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Hernandez Reyes JDLC, Santos Morales O, Hernandez Moreno L, Pino Alfonso PP, Neninger Vinageras E, Knigths Montalvo JL, Aguilar Sosa A, Gonzalez Morera A, Lorenzo-Luaces Alvárez P, Aguilar Venegas Y, Troche Concepción M, Medel Pérez L, Santiesteban González Y, García Fernández L, Regueiro Rodríguez L, Macías Abrahan A, Labrada Mon M, León Monzón K, Saavedra Hernández D, Crombet Ramos T. PREVAX: A Phase I Clinical Trial of an EGF-Based Vaccine in Moderate-to-Severe COPD Patients. Vaccines (Basel) 2024; 12:833. [PMID: 39203959 PMCID: PMC11359286 DOI: 10.3390/vaccines12080833] [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: 05/29/2024] [Revised: 07/01/2024] [Accepted: 07/16/2024] [Indexed: 09/03/2024] Open
Abstract
BACKGROUND EGFR has been suggested to contribute to COPD development and progression. Excessive ligand activation of the receptor leads to epithelial hyperproliferation and increased production of mucus, together with alterations in the primary cilia. The present study was designed to evaluate the safety and effect of depleting EGF in moderate-to-severe COPD patients, with an EGF-based vaccine. PATIENTS AND METHODS A phase I trial was conducted in subjects with moderate or severe COPD. The anti-EGF vaccine schedule consisted of 4 biweekly doses followed by 4 monthly boosters. The primary endpoint was the evaluation of the safety and immunogenicity of the vaccine, together with the change in FEV1 and physical function at week 24. RESULTS Twenty-six patients with moderate or severe COPD were included in the trial. The vaccine was well tolerated and no serious related adverse events were reported. Ninety percent of the individuals developed a protective antibody response. The specific anti-EGF antibodies had high avidity and were able to inhibit EGFR phosphorylation. At the end of vaccination, serum EGF became undetectable. At week 24, there was a clinically significant improvement in lung function, with a mean change in trough FEV1 of 106 mL. Patients also increased their physical functioning. CONCLUSIONS The EGF-based vaccine was immunogenic and provoked an EGF exhaustion in patients with moderate-to-severe COPD. Depleting EGF might result in a meaningful increase in FEV1, with good tolerability. The current results provide new avenues to treat chronic inflammatory lung diseases associated with EGFR aberrant signaling.
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Affiliation(s)
- Jenysbel de la C. Hernandez Reyes
- Center of Molecular Immunology, Havana 11600, Cuba; (J.d.l.C.H.R.); (O.S.M.); (A.G.M.); (P.L.-L.A.); (Y.A.V.); (M.T.C.); (L.M.P.); (Y.S.G.); (L.G.F.); (L.R.R.); (A.M.A.); (M.L.M.); (K.L.M.); (D.S.H.)
| | - Orestes Santos Morales
- Center of Molecular Immunology, Havana 11600, Cuba; (J.d.l.C.H.R.); (O.S.M.); (A.G.M.); (P.L.-L.A.); (Y.A.V.); (M.T.C.); (L.M.P.); (Y.S.G.); (L.G.F.); (L.R.R.); (A.M.A.); (M.L.M.); (K.L.M.); (D.S.H.)
| | - Laura Hernandez Moreno
- Hermanos Ameijeiras Hospital, Havana 10400, Cuba; (L.H.M.); (P.P.P.A.); (E.N.V.); (J.L.K.M.); (A.A.S.)
| | - Pedro Pablo Pino Alfonso
- Hermanos Ameijeiras Hospital, Havana 10400, Cuba; (L.H.M.); (P.P.P.A.); (E.N.V.); (J.L.K.M.); (A.A.S.)
| | - Elia Neninger Vinageras
- Hermanos Ameijeiras Hospital, Havana 10400, Cuba; (L.H.M.); (P.P.P.A.); (E.N.V.); (J.L.K.M.); (A.A.S.)
| | | | - Aliuska Aguilar Sosa
- Hermanos Ameijeiras Hospital, Havana 10400, Cuba; (L.H.M.); (P.P.P.A.); (E.N.V.); (J.L.K.M.); (A.A.S.)
| | - Amnely Gonzalez Morera
- Center of Molecular Immunology, Havana 11600, Cuba; (J.d.l.C.H.R.); (O.S.M.); (A.G.M.); (P.L.-L.A.); (Y.A.V.); (M.T.C.); (L.M.P.); (Y.S.G.); (L.G.F.); (L.R.R.); (A.M.A.); (M.L.M.); (K.L.M.); (D.S.H.)
| | - Patricia Lorenzo-Luaces Alvárez
- Center of Molecular Immunology, Havana 11600, Cuba; (J.d.l.C.H.R.); (O.S.M.); (A.G.M.); (P.L.-L.A.); (Y.A.V.); (M.T.C.); (L.M.P.); (Y.S.G.); (L.G.F.); (L.R.R.); (A.M.A.); (M.L.M.); (K.L.M.); (D.S.H.)
| | - Yadira Aguilar Venegas
- Center of Molecular Immunology, Havana 11600, Cuba; (J.d.l.C.H.R.); (O.S.M.); (A.G.M.); (P.L.-L.A.); (Y.A.V.); (M.T.C.); (L.M.P.); (Y.S.G.); (L.G.F.); (L.R.R.); (A.M.A.); (M.L.M.); (K.L.M.); (D.S.H.)
| | - Mayelin Troche Concepción
- Center of Molecular Immunology, Havana 11600, Cuba; (J.d.l.C.H.R.); (O.S.M.); (A.G.M.); (P.L.-L.A.); (Y.A.V.); (M.T.C.); (L.M.P.); (Y.S.G.); (L.G.F.); (L.R.R.); (A.M.A.); (M.L.M.); (K.L.M.); (D.S.H.)
| | - Loipa Medel Pérez
- Center of Molecular Immunology, Havana 11600, Cuba; (J.d.l.C.H.R.); (O.S.M.); (A.G.M.); (P.L.-L.A.); (Y.A.V.); (M.T.C.); (L.M.P.); (Y.S.G.); (L.G.F.); (L.R.R.); (A.M.A.); (M.L.M.); (K.L.M.); (D.S.H.)
| | - Yanela Santiesteban González
- Center of Molecular Immunology, Havana 11600, Cuba; (J.d.l.C.H.R.); (O.S.M.); (A.G.M.); (P.L.-L.A.); (Y.A.V.); (M.T.C.); (L.M.P.); (Y.S.G.); (L.G.F.); (L.R.R.); (A.M.A.); (M.L.M.); (K.L.M.); (D.S.H.)
| | - Lázara García Fernández
- Center of Molecular Immunology, Havana 11600, Cuba; (J.d.l.C.H.R.); (O.S.M.); (A.G.M.); (P.L.-L.A.); (Y.A.V.); (M.T.C.); (L.M.P.); (Y.S.G.); (L.G.F.); (L.R.R.); (A.M.A.); (M.L.M.); (K.L.M.); (D.S.H.)
| | - Lorena Regueiro Rodríguez
- Center of Molecular Immunology, Havana 11600, Cuba; (J.d.l.C.H.R.); (O.S.M.); (A.G.M.); (P.L.-L.A.); (Y.A.V.); (M.T.C.); (L.M.P.); (Y.S.G.); (L.G.F.); (L.R.R.); (A.M.A.); (M.L.M.); (K.L.M.); (D.S.H.)
| | - Amparo Macías Abrahan
- Center of Molecular Immunology, Havana 11600, Cuba; (J.d.l.C.H.R.); (O.S.M.); (A.G.M.); (P.L.-L.A.); (Y.A.V.); (M.T.C.); (L.M.P.); (Y.S.G.); (L.G.F.); (L.R.R.); (A.M.A.); (M.L.M.); (K.L.M.); (D.S.H.)
| | - Mayrel Labrada Mon
- Center of Molecular Immunology, Havana 11600, Cuba; (J.d.l.C.H.R.); (O.S.M.); (A.G.M.); (P.L.-L.A.); (Y.A.V.); (M.T.C.); (L.M.P.); (Y.S.G.); (L.G.F.); (L.R.R.); (A.M.A.); (M.L.M.); (K.L.M.); (D.S.H.)
| | - Kalet León Monzón
- Center of Molecular Immunology, Havana 11600, Cuba; (J.d.l.C.H.R.); (O.S.M.); (A.G.M.); (P.L.-L.A.); (Y.A.V.); (M.T.C.); (L.M.P.); (Y.S.G.); (L.G.F.); (L.R.R.); (A.M.A.); (M.L.M.); (K.L.M.); (D.S.H.)
| | - Danay Saavedra Hernández
- Center of Molecular Immunology, Havana 11600, Cuba; (J.d.l.C.H.R.); (O.S.M.); (A.G.M.); (P.L.-L.A.); (Y.A.V.); (M.T.C.); (L.M.P.); (Y.S.G.); (L.G.F.); (L.R.R.); (A.M.A.); (M.L.M.); (K.L.M.); (D.S.H.)
| | - Tania Crombet Ramos
- Center of Molecular Immunology, Havana 11600, Cuba; (J.d.l.C.H.R.); (O.S.M.); (A.G.M.); (P.L.-L.A.); (Y.A.V.); (M.T.C.); (L.M.P.); (Y.S.G.); (L.G.F.); (L.R.R.); (A.M.A.); (M.L.M.); (K.L.M.); (D.S.H.)
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2
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Christoph R, Giovanni A, Arne S, Sebastian V, Gerhard D, Angelika M, Marc S, Sonja H, Marie S, Lydia J, Michael F, Gerhardt H, Frank D, Martin A, Sonnleitner S, Walder G, Martin F, Martina P. Immunogenicity of tick-borne-encephalitis-virus-(TBEV)-vaccination and impact of age on humoral and cellular TBEV-specific immune responses in patients with rheumatoid arthritis. Vaccine 2024; 42:745-752. [PMID: 38242736 DOI: 10.1016/j.vaccine.2024.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 12/31/2023] [Accepted: 01/05/2024] [Indexed: 01/21/2024]
Abstract
Inactivated vaccines, such as tick-borne-encephalitis-virus-(TBEV) vaccine, have been discussed as less immunogenic in elderly and in immunocompromised patients. In this controlled cross-sectional cohort study, the antibody and cellular responses after TBEV-vaccination were investigated in 36 rheumatoid arthritis (RA) patients and 112 healthy controls (HC) by evaluating IgG-anti-TBEV concentration, neutralization and relative avidity index (RAI). Cellular reactivity was assessed by IFNgamma-producing spot-forming-units (SFU) by ELISPOT assay and flow cytometry. RA patients showed lower IgG-anti-TBEV compared to HC, which were influenced by age at and time since last TBEV vaccination and disease duration. High-responders regarding cellular immunity and avidity were less frequent in RA compared to HC. RA patients who had received booster vaccinations were more likely to demonstrate higher IgG-anti-TBEV responses compared to those who had not. In conclusion, RA patients showed a negative effect of age on anti-TBEV-IgG and immunological benefits of timely booster vaccination are suggested.
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Affiliation(s)
- Rack Christoph
- Department of Pediatrics, Pediatric Rheumatology/Special Immunology, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Almanzar Giovanni
- Department of Pediatrics, Pediatric Rheumatology/Special Immunology, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Schäfer Arne
- Department of Internal Medicine II, Department of Rheumatology/Clinical Immunology, University of Würzburg, 97080 Würzburg, Germany; Diabetes Zentrum Mergengtheim, Bad Mergentheim, Germany
| | - Völkl Sebastian
- Department of Pediatrics, Pediatric Rheumatology/Special Immunology, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Dobler Gerhard
- Institut für Mikrobiologie der Bundeswehr, 80937 Munich, Germany
| | - Mutterer Angelika
- Department of Pediatrics, Pediatric Rheumatology/Special Immunology, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Schmalzing Marc
- Department of Internal Medicine II, Department of Rheumatology/Clinical Immunology, University of Würzburg, 97080 Würzburg, Germany
| | - Hick Sonja
- Department of Pediatrics, Pediatric Rheumatology/Special Immunology, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Steimer Marie
- Department of Pediatrics, Pediatric Rheumatology/Special Immunology, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Jahn Lydia
- Department of Pediatrics, Pediatric Rheumatology/Special Immunology, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Fladerer Michael
- Department of Pediatrics, Pediatric Rheumatology/Special Immunology, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Hartmann Gerhardt
- General Medical Practice Dr. Hartmann, Hauptstraße 34, 97204 Höchberg, Germany
| | - Deininger Frank
- Rheumatology Practice Dr. Deininger, Haugerpfarrgasse 7, 97070 Würzburg, Germany
| | - Arbogast Martin
- Center of Rheumatology and Orthopedics, Hubertusstraße 40, 82487 Oberammergau, Germany
| | - Sissy Sonnleitner
- Laboratory for Hygiene and Microbiology, 9931 Außervillgraten, Austria
| | - Gernot Walder
- Laboratory for Hygiene and Microbiology, 9931 Außervillgraten, Austria
| | - Feuchtenberger Martin
- Department of Internal Medicine II, Department of Rheumatology/Clinical Immunology, University of Würzburg, 97080 Würzburg, Germany; Department of Rheumatology, MED|BAYERN OST Medical Center Altötting Burghausen, Rheumatologie Krankenhausstraße 1, 84489 Burghausen, Germany
| | - Prelog Martina
- Department of Pediatrics, Pediatric Rheumatology/Special Immunology, University Hospital Würzburg, 97080 Würzburg, Germany.
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3
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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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Clark LR, Johnson DR. Safety and Clinical Benefits of Adacel ® and Adacel ®-Polio Vaccination in Pregnancy: A Structured Literature Review. Infect Dis Ther 2023; 12:1955-2003. [PMID: 37653123 PMCID: PMC10505126 DOI: 10.1007/s40121-023-00847-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 07/03/2023] [Indexed: 09/02/2023] Open
Abstract
Vaccination in pregnancy using a tetanus toxoid, reduced dose diphtheria toxoid, and reduced dose acellular pertussis (Tdap) vaccine is important for prevention of severe pertussis disease in young infants. The objectives of this systematic literature review were to search for original research studies evaluating the vaccine effectiveness, immunogenicity, and safety of Adacel®/Adacel-Polio® used during pregnancy to prevent pertussis disease in young infants. Medical databases used included EMBASE, BIOSIS Previews, and Chemical Abstracts, with search terms related to pregnancy, vaccines/immunization, safety, pertussis, effectiveness/efficacy, and immune response; other potentially eligible reports were included where applicable. Search results were restricted to literature published from 1 January 1995 to 26 July 2021. A total of 2021 articles and 4 other reports were identified for primary review. A total of 49 publications qualified for inclusion after primary and secondary reviews. Effectiveness studies of Adacel or Adacel-Polio given in pregnancy consistently showed high levels of protection from pertussis disease in the newborn (vaccine effectiveness: 91-93%). In immunogenicity studies, the response in pregnant women was consistent with that of non-pregnant women. Infants of mothers vaccinated with Adacel or Adacel-Polio in pregnancy had higher anti-pertussis antibody levels at birth and at 2 months of age compared to infants born to women vaccinated with comparator vaccines, placebo, or those not vaccinated during pregnancy. There was evidence of a slightly decreased response to primary pertussis vaccination in infants of mothers vaccinated with Adacel or Adacel-Polio, but this was not thought to be clinically significant. In safety studies, Adacel or Adacel-Polio vaccination was well tolerated by pregnant woman and not associated with pregnancy, postpartum, or neonatal complications. In conclusion, Adacel or Adacel-Polio vaccination in pregnancy is highly effective in protecting young infants from pertussis disease, with a favorable safety profile for both pregnant women and their infants.
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Affiliation(s)
- Liana R Clark
- Global Medical, Sanofi, 1 Discovery Drive, Swiftwater, PA, 18370, USA.
| | - David R Johnson
- Global Medical, Sanofi, 1 Discovery Drive, Swiftwater, PA, 18370, USA
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Sonnleitner ST, Prelog M, Sonnleitner S, Hinterbichler E, Halbfurter H, Kopecky DBC, Almanzar G, Koblmüller S, Sturmbauer C, Feist L, Horres R, Posch W, Walder G. Cumulative SARS-CoV-2 mutations and corresponding changes in immunity in an immunocompromised patient indicate viral evolution within the host. Nat Commun 2022; 13:2560. [PMID: 35538074 PMCID: PMC9090742 DOI: 10.1038/s41467-022-30163-4] [Citation(s) in RCA: 58] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 04/19/2022] [Indexed: 01/07/2023] Open
Abstract
Different scenarios explaining the emergence of novel variants of concern (VOC) of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been reported, including their evolution in scarcely monitored populations, in animals as alternative hosts, or in immunocompromised individuals. Here we report SARS-CoV-2 immune escape mutations over a period of seven months in an immunocompromised patient with prolonged viral shedding. Signs of infection, viral shedding and mutation events are periodically analyzed using RT-PCR and next-generation sequencing based on naso-pharyngeal swabs, with the results complemented by immunological diagnostics to determine humoral and T cell immune responses. Throughout the infection course, 17 non-synonymous intra-host mutations are noted, with 15 (88.2%) having been previously described as prominent immune escape mutations (S:E484K, S:D950N, S:P681H, S:N501Y, S:del(9), N:S235F and S:H655Y) in VOCs. The high frequency of these non-synonymous mutations is consistent with multiple events of convergent evolution. Thus, our results suggest that specific mutations in the SARS-CoV-2 genome may represent positions with a fitness advantage, and may serve as targets in future vaccine and therapeutics development for COVID-19.
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Affiliation(s)
- Sissy Therese Sonnleitner
- Infektiologie Tirol, Department of Virology, 9931, Unterwalden 30, Außervillgraten, Austria.
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, 6020, Innsbruck, Austria.
| | - Martina Prelog
- Pediatric Rheumatology/Special Immunology, Department of Pediatrics, University Hospital Wuerzburg, Josef-Schneider-Str. 2, Wuerzburg, Germany
| | - Stefanie Sonnleitner
- Infektiologie Tirol, Department of Virology, 9931, Unterwalden 30, Außervillgraten, Austria
| | - Eva Hinterbichler
- Infektiologie Tirol, Department of Virology, 9931, Unterwalden 30, Außervillgraten, Austria
| | - Hannah Halbfurter
- Infektiologie Tirol, Department of Virology, 9931, Unterwalden 30, Außervillgraten, Austria
| | - Dominik B C Kopecky
- Infektiologie Tirol, Department of Virology, 9931, Unterwalden 30, Außervillgraten, Austria
| | - Giovanni Almanzar
- Pediatric Rheumatology/Special Immunology, Department of Pediatrics, University Hospital Wuerzburg, Josef-Schneider-Str. 2, Wuerzburg, Germany
| | - Stephan Koblmüller
- Institute of Biology, University of Graz, Universitätsplatz 2, 8010, Graz, Austria
| | - Christian Sturmbauer
- Institute of Biology, University of Graz, Universitätsplatz 2, 8010, Graz, Austria
| | - Leonard Feist
- GenXPro GmbH, Altenhoeferallee 3, 60438, Frankfurt am Main, Germany
| | - Ralf Horres
- GenXPro GmbH, Altenhoeferallee 3, 60438, Frankfurt am Main, Germany
| | - Wilfried Posch
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, 6020, Innsbruck, Austria
| | - Gernot Walder
- Infektiologie Tirol, Department of Virology, 9931, Unterwalden 30, Außervillgraten, Austria
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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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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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9
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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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10
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Vaccination titres pre- and post-transplant in paediatric renal transplant recipients and the impact of immunosuppressive therapy. Pediatr Nephrol 2018; 33:897-910. [PMID: 29322328 DOI: 10.1007/s00467-017-3868-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 11/29/2017] [Accepted: 12/04/2017] [Indexed: 02/01/2023]
Abstract
BACKGROUND Avoidance of vaccine-preventable infections in paediatric renal allograft recipients is of utmost importance. However, the development and maintenance of protective vaccination titres may be impaired in this patient population owing to their need for immunosuppressive medication. METHODS In the framework of the Cooperative European Paediatric Renal Transplant Initiative (CERTAIN), we therefore performed a multi-centre, multi-national study and analysed vaccination titres pre- and post-transplant in 155 patients with serial titre measurements in comparison with published data in healthy children. RESULTS The percentage of patients with positive vaccination titres before renal transplantation (RTx) was low, especially for diphtheria (38.5%, control 75%) and pertussis (21.3%, control 96.3%). As few as 58.1% of patients had a hepatitis B antibody (HBsAb) titre >100 IU/L before RTx. 38.1% of patients showed a vaccination titre loss post-transplant. Patients with an HBsAb titre between 10 and 100 IU/L before RTx experienced a significantly (p < 0.05) more frequent hepatitis B vaccination titre loss post-transplant than patients with an HBsAb titre >100 IU/L. The revaccination rate post-transplant was low and revaccination failed to induce positive titres in a considerable number of patients (27.3 to 83.3%). Treatment with rituximab was associated with a significantly increased risk of a vaccination titre loss post-transplant (odds ratio 4.26, p = 0.033). CONCLUSIONS These data show a low percentage of patients with positive vaccination titres pre-transplant, a low revaccination rate post-transplant with limited antibody response, and a high rate of vaccination titre losses.
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11
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Perez AC, Johnson A, Chen Z, Wilding GE, Malkowski MG, Murphy TF. Mapping Protective Regions on a Three-Dimensional Model of the Moraxella catarrhalis Vaccine Antigen Oligopeptide Permease A. Infect Immun 2018; 86:e00652-17. [PMID: 29203544 PMCID: PMC5820933 DOI: 10.1128/iai.00652-17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 11/25/2017] [Indexed: 11/20/2022] Open
Abstract
A vaccine against Moraxella catarrhalis would reduce tremendous morbidity, mortality, and financial burden by preventing otitis media in children and exacerbations of chronic obstructive pulmonary disease (COPD) in adults. Oligopeptide permease A (OppA) is a candidate vaccine antigen that is (i) a nutritional virulence factor expressed on the bacterial cell surface during infection, (ii) widely conserved among strains, (iii) highly immunogenic, and (iv) a protective antigen based on its capacity to induce protective responses in immunized animals. In the present study, we show that the antibodies to OppA following vaccination mediate accelerated clearance in animals after pulmonary challenge. To identify regions of OppA that bind protective antibodies, truncated constructs of OppA were engineered and studied to map regions of OppA with surface-accessible epitopes that bind high-avidity antibodies following vaccination. Protective epitopes were located in the N and C termini of the protein. Immunization of mice with constructs corresponding to these regions (T5 and T8) induced protective responses. Studies of overlapping peptide libraries of constructs T5 and T8 with OppA immune serum identified two discrete regions on each construct. These potentially protective regions were mapped on a three-dimensional computational model of OppA, where regions with solvent-accessible amino acids were identified as three potentially protective epitopes. In all, these studies revealed two regions with three specific epitopes in OppA that induce potentially protective antibody responses following vaccination. Detection of antibodies to these regions could serve to guide vaccine formulation and as a diagnostic tool for monitoring development of protective responses during clinical trials.
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Affiliation(s)
- Antonia C Perez
- Clinical and Translational Research Center, University at Buffalo, the State University of New York, Buffalo, New York, USA
- Division of Infectious Diseases, Department of Medicine, University at Buffalo, the State University of New York, Buffalo, New York, USA
| | - Antoinette Johnson
- Clinical and Translational Research Center, University at Buffalo, the State University of New York, Buffalo, New York, USA
- Division of Infectious Diseases, Department of Medicine, University at Buffalo, the State University of New York, Buffalo, New York, USA
| | - Ziqiang Chen
- Department of Biostatistics, University at Buffalo, the State University of New York, Buffalo, New York, USA
| | - Gregory E Wilding
- Department of Biostatistics, University at Buffalo, the State University of New York, Buffalo, New York, USA
| | - Michael G Malkowski
- Department of Structural Biology, University at Buffalo, the State University of New York, Buffalo, New York, USA
- Hauptman Woodward Medical Research Institute, Buffalo, New York, USA
| | - Timothy F Murphy
- Clinical and Translational Research Center, University at Buffalo, the State University of New York, Buffalo, New York, USA
- Division of Infectious Diseases, Department of Medicine, University at Buffalo, the State University of New York, Buffalo, New York, USA
- Department of Microbiology, University at Buffalo, the State University of New York, Buffalo, New York, USA
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12
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Diavatopoulos DA, Edwards KM. What Is Wrong with Pertussis Vaccine Immunity? Why Immunological Memory to Pertussis Is Failing. Cold Spring Harb Perspect Biol 2017; 9:cshperspect.a029553. [PMID: 28289059 DOI: 10.1101/cshperspect.a029553] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Memory responses seen after whole-cell pertussis (wP) and acellular pertussis (aP) vaccine priming are different and reflect better long-term protection against pertussis disease seen with the whole-cell vaccines. Although acellular vaccines generate higher levels of antigen-specific IgG to the antigens included in the aP vaccines, there are many more pertussis antigens included in whole-cell vaccines. Acellular vaccine priming is associated with skewing of the immune response to a more Th2-like response, whereas whole-cell priming is associated with a Th1/Th17 response. Repeated booster doses of acellular vaccine in children primed with acellular vaccine has been shown to result in progressively shorter duration of protection against disease. This may be explained by the generation of higher levels of antigen-specific IgG4, which does not bind complement and leads to a suboptimal inflammatory response and impaired phagocytosis and antimicrobial defense. In contrast, whole-cell priming followed by aP vaccine boosters results in better opsonization, phagocytosis, and complement mediated killing through the preferential induction of IgG1.
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Affiliation(s)
- Dimitri A Diavatopoulos
- Laboratory of Pediatric Infectious Diseases, Radboud Center for Infectious Diseases, Radboud University Medical Center, 6500 HB, Nijmegen, The Netherlands
| | - Kathryn Margaret Edwards
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee 37232.,Vanderbilt Vaccine Research Program, Vanderbilt University, Nashville, Tennessee 37332
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13
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Burdin N, Handy LK, Plotkin SA. What Is Wrong with Pertussis Vaccine Immunity? The Problem of Waning Effectiveness of Pertussis Vaccines. Cold Spring Harb Perspect Biol 2017; 9:a029454. [PMID: 28289064 PMCID: PMC5710106 DOI: 10.1101/cshperspect.a029454] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Pertussis is resurgent in some countries, particularly those in which children receive acellular pertussis (aP) vaccines in early infancy and boosters later in life. Immunologic studies show that, whereas whole-cell pertussis (wP) vaccines orient the immune system toward Th1/Th17 responses, acellular pertussis vaccines orient toward Th1/Th2 responses. Although aP vaccines do provide protection during the first years of life, the change in T-cell priming results in waning effectiveness of aP as early as 2-3 years post-boosters. Although other factors, such as increased virulence of pertussis strains, better diagnosis, and better surveillance may play a role, the increase in pertussis appears to be the result of waning immunity. In addition, studies in baboon models, requiring confirmation in humans, show that aP is less able to prevent nasopharyngeal colonization of Bordetella pertussis than wP or natural infection.
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Affiliation(s)
- Nicolas Burdin
- EU Research and Non Clinical Safety, R&D, Sanofi Pasteur, Campus Mérieux, 69280 Marcy l'Etoile, France
| | - Lori Kestenbaum Handy
- Assistant Professor of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Division of Infectious Diseases, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware 19803
| | - Stanley A Plotkin
- Emeritus Professor of Pediatrics, University of Pennsylvania, Vaxconsult, Doylestown, Pennsylvania 18902
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14
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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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15
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Moriuchi T, Otsuka N, Hiramatsu Y, Shibayama K, Kamachi K. A high seroprevalence of antibodies to pertussis toxin among Japanese adults: Qualitative and quantitative analyses. PLoS One 2017; 12:e0181181. [PMID: 28700751 PMCID: PMC5507317 DOI: 10.1371/journal.pone.0181181] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Accepted: 06/27/2017] [Indexed: 11/19/2022] Open
Abstract
In 2013, national serosurveillance detected a high seroprevalence of antibodies to pertussis toxin (PT) from Bordetella pertussis among Japanese adults. Thus, we aimed to determine the cause(s) of this high seroprevalence, and analyzed the titers of antibodies to PT and filamentous hemagglutinin (FHA) among adults (35-44 years old), young children (4-7 years old), and older children (10-14 years old). Our quantitative analyses revealed that adults had higher seroprevalences of anti-PT IgG and PT-neutralizing antibodies, and similar titers of anti-FHA IgG, compared to the young and older children. Positive correlations were observed between the titers of PT-neutralizing antibodies and anti-PT IgG in all age groups (rs values of 0.326-0.522), although the correlation tended to decrease with age. The ratio of PT-neutralizing antibodies to anti-PT IgG was significantly different when we compared the serum and purified IgG fractions among adults (p = 0.016), although this result was not observed among young and older children. Thus, it appears that some adults had non-IgG immunoglobulins to PT. Our analyses also revealed that adults had high-avidity anti-PT IgG (avidity index: 63.5%, similar results were observed among the children); however, the adults had lower-avidity anti-FHA IgG (37.9%, p < 0.05). It is possible that low-avidity anti-FHA IgG is related to infection with other respiratory pathogens (e.g., Bordetella parapertussis, Haemophilus influenzae, or Mycoplasma pneumoniae), which produces antibodies to FHA-like proteins. Our observations suggest that these adults had been infected with B. pertussis and other pathogen(s) during their adulthood.
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Affiliation(s)
- Takumi Moriuchi
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
- Department of Pediatrics, St Marianna University School of Medicine, Kawasaki, Japan
| | - Nao Otsuka
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yukihiro Hiramatsu
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Keigo Shibayama
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kazunari Kamachi
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
- * E-mail:
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16
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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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17
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Babakhanyan A, Fang R, Wey A, Salanti A, Sama G, Efundem C, Leke RJI, Chen JJ, Leke RGF, Taylor DW. Comparison of the specificity of antibodies to VAR2CSA in Cameroonian multigravidae with and without placental malaria: a retrospective case-control study. Malar J 2015; 14:480. [PMID: 26626275 PMCID: PMC4666123 DOI: 10.1186/s12936-015-1023-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 11/26/2015] [Indexed: 11/10/2022] Open
Abstract
Background Antibodies (Ab) to VAR2CSA prevent Plasmodium falciparum-infected erythrocytes from sequestrating in the placenta, i.e., prevent placental malaria (PM). The specificity of Ab to VAR2CSA associated with absence of PM is unknown. Accordingly, differences in the specificity of Ab to VAR2CSA were compared between multigravidae with and without PM who had Ab to VAR2CSA. Methods In a retrospective case–control study, plasma collected from Cameroonian multigravidae with (n = 96) and without (n = 324) PM were screened in 21 assays that measured antibody levels to full length VAR2CSA (FV2), individual VAR2CSA DBL domains, VAR2CSA domains from different genetic backgrounds (variants), as well as proportion of high avidity Ab to FV2. Results Multigravidae with and without PM had similar levels of Ab to FV2, the six VAR2CSA DBL domains and different variants, while the proportion of high avidity Ab to FV2 was significantly higher in women without PM at delivery (p = 0.0030) compared to women with PM. In a logistic regression model adjusted for gravidity and age, the percentage of high avidity Ab to FV2 was associated with reduced likelihood of PM in multigravidae. A 5 % increase in proportion of high avidity Ab to FV2 was associated with a nearly 15 % lower likelihood of PM. Conclusion Ab avidity to FV2 may be an important indicator of immunity to PM. Electronic supplementary material The online version of this article (doi:10.1186/s12936-015-1023-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anna Babakhanyan
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A Burns School of Medicine, University of Hawaii at Manoa, 651 Ilalo Street, BSB 320, Honolulu, HI, 96813, USA.
| | - Rui Fang
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A Burns School of Medicine, University of Hawaii at Manoa, 651 Ilalo Street, BSB 320, Honolulu, HI, 96813, USA.
| | - Andrew Wey
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A Burns School of Medicine, University of Hawaii at Manoa, 651 Ilalo Street, BSB 320, Honolulu, HI, 96813, USA.
| | - Ali Salanti
- Department of Immunology and Microbiology, Centre for Medical Parasitology, University of Copenhagen, Copenhagen, Denmark.
| | - Grace Sama
- Faculty of Medicine and Biomedical Research, Biotechnology Centre, University of Yaounde 1, Yaounde, Cameroon.
| | - Canisia Efundem
- Faculty of Medicine and Biomedical Research, Biotechnology Centre, University of Yaounde 1, Yaounde, Cameroon.
| | - Robert J I Leke
- Faculty of Medicine and Biomedical Research, Biotechnology Centre, University of Yaounde 1, Yaounde, Cameroon.
| | - John J Chen
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A Burns School of Medicine, University of Hawaii at Manoa, 651 Ilalo Street, BSB 320, Honolulu, HI, 96813, USA.
| | - Rose G F Leke
- Faculty of Medicine and Biomedical Research, Biotechnology Centre, University of Yaounde 1, Yaounde, Cameroon.
| | - Diane W Taylor
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A Burns School of Medicine, University of Hawaii at Manoa, 651 Ilalo Street, BSB 320, Honolulu, HI, 96813, USA.
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18
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Two consecutive randomized controlled pertussis booster trials in children initially vaccinated in infancy with an acellular vaccine: The first with a five-component Tdap vaccine to 5-year olds and the second with five- or monocomponent Tdap vaccines at age 14-15 years. Vaccine 2015; 33:3717-25. [PMID: 26057135 DOI: 10.1016/j.vaccine.2015.05.079] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 05/26/2015] [Accepted: 05/27/2015] [Indexed: 02/06/2023]
Abstract
Prior study children from a DTaP efficacy trial were recruited at ages 5 and 15 years to randomized booster trials addressing immunogenicity and reactogenicity; 475 preschool children received mixed or separate injections of a reduced antigen vaccine (Tdap5, Sanofi Pasteur MSD) and an inactivated polio vaccine, and 230 adolescents received the same or another booster vaccine (Tdap1, SSI, Denmark). Pre-vaccination antibody concentrations against pertussis antigens were significantly higher at 15 than 5 years of age, probably due to natural boosting between the studies. Tdap5 induced comparable anti-PT concentrations at both ages, but antibody responses were significantly higher to filamentous haemagglutinin, pertactin and fimbriae 2/3 in adolescents. As expected, a higher amount of PT (Tdap1, 20μg) induced a stronger anti-PT response than a lower amount (Tdap5, 2.5μg). The frequency of adverse events was low and there were no serious adverse reactions. All local reactions had an early onset and a short duration. A large swelling or redness of more than half of the upper arm circumference was reported in 8/475 5-year-olds and in 6/230 15-year-olds. Children vaccinated with Tdap5 reported more moderate pain in adolescence than at preschool age, whereas itching was only reported in preschool children. Sweden introduced DTaP vaccines in 1996 after a 17-year hiatus with no general pertussis vaccination and pertussis was still endemic at the time of the studies. The frequency of adverse events was nevertheless low in both preschool children and adolescents and antibody responses were adequate. These studies document immunogenicity and reactogenicity in a trial cohort consecutively vaccinated with acellular pertussis vaccines from infancy to adolescence. The adolescent study was registered at ClinicalTrials.gov on 26 March 2009 (NCT00870350).
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Assessment of antibody level and avidity against Bordetella pertussis in a cohort of Egyptian individuals aged 1-18 years. J Adv Res 2015; 7:105-11. [PMID: 26843976 PMCID: PMC4703483 DOI: 10.1016/j.jare.2015.03.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 01/28/2015] [Accepted: 03/14/2015] [Indexed: 11/21/2022] Open
Abstract
Pertussis specific antibodies were studied with respect to quality and quantity in a cohort of apparently healthy Egyptian children and adolescents, with their age range between 1 and 18 years, in an attempt to get a close and clear insight into the current humoral immunization status in this specified group and to try find a relation between the antibody levels and their avidities in eradication of this devastating infectious disease. Our results showed that avidity increase was most marked in young school children (6–8 years) where it seemed to reach a plateau in older children and adolescents. Antibody titer was highest in toddlers (1–2 years) and young school children (6–8 years) groups, most probably following vaccination and/or booster doses. Among children aged 1–5 years, 28% had highly avid and 50% had high titer antibodies, whereas in adolescents aged 13–18 years, 70% had highly avid antibodies and only 30% had high titer antibodies. The results clearly demonstrated that while levels of anti-Bordetella pertussis (B. pertussis) antibodies wane with growing age, the avidity seems to increase, to a plateau, irrespective of further antigen exposure in a pattern showing complete independence of avidity on concentration. The present study draws attention to the importance of avidity measurements, together with conventional ELISAs, for evaluating immunity against pertussis. Being based on a limited sample size, it could open doors for larger-scale surveys to be possible indicators for the need and timing of booster vaccination doses among Egyptians.
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Abu Raya B, Bamberger E, Almog M, Peri R, Srugo I, Kessel A. Immunization of pregnant women against pertussis: the effect of timing on antibody avidity. Vaccine 2015; 33:1948-52. [PMID: 25744227 DOI: 10.1016/j.vaccine.2015.02.059] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 01/26/2015] [Accepted: 02/20/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND The Centers for Disease Control and Prevention recommend tetanus-diphteria-acellular pertussis (Tdap) immunization during pregnancy, preferably at 27-36 weeks gestation. AIMS First, to assess the relative avidity index (RAI) of umbilical cord immunoglobulin G (IgG) to pertussis toxin (PT) for newborns of women immunized with Tdap during late pregnancy as compared to unimmunized women. Second, to assess whether there is a preferential period of gestational Tdap immunization that provides the highest RAI of umbilical cord IgG to PT. METHODS RAI of IgG to PT was assessed via an adapted ELISA using NH4SCN as a dissociating agent. RESULTS We found that newborns of women immunized with Tdap during late pregnancy (n=52) had higher mean RAI of umbilical cord IgG to PT than those of unimmunized women (n=8), 73.77%±12.08 (95% CI, 70.41-77.13) vs. 50.23%±21.32 (95% CI, 32.41-68.06), p<0.001. Further, the RAI of umbilical cord IgG to PT was significantly higher in newborns of women immunized at 27-30(+6) weeks gestation (n=20) when compared with newborns of women immunized at 31-36 weeks (n=22) and >36 weeks (n=7), 79.53%±5.61 (95% CI, 76.91-82.16) vs. 71.56%±12.58 (95% CI, 65.98-77.14) vs. 63.93%±17.98 (95% CI, 47.31-80.56), p<0.03. CONCLUSION Gestational Tdap immunization between 27 and 30(+6) weeks resulted in the highest avidity of IgG to PT conveyed at delivery as compared with immunization beyond 31 weeks gestation. Future studies should be conducted to confirm our findings to optimize pertussis-controlling strategies.
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Affiliation(s)
- Bahaa Abu Raya
- Department of Pediatrics, Bnai Zion Medical Center, Golomb St. 47, Haifa 31048, Israel; The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Efron St. 1, Haifa 31096, Israel.
| | - Ellen Bamberger
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Efron St. 1, Haifa 31096, Israel; Clinical Microbiology Laboratory, Bnai Zion Medical Center, Golomb St. 47, Haifa 31048, Israel
| | - Meital Almog
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Efron St. 1, Haifa 31096, Israel; Division of Allergy and Clinical Immunology, Bnai Zion Medical Center, Golomb St. 47, Haifa 31048, Israel
| | - Regina Peri
- Division of Allergy and Clinical Immunology, Bnai Zion Medical Center, Golomb St. 47, Haifa 31048, Israel
| | - Isaac Srugo
- Department of Pediatrics, Bnai Zion Medical Center, Golomb St. 47, Haifa 31048, Israel; The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Efron St. 1, Haifa 31096, Israel; Clinical Microbiology Laboratory, Bnai Zion Medical Center, Golomb St. 47, Haifa 31048, Israel
| | - Aharon Kessel
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Efron St. 1, Haifa 31096, Israel; Division of Allergy and Clinical Immunology, Bnai Zion Medical Center, Golomb St. 47, Haifa 31048, Israel
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Edwards KM. Review of the laboratory approaches to the detection of antibody and cell-mediated immunity to pertussis disease and vaccine. Expert Rev Vaccines 2014; 13:1183-90. [DOI: 10.1586/14760584.2014.946015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Pertussis-specific memory B-cell and humoral IgG responses in adolescents after a fifth consecutive dose of acellular pertussis vaccine. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2014; 21:1301-8. [PMID: 25008903 DOI: 10.1128/cvi.00280-14] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In order to impede the increase in pertussis incidence in the adolescent group, a school-leaving booster dose administered at the age of 14 to 16 years will be introduced in Sweden in 2016. Preceding this introduction, an open-label, randomized, multicenter, clinical trial without a control group and with blinded analysis was performed, investigating both safety and immunogenicity. Reported here are the memory B-cell and serological responses detected in a smaller cohort (n = 34) of the 230 subjects recruited to the study. All subjects had received primary vaccination consisting of three doses of diphtheria-tetanus-5-component pertussis (DTaP5) vaccine, at 3, 5, and 12 months of age, and a tetanus-low-dose diphtheria-5-component pertussis (Tdap5) vaccine booster at 5.5 years. In this study, the subjects were randomly assigned and received either a Tdap1 or Tdap5 booster. Of the 230 participants, 34 subjects had samples available for evaluation of IgG-producing memory B-cell responses. Both vaccine groups had significant increases in pertussis toxin-specific serum IgG levels, but only the 1-component group showed significant increases in pertussis toxin-specific memory B cells. The 5-component group had significant increases in filamentous hemagglutinin- and pertactin-specific memory B-cell and serum IgG levels; these were not seen in the 1-component group, as expected. In conclusion, this study shows that a 5th consecutive dose of an acellular pertussis vaccine induces B-cell responses in vaccinated adolescents. (This study has been registered at EudraCT under registration no. 2008-008195-13 and at ClinicalTrials.gov under registration no. NCT00870350.).
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Lynch HE, Stewart SM, Kepler TB, Sempowski GD, Alam SM. Surface plasmon resonance measurements of plasma antibody avidity during primary and secondary responses to anthrax protective antigen. J Immunol Methods 2013; 404:1-12. [PMID: 24316020 DOI: 10.1016/j.jim.2013.11.026] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 11/21/2013] [Accepted: 11/25/2013] [Indexed: 10/25/2022]
Abstract
Establishment of humoral immunity against pathogens is dependent on events that occur in the germinal center and the subsequent induction of high-affinity neutralizing antibodies. Quantitative assays that allow monitoring of affinity maturation and duration of antibody responses can provide useful information regarding the efficacy of vaccines and adjuvants. Using an anthrax protective antigen (rPA) and alum model antigen/adjuvant system, we describe a methodology for monitoring antigen-specific serum antibody concentration and avidity by surface plasmon resonance during primary and secondary immune responses. Our analyses showed that following a priming dose in mice, rPA-specific antibody concentration and avidity increases over time and reaches a maximal response in about six weeks, but gradually declines in the absence of antigenic boost. Germinal center reactions were observed early with maximal development achieved during the primary response, which coincided with peak antibody avidity responses to primary immunization. Boosting with antigen resulted in a rapid increase in rPA-specific antibody concentration and five-fold increase in avidity, which was not dependent on sustained GC development. The described methodology couples surface plasmon resonance-based plasma avidity measurements with germinal center analysis and provides a novel way to monitor humoral responses that can play a role in facilitating vaccine and adjuvant development.
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Affiliation(s)
- Heather E Lynch
- Duke Human Vaccine Institute and Departments of Medicine, Duke University Medical Center, Durham, NC 27710, United States
| | - Shelley M Stewart
- Duke Human Vaccine Institute and Departments of Medicine, Duke University Medical Center, Durham, NC 27710, United States
| | - Thomas B Kepler
- Department of Microbiology, Boston University School of Medicine, Boston, MA 02118, United States
| | - Gregory D Sempowski
- Duke Human Vaccine Institute and Departments of Medicine, Duke University Medical Center, Durham, NC 27710, United States
| | - S Munir Alam
- Duke Human Vaccine Institute and Departments of Medicine, Duke University Medical Center, Durham, NC 27710, United States.
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Klein NP, Bartlett J, Fireman B, Rowhani-Rahbar A, Baxter R. Comparative effectiveness of acellular versus whole-cell pertussis vaccines in teenagers. Pediatrics 2013; 131:e1716-22. [PMID: 23690518 DOI: 10.1542/peds.2012-3836] [Citation(s) in RCA: 133] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND During the 1990s, the United States switched from combined diphtheria, tetanus toxoids, whole-cell pertussis (DTwP) vaccines to combined acellular pertussis (DTaP) vaccines because of safety concerns. After a 2010-2011 pertussis outbreak, we sought to evaluate whether disease risk in 10 to 17 year olds differed between those who previously received DTwP from those who received DTaP. METHODS A case-control study among individuals born from 1994 to 1999 who received 4 pertussis-containing vaccines during the first 2 years of life at Kaiser Permanente Northern California (KPNC). We separately compared pertussis polymerase chain reaction (PCR)-positive cases with PCR-negative and KPNC-matched controls. We assessed risk of pertussis relative to vaccine type in early childhood (4 DTwPs, mixed DTwP/DTaP, or 4 DTaPs) by using conditional logistic regression stratified for calendar time and adjusted for gender, race, medical clinic, and receipt of reduced antigen content acellular pertussis (Tdap) vaccine. RESULTS We compared 138 PCR-positive cases with 899 PCR-negative and 54 339 KPNC-matched controls. Teenagers who had received 4 DTwPs were much less likely to be pertussis PCR-positive than those who had received 4 DTaPs (odds ratio 5.63, 95% confidence interval 2.55-12.46) or mixed DTwP/DTaP vaccines (odds ratio 3.77, 95% confidence interval 1.57-9.07). Decreasing number of DTwP doses was significantly associated with increased pertussis risk (P < .0001). CONCLUSIONS Teenagers who received DTwP vaccines in childhood were more protected during a pertussis outbreak than were those who received DTaP vaccines.
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Affiliation(s)
- Nicola P Klein
- Kaiser Permanente Vaccine Study Center, Oakland, CA 94612, USA.
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