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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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Diks AM, de Graaf H, Teodosio C, Groenland RJ, de Mooij B, Ibrahim M, Hill AR, Read RC, van Dongen JJ, Berkowska MA. Distinct early cellular kinetics in participants protected against colonization upon Bordetella pertussis challenge. J Clin Invest 2023; 133:163121. [PMID: 36649086 PMCID: PMC9974097 DOI: 10.1172/jci163121] [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] [Received: 06/29/2022] [Accepted: 01/10/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUNDTo date, only limited data are available on the mechanisms of protection against colonization with Bordetella pertussis in humans.METHODSIn this study, the cellular responses to B. pertussis challenge were monitored longitudinally using high-dimensional EuroFlow-based flow cytometry, allowing quantitative detection of more than 250 different immune cell subsets in the blood of 15 healthy donors.RESULTSParticipants who were protected against colonization showed different early cellular responses compared with colonized participants. Especially prominent for colonization-protected participants were the early expansion of CD36- nonclassical monocytes on day 1 (D1), natural killer cells (D3), follicular T helper cells (D1-D3), and plasma cells (D3). Plasma cell expansion on D3 correlated negatively with the CFU load on D7 and D9 after challenge. Increased plasma cell maturation on D11-D14 was found in participants with seroconversion.CONCLUSIONThese early cellular immune responses following experimental infection can now be further characterized and potentially linked to an efficient mucosal immune response, preventing colonization. Ultimately, their presence may be used to evaluate whether new B. pertussis vaccine candidates are protective against B. pertussis colonization, e.g., by bacterial challenge after vaccination.TRIAL REGISTRATIONClinicalTrials.gov NCT03751514.FUNDINGInnovative Medicines Initiative 2 Joint Undertaking and the EuroFlow Consortium.
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Affiliation(s)
- Annieck M Diks
- Department of Immunology, Leiden University Medical Center, Leiden, Netherlands
| | - Hans de Graaf
- Faculty of Medicine and.,NIHR Southampton Biomedical Research Centre, University of Southampton, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Cristina Teodosio
- Department of Immunology, Leiden University Medical Center, Leiden, Netherlands.,Centro de Investigación del Cáncer-Instituto de Biología Molecular y Celular del Cáncer (CIC-IBMCC, USAL-CSIC-FICUS) and Department of Medicine, University of Salamanca, Salamanca, Spain
| | - Rick J Groenland
- Department of Immunology, Leiden University Medical Center, Leiden, Netherlands
| | - Bas de Mooij
- Department of Immunology, Leiden University Medical Center, Leiden, Netherlands
| | - Muktar Ibrahim
- NIHR Southampton Biomedical Research Centre, University of Southampton, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Alison R Hill
- NIHR Southampton Biomedical Research Centre, University of Southampton, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Robert C Read
- NIHR Southampton Biomedical Research Centre, University of Southampton, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Jacques Jm van Dongen
- Department of Immunology, Leiden University Medical Center, Leiden, Netherlands.,Centro de Investigación del Cáncer-Instituto de Biología Molecular y Celular del Cáncer (CIC-IBMCC, USAL-CSIC-FICUS) and Department of Medicine, University of Salamanca, Salamanca, Spain
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3
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Knuutila A, Duncan J, Li F, Eletu S, Litt D, Fry N, He Q. Oral fluid-based lateral flow point-of-care assays for pertussis serology. J Med Microbiol 2023; 72. [PMID: 36763084 DOI: 10.1099/jmm.0.001668] [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: 02/11/2023] Open
Abstract
Introduction. Current serological diagnosis of pertussis is usually performed by ELISA, which is typically performed in larger diagnostic or reference laboratories, requires trained staff, and due to sample batching may have longer turnaround times.Hypothesis and Aim. A rapid point-of-care (POC) assay for pertussis serology would aid in both the diagnosis and surveillance of the disease.Methodology. A quantitative lateral flow (LF)-based immunoassay with fluorescent Eu-nanoparticle reporters was developed for the detection of anti-pertussis toxin (PT) and adenylate cyclase toxin (ACT) antibodies from oral fluid samples (N=100), from suspected pertussis cases with respiratory symptoms.Results. LF assay results were compared to those obtained with anti-PT IgG oral fluid ELISA. For an ELISA cut-off value of 50 arbitrary units, the overall agreement between the assays was 91/100 (91 %), the sensitivity was 63/70 (90 %) and the specificity was 28/30 (93 %). No ACT-specific antibodies were detected from oral fluid samples; however, the signal readout positively correlated to those patients with high anti-PT IgG antibodies.Conclusion. The developed LF assay was a specific, sensitive and rapid test for serological diagnosis of pertussis with anti-PT antibodies and is a suitable POC test using oral fluid samples.
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Affiliation(s)
- Aapo Knuutila
- Institute of Biomedicine, University of Turku, Kiinamyllynkatu 10, Turku, Finland
| | - John Duncan
- Vaccine Preventable Bacteria Section, UK Health Security Agency, London, UK
| | - Fu Li
- Vaccine Preventable Bacteria Section, UK Health Security Agency, London, UK
| | - Seyi Eletu
- Vaccine Preventable Bacteria Section, UK Health Security Agency, London, UK
| | - David Litt
- Vaccine Preventable Bacteria Section, UK Health Security Agency, London, UK
| | - Norman Fry
- Vaccine Preventable Bacteria Section, UK Health Security Agency, London, UK.,Immunisation and Vaccine Preventable Diseases, UK Health Security Agency, London, UK
| | - Qiushui He
- Institute of Biomedicine, University of Turku, Kiinamyllynkatu 10, Turku, Finland.,InFLAMES Research Flagship Center, University of Turku, Kiinamyllynkatu 10, Turku, Finland
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Versteegen P, Berbers GA, Smits G, Sanders EA, van der Klis FR, de Melker HE, van der Maas NA. More than 10 years after introduction of an acellular pertussis vaccine in infancy: a cross-sectional serosurvey of pertussis in the Netherlands. THE LANCET REGIONAL HEALTH. EUROPE 2021; 10:100196. [PMID: 34806066 PMCID: PMC8589709 DOI: 10.1016/j.lanepe.2021.100196] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background Pertussis is a respiratory disease and still endemic despite high vaccination coverage. In the Dutch national immunisation programme (NIP) whole cell pertussis (wP) priming vaccines for infants were replaced by acellular pertussis (aP) priming vaccines in 2005. Serosurveillance gives the opportunity to objectively monitor effects of changes in the NIP on infection prevalence and vaccine response in the population over time. Methods For this population-based cross-sectional serosurvey a representative sample of Dutch residents (0-89 years) was drawn in 2016/2017. Primary outcome was the percentage of participants with pertussis toxin specific antibody concentrations ≥ 100 IU/ml as an indicator of recent infection, and to identify groups possibly more vulnerable to pertussis infection. Percentages were compared with previous results from 2006/2007. Findings In total 7621 persons were included in the analysis. An increase in recent infections from 3•5% to 5•9% was found in the population from 7 years and older (n=6013) in 2016/2017 compared with 2006/2007. Most noteworthy increase was seen in 12-18-year-olds who were wP primed and aP boosted. Interpretation Infection prevalence is still increasing in the Netherlands inducing a risk of pertussis disease in vulnerable (age) groups. Delaying the preschool booster might prolong the period of protection during primary school and thereby possibly protect younger siblings. Extra boosters might be considered for risk populations like older adults and people with (pulmonary) co-morbidities, since they have higher chances of complications and hospitalisation. An unedited Dutch translation of the abstract is available in Supplementary text 1: Nederlandse samenvatting. Funding The Dutch Ministry of Health, Welfare, and Sport.
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Affiliation(s)
- Pauline Versteegen
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, 3720 BA, Netherlands
- Corresponding author: Pauline Versteegen, MD, Centre for Infectious Disease Control, National Institute of Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands, +31 6 23 76 44 11
| | - Guy A.M. Berbers
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, 3720 BA, Netherlands
| | - Gaby Smits
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, 3720 BA, Netherlands
| | - Elisabeth A.M. Sanders
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, 3720 BA, Netherlands
- Wilhelmina Children's Hospital, Department of Paediatric Immunology and Infectious Diseases, Lundlaan 6, 3584 EA Utrecht, Netherlands
| | - Fiona R.M. van der Klis
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, 3720 BA, Netherlands
| | - Hester E. de Melker
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, 3720 BA, Netherlands
| | - Nicoline A.T. van der Maas
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, 3720 BA, Netherlands
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Versteegen P, Valente Pinto M, Barkoff AM, van Gageldonk PGM, van de Kassteele J, van Houten MA, Sanders EAM, de Groot R, Diavatopoulos DA, Bibi S, Luoto R, He Q, Buisman AM, Kelly DF, Mertsola J, Berbers GAM. Responses to an acellular pertussis booster vaccination in children, adolescents, and young and older adults: A collaborative study in Finland, the Netherlands, and the United Kingdom. EBioMedicine 2021; 65:103247. [PMID: 33647770 PMCID: PMC7920834 DOI: 10.1016/j.ebiom.2021.103247] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 02/02/2021] [Accepted: 02/02/2021] [Indexed: 01/08/2023] Open
Abstract
Background Pertussis can lead to serious disease and even death
in infants. Older adults are more vulnerable to complications as well. In
high-income countries, acellular pertussis vaccines are used for priming
vaccination. In the administration of booster vaccinations to different age
groups and target populations there is a substantial between-country variation.
We investigated the effect of age on the response to acellular pertussis booster
vaccination in three European countries. Methods This phase IV longitudinal intervention study
performed in Finland, the Netherlands and the United Kingdom between October
2017 and January 2019 compared the vaccine responses between healthy
participants of four age groups: children (7–10y), adolescents (11–15y), young
adults (20–34y), and older adults (60–70y). All participants received a
three-component acellular pertussis vaccine. Serum IgG and IgA antibody
concentrations to pertussis antigens at day 0, 28, and 1 year were measured with
a multiplex immunoassay, using pertussis toxin concentrations at day 28 as
primary outcome. This trial is registered with ClinicalTrialsRegister.eu
(2016–003,678–42). Findings Children (n = 109), adolescents
(n = 121), young adults
(n = 74), and older adults
(n = 75) showed high IgG antibody concentrations to
pertussis toxin at day 28 with GMCs of 147 (95% CI 120–181), 161 (95% CI
132–196), 103 (95% CI 80–133), and 121 IU/ml (95% CI 94–155), respectively. A
significant increase in GMCs for vaccine antigens in all age groups by 28 days
was found which had decreased by 1 year. Differences in patterns of IgG GMCs at
28 days and 1 year post-vaccination did not have a consistent relationship to
age. In contrast, IgA antibodies for all antigens increased with age at all
timepoints. Interpretation Acellular pertussis booster vaccination induces
significant serum IgG responses to pertussis antigens across the age range which
are not uniformly less in older adults. Acellular boosters could be considered
for older adults to reduce the health and economic burden of
pertussis.
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Affiliation(s)
- Pauline Versteegen
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Antonie van Leeuwenhoeklaan 9, Bilthoven 3720 BA, Netherlands
| | - Marta Valente Pinto
- University of Oxford, Department of Paediatrics, Oxford Vaccine Group, Oxford OX3 7LE, United Kingdom
| | - Alex M Barkoff
- University of Turku, Institute of Biomedicine, Microbiology, Virology and Immunology, and Turku University Hospital, Turku 20500, Finland
| | - Pieter G M van Gageldonk
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Antonie van Leeuwenhoeklaan 9, Bilthoven 3720 BA, Netherlands
| | - Jan van de Kassteele
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Antonie van Leeuwenhoeklaan 9, Bilthoven 3720 BA, Netherlands
| | | | - Elisabeth A M Sanders
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Antonie van Leeuwenhoeklaan 9, Bilthoven 3720 BA, Netherlands; Wilhelmina Children's Hospital, Department of Paediatric Immunology and Infectious Diseases, Lundlaan 6, 3584 EA Utrecht, Netherlands
| | - Ronald de Groot
- Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine, Nijmegen 6525 GA, Netherlands
| | - Dimitri A Diavatopoulos
- Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine, Nijmegen 6525 GA, Netherlands
| | - Sagida Bibi
- University of Oxford, Department of Paediatrics, Oxford Vaccine Group, Oxford OX3 7LE, United Kingdom
| | - Raakel Luoto
- University of Turku, Institute of Biomedicine, Microbiology, Virology and Immunology, and Turku University Hospital, Turku 20500, Finland
| | - Qiushui He
- University of Turku, Institute of Biomedicine, Microbiology, Virology and Immunology, and Turku University Hospital, Turku 20500, Finland
| | - Anne-Marie Buisman
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Antonie van Leeuwenhoeklaan 9, Bilthoven 3720 BA, Netherlands
| | - Dominic F Kelly
- University of Oxford, Department of Paediatrics, Oxford Vaccine Group, Oxford OX3 7LE, United Kingdom; Oxford University Hospitals NHS Foundation Trust, Headington, Oxford OX3 9DU, United Kingdom
| | - Jussi Mertsola
- University of Turku, Institute of Biomedicine, Microbiology, Virology and Immunology, and Turku University Hospital, Turku 20500, Finland
| | - Guy A M Berbers
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Antonie van Leeuwenhoeklaan 9, Bilthoven 3720 BA, Netherlands.
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Subissi L, Rodeghiero C, Martini H, Litzroth A, Huygen K, Leroux-Roels G, Piérard D, Desombere I. Assessment of IgA anti-PT and IgG anti-ACT reflex testing to improve Bordetella pertussis serodiagnosis in recently vaccinated subjects. Clin Microbiol Infect 2019; 26:645.e1-645.e8. [PMID: 31610300 DOI: 10.1016/j.cmi.2019.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 09/22/2019] [Accepted: 10/01/2019] [Indexed: 01/23/2023]
Abstract
OBJECTIVES Quantifying IgG antibodies to pertussis toxin (PT) is the most specific and sensitive method for the serodiagnosis of a Bordetella pertussis infection. Since PT is a component of acellular pertussis vaccines, anti-PT IgG is also induced by vaccination, precluding pertussis serodiagnosis based exclusively on anti-PT IgG in recently vaccinated subjects. Here, we aim to identify additional B. pertussis-specific serological markers that can discriminate between infection and recent vaccination. METHODS The clinical usefulness of measuring IgA directed to the vaccine antigen PT and IgG directed to non-vaccine antigens (Fim2/3, LPS, ACT, CatACT) was evaluated in nine well characterized subject groups, aged 10-89 years (n = 390). Serum anti-PT IgG levels (>125 IU/mL) served as an indicator for a recent B. pertussis infection. Comparing symptomatic pertussis-infected subjects (n = 140) with recently vaccinated, non-infected subjects (n = 100) revealed the optimal cut-off, accuracy, sensitivity and specificity for each single parameter. RESULTS For pertussis diagnosis in recently vaccinated subjects, the measurement of anti-PT IgA (cut-off 15 IU/mL) and anti-ACT IgG (cut-off 15 U/mL) resulted in accuracies of 95% (91.5-97.1) and 87.5% (82.7-91.1), sensitivities of 92.9% (87.4-96.0) and 83.6% (76.5-88.8) and specificities of 98% (93.0-99.4) and 93% (86.3-96.6), respectively. Comparing anti-PT IgA levels between the youngest (10-19 years, n = 38) and oldest (70-89 years, n = 17) age groups revealed an age-dependent increase in antibody levels in pertussis-infected subjects (p < 0.0001). CONCLUSIONS Reflex testing of anti-PT IgA and anti-ACT IgG improves pertussis serodiagnosis in recently vaccinated symptomatic subjects with elevated anti-PT IgG levels. Furthermore, both markers can discriminate between vaccination and recent infection in pertussis serosurveillance studies.
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Affiliation(s)
- L Subissi
- National Reference Centre (NRC) for Bordetella pertussis, Sciensano, Brussels, Belgium; European Programme for Public Health Microbiology Training, European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - C Rodeghiero
- National Reference Centre (NRC) for Bordetella pertussis, Sciensano, Brussels, Belgium
| | - H Martini
- National Reference Centre (NRC) for Bordetella pertussis, Universitair Ziekenhuis, Brussel, Belgium
| | - A Litzroth
- Epidemiology of Infectious Diseases, Sciensano, Brussels, Belgium
| | - K Huygen
- National Reference Centre (NRC) for Bordetella pertussis, Sciensano, Brussels, Belgium
| | | | - D Piérard
- National Reference Centre (NRC) for Bordetella pertussis, Universitair Ziekenhuis, Brussel, Belgium
| | - I Desombere
- National Reference Centre (NRC) for Bordetella pertussis, Sciensano, Brussels, Belgium.
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Fumimoto R, Otsuka N, Kamiya H, Sunagawa T, Tanaka-Taya K, Kamachi K, Shibayama K. Seroprevalence of IgA and IgM antibodies to Bordetella pertussis in healthy Japanese donors: Assessment for the serological diagnosis of pertussis. PLoS One 2019; 14:e0219255. [PMID: 31260500 PMCID: PMC6602288 DOI: 10.1371/journal.pone.0219255] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 06/19/2019] [Indexed: 12/03/2022] Open
Abstract
Pertussis is a human respiratory infection caused by the gram-negative bacterium, Bordetella pertussis. To evaluate the pertussis burden and vaccine efficacy, diagnosis and epidemiological surveillance should be based on accurate and valid diagnostic methods. Recently, the serodiagnostic tests Novagnost Bordetella pertussis IgA and IgM were approved in Japan for pertussis diagnostics. Although the anti-pertussis toxin (PT) IgG assay has been used for pertussis diagnosis worldwide, little is known about the anti-B. pertussis IgA and IgM assays. In this study, serum samples from 460 healthy donors were examined to determine the seroprevalence of anti-B. pertussis IgA and IgM in a Japanese population, and its correlation with donor age. Our data demonstrated that anti-B. pertussis IgA and IgM are positively and negatively correlated with age (r = 0.27, r = -0.37; P < 0.001, respectively). Age-specific analysis revealed high titers of anti-B. pertussis IgA in adults (46–50 years), while anti-B. pertussis IgM titers were high in schoolchildren (6–10, 11–15 years). When applying the arbitrary cut-off values for these ages, 17.6% and 39.5% of healthy donors were interpreted as pertussis-positive or indeterminate with anti-B. pertussis IgA (46–50 years) and IgM (11–15 years) titers, respectively. Overall, our findings indicated that the Novagnost Bordetella pertussis IgA and IgM testing could be greatly affected by subject age, limiting its value for pertussis diagnosis.
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Affiliation(s)
- Rei Fumimoto
- Department of Bacteriology II, National Institute of Infectious Diseases, Musashimurayama, Tokyo, Japan
- Department of Pediatrics, St Marianna University School of Medicine, Kawasaki, Japan
| | - Nao Otsuka
- Department of Bacteriology II, National Institute of Infectious Diseases, Musashimurayama, Tokyo, Japan
- * E-mail:
| | - Hajime Kamiya
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tomimasa Sunagawa
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Keiko Tanaka-Taya
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kazunari Kamachi
- Department of Bacteriology II, National Institute of Infectious Diseases, Musashimurayama, Tokyo, Japan
| | - Keigo Shibayama
- Department of Bacteriology II, National Institute of Infectious Diseases, Musashimurayama, Tokyo, Japan
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May ML, Evans J, Holgate T, Doi SA, Ross P, Robson JM. Pertussis toxin IgA testing over-diagnoses recent pertussis infection. Pathology 2017; 49:770-775. [DOI: 10.1016/j.pathol.2017.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 08/02/2017] [Accepted: 08/07/2017] [Indexed: 10/18/2022]
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Chen Z, He Q. Immune persistence after pertussis vaccination. Hum Vaccin Immunother 2017; 13:744-756. [PMID: 28045580 PMCID: PMC5404361 DOI: 10.1080/21645515.2016.1259780] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 10/20/2016] [Accepted: 11/08/2016] [Indexed: 12/17/2022] Open
Abstract
Pertussis is one of the most prevalent vaccine-preventable diseases worldwide. The true infection rate is significantly higher than the reported incidence rate. An increased prevalence of pertussis in older populations has been found, mainly caused by waning immunity after vaccination. Vaccine-induced immunity differs due to variation in vaccine content, schedule and coverage. Protection following acellular pertussis vaccines has been suggested to wane faster than whole cell pertussis vaccines. However, long-term immune persistence of whole cell pertussis vaccines may be confounded by a progressive acquisition of natural immunity. The World Health Organization has recommended that a switch from whole cell to acellular pertussis vaccines for primary immunization in infants should only be considered if additional periodic boosters or maternal immunization can be ensured and sustained in the national immunization schedules. In this review, we present data on immune persistence after different pertussis vaccinations and compare the findings from countries with different vaccination strategies. Future aspects in serological studies are briefly discussed.
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Affiliation(s)
- Zhiyun Chen
- Department of Medical Microbiology and Research Centre of Microbiome, Capital Medical University, Beijing, China
| | - Qiushui He
- Department of Medical Microbiology and Research Centre of Microbiome, Capital Medical University, Beijing, China
- Department of Medical Microbiology and Immunology, University of Turku, Turku, Finland
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Caboré RN, Maertens K, Dobly A, Leuridan E, Van Damme P, Huygen K. Influence of maternal vaccination against diphtheria, tetanus, and pertussis on the avidity of infant antibody responses to a pertussis containing vaccine in Belgium. Virulence 2017; 8:1245-1254. [PMID: 28277900 DOI: 10.1080/21505594.2017.1296998] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Maternal antibodies induced by vaccination during pregnancy cross the placental barrier and can close the susceptibility gap to pertussis in young infants up to the start of primary immunization. As not only the quantity but also the quality of circulating antibodies is important for protection, we assessed whether maternal immunization affects the avidity of infant vaccine-induced IgG antibodies, in the frame of a prospective clinical trial on pregnancy vaccination in Belgium. Infants born from Tdap (Boostrix®) vaccinated (N = 55) and unvaccinated (N = 26) mothers were immunized with a hexavalent pertussis containing vaccine (Infanrix Hexa®) at 8, 12 and 16 weeks, followed by a fourth dose at 15 months of age. Right before and one month after this fourth vaccine dose, the avidity of IgG antibodies against diphtheria toxin (DT), tetanus toxin (TT), pertussis toxin (PT), filamentous hemagglutinin (FHA) and pertactin (Prn) was determined using 1.5 M ammonium thiocyanate as dissociating agent. In both groups, antibody avidity was moderate for TT, PT, FHA and Prn and low for DT after priming. After a fourth dose, antibody avidity increased significantly to high avidity for TT and PT, whereas it remained moderate for FHA and Prn and low for DT. The avidity correlated positively with antibody level in both study groups, yet not significantly for PT. When comparing both study groups, only PT-specific antibodies showed significantly lower avidity in infants born from vaccinated than from unvaccinated mothers after the fourth vaccine dose. The clinical significance of lower avidity of vaccine induced infant antibodies after maternal vaccination, if any, needs further investigation.
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Affiliation(s)
- Raïssa Nadège Caboré
- a National Reference Centre for Bordetella & National Reference Centre for Toxigenic Corynebacteria , Scientific Service Immunology, Scientific Institute of Public Health (WIV-ISP) , Brussels , Belgium
| | - Kirsten Maertens
- b Centre for the Evaluation of Vaccination , Vaccine & Infectious Diseases Institute, University of Antwerp , Antwerp , Belgium
| | - Alexandre Dobly
- c Scientific Service Biological Standardisation , Scientific Institute of Public Health (WIV-ISP) , Brussels , Belgium
| | - Elke Leuridan
- b Centre for the Evaluation of Vaccination , Vaccine & Infectious Diseases Institute, University of Antwerp , Antwerp , Belgium
| | - Pierre Van Damme
- b Centre for the Evaluation of Vaccination , Vaccine & Infectious Diseases Institute, University of Antwerp , Antwerp , Belgium
| | - Kris Huygen
- a National Reference Centre for Bordetella & National Reference Centre for Toxigenic Corynebacteria , Scientific Service Immunology, Scientific Institute of Public Health (WIV-ISP) , Brussels , Belgium
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van Twillert I, Bonačić Marinović AA, Kuipers B, van Gaans-van den Brink JAM, Sanders EAM, van Els CACM. Impact of age and vaccination history on long-term serological responses after symptomatic B. pertussis infection, a high dimensional data analysis. Sci Rep 2017; 7:40328. [PMID: 28091579 PMCID: PMC5238437 DOI: 10.1038/srep40328] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 12/05/2016] [Indexed: 12/17/2022] Open
Abstract
Capturing the complexity and waning patterns of co-occurring immunoglobulin (Ig) responses after clinical B. pertussis infection may help understand how the human host gradually loses protection against whooping cough. We applied bi-exponential modelling to characterise and compare B. pertussis specific serological dynamics in a comprehensive database of IgG, IgG subclass and IgA responses to Ptx, FHA, Prn, Fim2/3 and OMV antigens of (ex-) symptomatic pertussis cases across all age groups. The decay model revealed that antigen type and age group were major factors determining differences in levels and kinetics of Ig (sub) classes. IgG-Ptx waned fastest in all age groups, while IgA to Ptx, FHA, Prn and Fim2/3 decreased fast in the younger but remained high in older (ex-) cases, indicating an age-effect. While IgG1 was the main IgG subclass in response to most antigens, IgG2 and IgG3 dominated the anti-OMV response. Moreover, vaccination history plays an important role in post-infection Ig responses, demonstrated by low responsiveness to Fim2/3 in unvaccinated elderly and by elevated IgG4 responses to multiple antigens only in children primed with acellular pertussis vaccine (aP). This work highlights the complexity of the immune response to this re-emerging pathogen and factors determining its Ig quantity and quality.
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Affiliation(s)
- Inonge van Twillert
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Axel A Bonačić Marinović
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Betsy Kuipers
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - Elisabeth A M Sanders
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.,Department of Immunology and Infectious Diseases, Wilhelmina Childrens Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Cécile A C M van Els
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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Lapidot R, Gill CJ. The Pertussis resurgence: putting together the pieces of the puzzle. TROPICAL DISEASES TRAVEL MEDICINE AND VACCINES 2016; 2:26. [PMID: 28883970 PMCID: PMC5530967 DOI: 10.1186/s40794-016-0043-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 11/23/2016] [Indexed: 01/13/2023]
Abstract
Pertussis incidence is rising in almost every country where acellular pertussis (aP) vaccines have been introduced, and is occurring across all age groups from infancy to adulthood. The key question is why? While several known factors such as waning of immunity, detection bias due to more sensitive tests and higher awareness of the disease among practitioners, and evolutionary shifts among B. pertussis all likely contribute, collectively, these do not adequately explain the existing epidemiologic data, suggesting that additional factors also contribute. Key amongst these is recent data indicating that the immune responses induced by aP vaccines differ fundamentally from those induced by the whole cell pertussis (wP) vaccines, and do not lead to mucosal immunity. If so, it appears likely that differences in how the two categories of vaccines work, may be pivotal to our overall understanding of the pertussis resurgence.
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Affiliation(s)
- Rotem Lapidot
- Department of Pediatric Infectious Diseases, Boston Medical Center, Boston, MA USA
| | - Christopher J Gill
- Department of Global Health, Boston University School of Public Health, Boston, MA USA.,Center for Global Health and Development, Boston University School of Public Health, 801 Massachusetts Avenue, Boston, MA 02118 USA
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Voysey M, Kandasamy R, Yu LM, Baudin M, Sadorge C, Thomas S, John T, Pollard AJ. The predicted persistence and kinetics of antibody decline 9 years after pre-school booster vaccination in UK children. Vaccine 2016; 34:4221-4228. [DOI: 10.1016/j.vaccine.2016.06.051] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 06/13/2016] [Accepted: 06/14/2016] [Indexed: 10/21/2022]
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Chen CC, Balderston McGuiness C, Krishnarajah G, Blanchette CM, Wang Y, Sun K, Buck PO. Estimated incidence of pertussis in people aged <50 years in the United States. Hum Vaccin Immunother 2016; 12:2536-2545. [PMID: 27246119 PMCID: PMC5085009 DOI: 10.1080/21645515.2016.1186313] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
The introduction of pertussis vaccination in the United States (US) in the 1940s has greatly reduced its burden. However, the incidence of pertussis is difficult to quantify, as many cases are not laboratory-confirmed or reported, particularly in adults. This study estimated pertussis incidence in a commercially insured US population aged <50 years. Data were extracted from IMS' PharMetrics Plus claims database for patients with a diagnosis of pertussis or cough illness using International Classification of Diseases (ICD-9) codes, a commercial outpatient laboratory database for patients with a pertussis laboratory test, and the Centers for Disease Control influenza surveillance database. US national pertussis incidence was projected using 3 methods: (1) diagnosed pertussis, defined as a claim for pertussis (ICD-9 033.0, 033.9, 484.3) during 2008–2013; (2) based on proxy pertussis predictive logistic regression models; (3) using the fraction of cough illness (ICD-9 033.0, 033.9, 484.3, 786.2, 466.0, 466.1, 487.1) attributed to laboratory-confirmed pertussis, estimated by time series linear regression models. Method 1 gave a projected annual incidence of diagnosed pertussis of 9/100,000, which was highest in those aged <1 year. Method 2 gave an average annual projected incidence of 21/100,000. Method 3 gave an overall regression-estimated weighted annual incidence of pertussis of 649/100,000, approximately 58–93 times higher than method 1 depending on the year. These estimations, which are consistent with considerable underreporting of pertussis in people aged <50 years and provide further evidence that the majority of cases go undetected, especially with increasing age, may aid in the development of public health programs to reduce pertussis burden.
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Affiliation(s)
| | | | | | | | | | - Kainan Sun
- a IMS Health , Plymouth Meeting , PA , USA
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van Twillert I, Bonačić Marinović AA, van Gaans-van den Brink JAM, Kuipers B, Berbers GAM, van der Maas NAT, Verheij TJM, Versteegh FGA, Teunis PFM, van Els CACM. The Use of Innovative Two-Component Cluster Analysis and Serodiagnostic Cut-Off Methods to Estimate Prevalence of Pertussis Reinfections. PLoS One 2016; 11:e0148507. [PMID: 26848833 PMCID: PMC4743910 DOI: 10.1371/journal.pone.0148507] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 01/19/2016] [Indexed: 01/13/2023] Open
Abstract
Bordetella pertussis circulates even in highly vaccinated countries affecting all age groups. Insight into the scale of concealed reinfections is important as they may contribute to transmission. We therefore investigated whether current single-point serodiagnostic methods are suitable to estimate the prevalence of pertussis reinfection. Two methods based on IgG-Ptx plasma levels alone were used to evaluate the proportion of renewed seroconversions in the past year in a cohort of retrospective pertussis cases ≥ 24 months after a proven earlier symptomatic infection. A Dutch population database was used as a baseline. Applying a classical 62.5 IU/ml IgG-Ptx cut-off, we calculated a seroprevalence of 15% in retrospective cases, higher than the 10% observed in the population baseline. However, this method could not discriminate between renewed seroconversion and waning of previously infection-enhanced IgG-Ptx levels. Two-component cluster analysis of the IgG-Ptx datasets of both pertussis cases and the general population revealed a continuum of intermediate IgG-Ptx levels, preventing the establishment of a positive population and the comparison of prevalence by this alternative method. Next, we investigated the complementary serodiagnostic value of IgA-Ptx levels. When modelling datasets including both convalescent and retrospective cases we obtained new cut-offs for both IgG-Ptx and IgA-Ptx that were optimized to evaluate renewed seroconversions in the ex-cases target population. Combining these cut-offs two-dimensionally, we calculated 8.0% reinfections in retrospective cases, being below the baseline seroprevalence. Our study for the first time revealed the shortcomings of using only IgG-Ptx data in conventional serodiagnostic methods to determine pertussis reinfections. Improved results can be obtained with two-dimensional serodiagnostic profiling. The proportion of reinfections thus established suggests a relatively increased period of protection to renewed infection after clinical pertussis.
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Affiliation(s)
- Inonge van Twillert
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Axel A. Bonačić Marinović
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - Betsy Kuipers
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Guy A. M. Berbers
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Nicoline A. T. van der Maas
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Theo J. M. Verheij
- Julius Center Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Florens G. A. Versteegh
- Department of Pediatrics, Groene Hart Ziekenhuis, Gouda, the Netherlands
- Ghent University Hospital, department of pediatrics, Ghent, Belgium
| | - Peter F. M. Teunis
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- RSPH, Emory University, Atlanta, United States of America
| | - Cécile A. C. M. van Els
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- * E-mail:
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Masseria C, Krishnarajah G. The estimated incidence of pertussis in people aged 50 years old in the United States, 2006-2010. BMC Infect Dis 2015; 15:534. [PMID: 26584525 PMCID: PMC4653927 DOI: 10.1186/s12879-015-1269-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Accepted: 11/05/2015] [Indexed: 11/15/2022] Open
Abstract
Background Pertussis is believed to be widely underreported and under-recognized, particularly among adults. The aim of this study was to estimate the incidence of private practitioner-attended cough illness that could be attributed to Bordetella pertussis in adults aged ≥50 years in the US. Methods Multiple linear regressions were employed to estimate the overall incidence of pertussis. Data were extracted from IMS’ private practice database of longitudinal, patient-level claims and IMS’ commercial laboratory database during 4/1/2006–12/31/2010. Patients were ≥50 years old and had ≥1 ICD-9-CM claim for cough illness relating to pertussis, cough, or acute bronchitis. Pertussis positive laboratory tests, seasonal and secular variables were used for estimating the B. pertussis attributable fraction of cough illness. Results During the study period, there were 20.7 million cases of cough illness among people aged 50–64 and 27.5 million cases among those ≥65; of which the model attributed 2.5 and 1.7 %, respectively, to B. pertussis. The estimated incidences of cough illness attributed to B. pertussis during the study period were on average 202 and 257/100,000 among people aged 50–64 and ≥65 years, respectively, and increased over the years in both age groups. Depending on the year, estimated pertussis incidences were 42 to 105 times higher than medically attended ones in the same database. Conclusions These findings indicate that the B. pertussis disease incidence in adults aged ≥50 years is significantly higher than generally estimated. Additional research regarding pertussis reporting and diagnosis in the adult populations is needed to validate these findings.
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Affiliation(s)
- Cristina Masseria
- Global Health & Value, Pfizer Inc., 235 E 42nd street, New York, NY, 10017, USA.
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The History of Pertussis (Whooping Cough); 1906–2015: Facts, Myths, and Misconceptions. CURR EPIDEMIOL REP 2015. [DOI: 10.1007/s40471-015-0041-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Pertussis in the newborn: certainties and uncertainties in 2014. Paediatr Respir Rev 2015; 16:112-8. [PMID: 25613084 DOI: 10.1016/j.prrv.2014.01.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 12/27/2013] [Accepted: 01/25/2014] [Indexed: 10/25/2022]
Abstract
Bordetella pertussis infection remains a serious potential health risk to infants, specially in those too young to be vaccinated. Over the recent years, numerous sources highlighted a widespread resurgence, making it, again, a challenging disease. Globally, pertussis is ranked among the 10 leading causes of childhood mortality. This review summarizes the most recent literature and will address the most important aspects that pediatricians and neonatologists must be familiar with, when treating a newborńs pertussis infection.
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Cherry JD. Adult pertussis in the pre- and post-vaccine eras: lifelong vaccine-induced immunity? Expert Rev Vaccines 2014; 13:1073-80. [DOI: 10.1586/14760584.2014.935765] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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