London, UK
| | - Gayatri Amirthalingam
- 1Department of Immunisation, Hepatitis and Blood Safety, Public Health England, London, UK
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19
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Rice T, Kampmann B, Holder B. One size fits all? Antibody avidity measurement against multiple antigens in maternal vaccination studies. Virulence 2017; 8:1066-1068. [PMID: 28441089 DOI: 10.1080/21505594.2017.1321192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Thomas Rice
- a Paediatrics, Division of Infectious Diseases , Centre for International Child Health, Imperial College London , London , UK
| | - Beate Kampmann
- a Paediatrics, Division of Infectious Diseases , Centre for International Child Health, Imperial College London , London , UK
| | - Beth Holder
- a Paediatrics, Division of Infectious Diseases , Centre for International Child Health, Imperial College London , London , UK
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20
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Pertussis diagnosis in Belgium: results of the National Reference Centre for Bordetella anno 2015. Epidemiol Infect 2017; 145:2366-2373. [PMID: 28578723 DOI: 10.1017/s0950268817001108] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
In 2015, the Belgian National Reference Centre for Bordetella analyzed 4110 respiratory samples by qPCR and 4877 serum samples by serology. Whereas about 50% of respiratory samples were from infants and children below the age of five, serum samples were distributed among all age categories. A total of 394 (9·6%) cases was diagnosed as positive for Bordetella pertussis by qPCR and 844 (17·3%) cases were diagnosed as acute infection by serology (anti-pertussis toxin (PT) IgG > 125 IU/ml). Another 1042 (21·4%) sera had anti-PT IgG between 55 and 125 IU/ml reflecting a vaccination or pertussis infection during the last 1-2 years. Seventy per cent of the pertussis cases diagnosed by qPRC were in infants and children younger than 14 years old, whereas the highest number of sera with anti-PT levels >125 IU/ml was in the age group of 10-14 years old. Based on the limited data of the last vaccination (reported for only 15% of the samples), recent booster vaccination in the teenager group may have contributed only minimally to these elevated anti-PT levels. The highest number of sera with anti-PT titers between 55 and 125 IU/ml was found in the age category 50-59 years old. It is clear that pertussis continues to be a problem in Belgium and that other vaccination strategies (maternal vaccination, cocoon vaccination) and ultimately better vaccines will be needed to control this highly infectious respiratory disease.
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