1
|
Gillard J, Suffiotti M, Brazda P, Venkatasubramanian PB, Versteegen P, de Jonge MI, Kelly D, Bibi S, Pinto MV, Simonetti E, Babiceanu M, Kettring A, Teodosio C, de Groot R, Berbers G, Stunnenberg HG, Schanen B, Fenwick C, Huynen MA, Diavatopoulos DA. Antiviral responses induced by Tdap-IPV vaccination are associated with persistent humoral immunity to Bordetella pertussis. Nat Commun 2024; 15:2133. [PMID: 38459022 PMCID: PMC10923912 DOI: 10.1038/s41467-024-46560-w] [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: 03/01/2022] [Accepted: 03/01/2024] [Indexed: 03/10/2024] Open
Abstract
Many countries continue to experience pertussis epidemics despite widespread vaccination. Waning protection after booster vaccination has highlighted the need for a better understanding of the immunological factors that promote durable protection. Here we apply systems vaccinology to investigate antibody responses in adolescents in the Netherlands (N = 14; NL) and the United Kingdom (N = 12; UK) receiving a tetanus-diphtheria-acellular pertussis-inactivated poliovirus (Tdap-IPV) vaccine. We report that early antiviral and interferon gene expression signatures in blood correlate to persistence of pertussis-specific antibody responses. Single-cell analyses of the innate response identified monocytes and myeloid dendritic cells (MoDC) as principal responders that upregulate antiviral gene expression and type-I interferon cytokine production. With public data, we show that Tdap vaccination stimulates significantly lower antiviral/type-I interferon responses than Tdap-IPV, suggesting that IPV may promote antiviral gene expression. Subsequent in vitro stimulation experiments demonstrate TLR-dependent, IPV-specific activation of the pro-inflammatory p38 MAP kinase pathway in MoDCs. Together, our data provide insights into the molecular host response to pertussis booster vaccination and demonstrate that IPV enhances innate immune activity associated with persistent, pertussis-specific antibody responses.
Collapse
Affiliation(s)
- Joshua Gillard
- Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Madeleine Suffiotti
- Service of Immunology and Allergy, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Peter Brazda
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | | | - Pauline Versteegen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Marien I de Jonge
- Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dominic Kelly
- Department of Paediatrics, Oxford Vaccine Group, University of Oxford, Oxford, UK
- Oxford NIHR Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Sagida Bibi
- Department of Paediatrics, Oxford Vaccine Group, University of Oxford, Oxford, UK
- Oxford NIHR Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Marta Valente Pinto
- Department of Paediatrics, Oxford Vaccine Group, University of Oxford, Oxford, UK
- Oxford NIHR Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Caparica, Almada, Portugal
| | - Elles Simonetti
- Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | | | - Cristina Teodosio
- Leiden University Medical Center, Immunohematology & Blood Transfusion, Leiden, The Netherlands
| | - Ronald de Groot
- Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Guy Berbers
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | | | | | - Craig Fenwick
- Service of Immunology and Allergy, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Martijn A Huynen
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dimitri A Diavatopoulos
- Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
- Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands.
| |
Collapse
|
2
|
Aydin I, May M, Pisano F, Mpofu-Maetzig N, Grode L, Parekh S, Pujari P, Shewale S, Desai S, Sharma H, Rao H, Gautam M, Gairola S, Shaligram U. Safety and immunogenicity of SIIPL Tdap, a new tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine, in healthy subjects 4-65 years of age: A Phase II/III randomized, observer-blinded, active controlled, multicenter clinical study in Germany. Vaccine 2023; 41:6810-6819. [PMID: 37827966 DOI: 10.1016/j.vaccine.2023.09.060] [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: 07/24/2023] [Revised: 09/27/2023] [Accepted: 09/28/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND This study assessed the safety and immunogenicity of a new booster vaccine against tetanus, diphtheria, and pertussis manufactured by Serum Institute of India Pvt. Ltd (SIIPL Tdap). METHODS The Phase II/III trial was randomized (2:1), observer blinded and active controlled. Healthy subjects aged 4-65 years received a single dose of either SIIPL Tdap or comparator Tdap vaccine (Boostrix®, GlaxoSmithKline, Belgium), and were followed-up for 30 days. Blood samples for safety and immunogenicity assessments were collected pre-vaccination and on day 30 post-vaccination. The study assessed safety and reactogenicity of SIIPL Tdap compared to the comparator Tdap as well as the co-primary immunogenicity outcomes: (i) seroprotection rates against diphtheria toxoid (DT) and tetanus toxoid (TT) and (ii) the booster response rates against pertussis toxoid (PT), filamentous hemagglutinin (FHA) and pertactin (PRN) 30 days post-vaccination in all study subjects. A margin of -10 % was used for non-inferiority testing. Secondary outcomes included the booster response rates against DT and TT, seropositivity rates against pertussis antigens, and antibody geometric mean concentrations (GMCs) for all vaccine components. RESULTS At Day 30 post-vaccination, SIIPL Tdap was assessed as non-inferior to the comparator Tdap in terms of: i) seroprotection rates against DT (94.4 % vs. 94.9 %) and TT (99.9 % vs. 100 %) and ii) pertussis booster response rates (93.8 % vs. 88.4 % anti-PT, 89.7 % vs. 90.9 % anti-FHA and 86.3 % vs. 84.4 % anti-PRN), for SIIPL Tdap versus comparator Tdap, respectively. GMCs for anti-PT and anti-PRN were higher in subjects vaccinated with SIIPL Tdap compared to comparator Tdap. All other secondary outcomes were comparable. The overall frequency of local and systemic solicited AEs was comparable; no treatment related SAEs were reported. CONCLUSIONS Booster vaccination with SIIPL Tdap was non-inferior to comparator Tdap with respect to the immunogenicity of the vaccine components and was equally well tolerated. EudraCT number: 2019-002706-46.
Collapse
Affiliation(s)
- Inci Aydin
- Serum Life Science Europe GmbH, Hannover, Germany.
| | - Marcus May
- Serum Life Science Europe GmbH, Hannover, Germany
| | - Fabio Pisano
- Serum Life Science Europe GmbH, Hannover, Germany.
| | | | | | - Sameer Parekh
- Serum Institute of India Private Limited, Pune, India
| | - Pramod Pujari
- Serum Institute of India Private Limited, Pune, India
| | - Sunil Shewale
- Serum Institute of India Private Limited, Pune, India
| | - Shivani Desai
- Serum Institute of India Private Limited, Pune, India
| | - Hitt Sharma
- Serum Institute of India Private Limited, Pune, India
| | - Harish Rao
- Serum Institute of India Private Limited, Pune, India
| | - Manish Gautam
- Serum Institute of India Private Limited, Pune, India
| | - Sunil Gairola
- Serum Institute of India Private Limited, Pune, India
| | | |
Collapse
|
3
|
Sartoretti J, Fontannaz P, Martinez de Tejada B, Othenin-Girard V, Chilin A, Lemaître B, Blanchard-Rohner G, Siegrist CA, Eberhardt CS. Influence of Timing of Maternal Pertussis Immunization on the Avidity of Transferred Antibodies in Term and Preterm Neonates. Clin Infect Dis 2023; 77:645-648. [PMID: 37073575 PMCID: PMC10444006 DOI: 10.1093/cid/ciad227] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 04/05/2023] [Accepted: 04/12/2023] [Indexed: 04/20/2023] Open
Abstract
The timing of maternal pertussis vaccination influences the titers of cord-blood anti-pertussis antibodies. Whether it affects their avidity is unknown. We demonstrate in 298 term and 72 preterm neonates that antibody avidity is independent of the timing of maternal vaccination, whether comparing second with third trimester or intervals before birth.
Collapse
Affiliation(s)
- Julie Sartoretti
- Center for Vaccinology and Neonatal Immunology, Department of Pathology-Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of General Pediatrics, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland
- Department for Pediatrics, Gynecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Paola Fontannaz
- Center for Vaccinology and Neonatal Immunology, Department of Pathology-Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Begoña Martinez de Tejada
- Department for Pediatrics, Gynecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Obstetrics, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Véronique Othenin-Girard
- Department for Pediatrics, Gynecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Antonina Chilin
- Division of Obstetrics, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Barbara Lemaître
- Division of Laboratory Medicine, Department of Diagnostics and of Medical Specialties, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Géraldine Blanchard-Rohner
- Center for Vaccinology and Neonatal Immunology, Department of Pathology-Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of General Pediatrics, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland
- Department for Pediatrics, Gynecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Claire-Anne Siegrist
- Center for Vaccinology and Neonatal Immunology, Department of Pathology-Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of General Pediatrics, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland
- Department for Pediatrics, Gynecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Center for Vaccinology, University Hospitals of Geneva, Geneva, Switzerland
| | - Christiane Sigrid Eberhardt
- Center for Vaccinology and Neonatal Immunology, Department of Pathology-Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department for Pediatrics, Gynecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Center for Vaccinology, University Hospitals of Geneva, Geneva, Switzerland
| |
Collapse
|
4
|
Sedney CJ, Harvill ET. The Neonatal Immune System and Respiratory Pathogens. Microorganisms 2023; 11:1597. [PMID: 37375099 PMCID: PMC10301501 DOI: 10.3390/microorganisms11061597] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/02/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Neonates are more susceptible to some pathogens, particularly those that cause infection in the respiratory tract. This is often attributed to an incompletely developed immune system, but recent work demonstrates effective neonatal immune responses to some infection. The emerging view is that neonates have a distinctly different immune response that is well-adapted to deal with unique immunological challenges of the transition from a relatively sterile uterus to a microbe-rich world, tending to suppress potentially dangerous inflammatory responses. Problematically, few animal models allow a mechanistic examination of the roles and effects of various immune functions in this critical transition period. This limits our understanding of neonatal immunity, and therefore our ability to rationally design and develop vaccines and therapeutics to best protect newborns. This review summarizes what is known of the neonatal immune system, focusing on protection against respiratory pathogens and describes challenges of various animal models. Highlighting recent advances in the mouse model, we identify knowledge gaps to be addressed.
Collapse
Affiliation(s)
| | - Eric T. Harvill
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA;
| |
Collapse
|
5
|
Caulfield AD, Callender M, Harvill ET. Generating enhanced mucosal immunity against Bordetella pertussis: current challenges and new directions. Front Immunol 2023; 14:1126107. [PMID: 36895562 PMCID: PMC9990818 DOI: 10.3389/fimmu.2023.1126107] [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: 12/17/2022] [Accepted: 02/08/2023] [Indexed: 02/23/2023] Open
Abstract
Bordetella pertussis (Bp) is the highly transmissible etiologic agent of pertussis, a severe respiratory disease that causes particularly high morbidity and mortality in infants and young children. Commonly known as "whooping cough," pertussis is one of the least controlled vaccine-preventable diseases worldwide with several countries experiencing recent periods of resurgence despite broad immunization coverage. While current acellular vaccines prevent severe disease in most cases, the immunity they confer wanes rapidly and does not prevent sub clinical infection or transmission of the bacterium to new and vulnerable hosts. The recent resurgence has prompted new efforts to generate robust immunity to Bp in the upper respiratory mucosa, from which colonization and transmission originate. Problematically, these initiatives have been partially hindered by research limitations in both human and animal models as well as potent immunomodulation by Bp. Here, we consider our incomplete understanding of the complex host-pathogen dynamics occurring in the upper airway to propose new directions and methods that may address critical gaps in research. We also consider recent evidence that supports the development of novel vaccines specifically designed to generate robust mucosal immune responses capable of limiting upper respiratory colonization to finally halt the ongoing circulation of Bordetella pertussis.
Collapse
Affiliation(s)
- Amanda D. Caulfield
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | | | | |
Collapse
|
6
|
Havers FP, Skoff TH, Rench MA, Epperson M, Rajam G, Schiffer J, Hariri S, Swaim LS, Baker CJ, Healy CM. Maternal Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Vaccination During Pregnancy: Impact on Infant Anti-Pertussis Antibody Concentrations by Maternal Pertussis Priming Series. Clin Infect Dis 2023; 76:e1087-e1093. [PMID: 35642525 DOI: 10.1093/cid/ciac432] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/10/2022] [Accepted: 05/26/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Acellular pertussis (aP) vaccines replaced whole-cell pertussis (wP) vaccines for the US childhood primary series in 1997. As women primed with aP vaccines enter childbearing age, protection of infants through tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccination during pregnancy may be impacted. METHODS Term infants born to women vaccinated with Tdap during pregnancy were included. Geometric mean concentrations (GMCs) of pertussis-specific immunoglobulin G antibodies (international units per milliliter) in cord blood of infants born to women born after 1997 (aP-primed) were compared with those born to women born before 1992 (wP-primed). RESULTS 253 and 506 infants born to aP- and wP-primed women, respectively, were included. Compared with wP-primed women, aP-primed women were younger, more likely to be Hispanic or non-Hispanic Black, and had lower-birthweight infants (P < .01 for all). Antibodies against pertussis toxin (PT) and filamentous hemagglutinin (FHA) were lower among infants born to aP-primed vs wP-primed women (PT, 17.3 vs 36.4; GMC ratio, .475; 95% confidence interval [CI], .408-.552 and FHA, 104.6 vs 121.4; GMC ratio, 0.861; 95% CI, .776-.958). No differences were observed for anti-fimbriae or anti-pertactin antibodies. CONCLUSIONS Transplacental anti-pertussis antibody concentrations in infants of women vaccinated with Tdap during pregnancy differed by type of childhood vaccine the women received. Notably, anti-PT antibody levels, considered most important in preventing severe infant disease, were lower in infants born to aP-primed vs wP-primed women. Maternal Tdap vaccination may confer less protection against pertussis in infants born to aP-primed vs those born to wP-primed women.
Collapse
Affiliation(s)
- Fiona P Havers
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Tami H Skoff
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Marcia A Rench
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Monica Epperson
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Gowrisankar Rajam
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jarad Schiffer
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Susan Hariri
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Laurie S Swaim
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA
| | - Carol J Baker
- Department of Pediatrics, University of Texas Health Sciences Center at Houston, Houston, Texas, USA
| | - C Mary Healy
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| |
Collapse
|
7
|
Pertussis Prevalence in Adult Population in Greece: A Seroprevalence Nationwide Study. Vaccines (Basel) 2022; 10:vaccines10091511. [PMID: 36146589 PMCID: PMC9502282 DOI: 10.3390/vaccines10091511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 11/17/2022] Open
Abstract
The reported cases of pertussis vary considerably globally. In the present nationwide study, we aimed to record the Bordetella pertussis prevalence in Greece by measuring serum IgG specific antibody levels to pertussis toxin (anti-PT IgG). General practitioners and laboratories participated in this study from 12 regions of Greece. A geographically stratified sampling plan based on regional units (NUTS level 2) was applied in order to produce a representative sample, taking into consideration age group (30−39, 40−49, 50−59, 60−69, 70−79 and 80+) and sex. In total, 1169 subjects participated in the study. The percentage of participants with anti-PT IgG antibodies higher than 50 IU/mL was 3.7%. The levels of anti-PT IgG antibodies of total sample ranged between 1.46 IU/mL to 126.60 IU/mL, with mean 17.74 IU/mL and standard deviation 14.03 U/mL (p-value < 0.001). The total seroprevalence of Greek regions for pertussis disease varied significantly among prefectures. The region with the highest seroprevalence was Peloponnese 21.3%, followed by the region of Central Greece 15.3%. The proportion of adults who have pertussis specific antibodies <50 IU/mL has been >90%, suggesting that a large number of adults may be vulnerable to infection of pertussis despite well-established vaccination programs in Greece. Despite the fact that vaccination reduced the number of reported pertussis cases in the last decades in Greece, our seroprevalence study may indicate that the herd immunity level among Greek adults is suboptimal.
Collapse
|
8
|
Hattabi H, Bouchez C, Dubos F, Martinot A, Faure K, Dessein R, Bartolo S, Subtil D. [Should French pregnant women be vaccinated against pertussis during pregnancy?]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2022; 50:486-493. [PMID: 35483610 DOI: 10.1016/j.gofs.2022.02.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 02/03/2022] [Accepted: 02/20/2022] [Indexed: 06/14/2023]
Abstract
Many countries with a high perinatal level have started a policy of vaccination of pregnant women against pertussis. To date, France has not chosen this policy. The objective was to review knowledge on pertussis mortality in infants. Compare the strategies available to protect the infant before his first vaccination, scheduled for two months of age. We proceeded to a litterature analysis, from January 1998 to 2021. Search by the following keywords used ; "Whooping cough, vaccination, pregnancy, strategy, cocooning", on the scientific basis of "Pubmed", as well as French and foreign vaccination recommendations. Currently 90% of whooping cough deaths are concerning infants under six months of age and this mortality represents 2% of mortality in the first year of life. Vaccination at birth is not effective. The cocooning strategy, which consists of vaccinating those around the child, is expensive and difficult to implement. A systematic vaccination policy for pregnant women is effective and reasonably expensive when compared to the cocooning strategy. In England, it was recently accompanied by a 78% reduction in confirmed cases of pertussis in infants under six months of age. In conclusion, compared to cocooning strategy, pertussis vaccination of pregnant women appears more effective and cost-effective, and this with each pregnancy.
Collapse
Affiliation(s)
- H Hattabi
- University Lille, CHU Lille, pôle femme mère nouveau-né, hôpital Jeanne de Flandre, 59000 Lille, France.
| | - C Bouchez
- University Lille, CHU Lille, pôle femme mère nouveau-né, hôpital Jeanne de Flandre, 59000 Lille, France
| | - F Dubos
- University Lille, CHU Lille, pôle enfant, hôpital Jeanne de Flandre, 59000 Lille, France; University Lille, EA 2694, METRICS, Evaluation des technologies de santé et des pratiques médicales. CHU Lille, hôpital Jeanne de Flandre, 59000 Lille, France
| | - A Martinot
- University Lille, CHU Lille, pôle enfant, hôpital Jeanne de Flandre, 59000 Lille, France; University Lille, EA 2694, METRICS, Evaluation des technologies de santé et des pratiques médicales. CHU Lille, hôpital Jeanne de Flandre, 59000 Lille, France
| | - K Faure
- University Lille, CHU Lille, service de maladies infectieuses, rue Michel Polonowski, 59000 Lille, France; University Lille, EA7366, recherche translationnelle relation hôte-pathogènes, faculté de médecine pôle recherche, 59045 Lille, France
| | - R Dessein
- University Lille, EA7366, recherche translationnelle relation hôte-pathogènes, faculté de médecine pôle recherche, 59045 Lille, France
| | - S Bartolo
- University Lille, CHU Lille, pôle femme mère nouveau-né, hôpital Jeanne de Flandre, 59000 Lille, France; University Lille, EA 2694, METRICS, Evaluation des technologies de santé et des pratiques médicales. CHU Lille, hôpital Jeanne de Flandre, 59000 Lille, France
| | - D Subtil
- University Lille, CHU Lille, pôle femme mère nouveau-né, hôpital Jeanne de Flandre, 59000 Lille, France; University Lille, EA 2694, METRICS, Evaluation des technologies de santé et des pratiques médicales. CHU Lille, hôpital Jeanne de Flandre, 59000 Lille, France
| |
Collapse
|
9
|
Weaver KL, Blackwood CB, Horspool AM, Pyles GM, Sen-Kilic E, Grayson EM, Huckaby AB, Witt WT, DeJong MA, Wolf MA, Damron FH, Barbier M. Long-Term Analysis of Pertussis Vaccine Immunity to Identify Potential Markers of Vaccine-Induced Memory Associated With Whole Cell But Not Acellular Pertussis Immunization in Mice. Front Immunol 2022; 13:838504. [PMID: 35211125 PMCID: PMC8861382 DOI: 10.3389/fimmu.2022.838504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 01/19/2022] [Indexed: 12/13/2022] Open
Abstract
Over two decades ago acellular pertussis vaccines (aP) replaced whole cell pertussis vaccines (wP) in several countries. Since then, a resurgence in pertussis has been observed, which is hypothesized to be linked, in part, to waning immunity. To better understand why waning immunity occurs, we developed a long-term outbred CD1 mouse model to conduct the longest murine pertussis vaccine studies to date, spanning out to 532 days post primary immunization. Vaccine-induced memory results from follicular responses and germinal center formation; therefore, cell populations and cytokines involved with memory were measured alongside protection from challenge. Both aP and wP immunization elicit protection from intranasal challenge by decreasing bacterial burden in both the upper and lower airways, and by generation of pertussis specific antibody responses in mice. Responses to wP vaccination were characterized by a significant increase in T follicular helper cells in the draining lymph nodes and CXCL13 levels in sera compared to aP mice. In addition, a population of B. pertussis+ memory B cells was found to be unique to wP vaccinated mice. This population peaked post-boost, and was measurable out to day 365 post-vaccination. Anti-B. pertussis and anti-pertussis toxoid antibody secreting cells increased one day after boost and remained high at day 532. The data suggest that follicular responses, and in particular CXCL13 levels in sera, could be monitored in pre-clinical and clinical studies for the development of the next-generation pertussis vaccines.
Collapse
Affiliation(s)
- Kelly L. Weaver
- Department of Microbiology, Immunology, and Cell Biology, West Virginia University, Morgantown, WV, United States,Vaccine Development Center, West Virginia University Health Sciences Center, Morgantown, WV, United States
| | - Catherine B. Blackwood
- Department of Microbiology, Immunology, and Cell Biology, West Virginia University, Morgantown, WV, United States,Vaccine Development Center, West Virginia University Health Sciences Center, Morgantown, WV, United States
| | - Alexander M. Horspool
- Department of Microbiology, Immunology, and Cell Biology, West Virginia University, Morgantown, WV, United States,Vaccine Development Center, West Virginia University Health Sciences Center, Morgantown, WV, United States
| | - Gage M. Pyles
- Department of Microbiology, Immunology, and Cell Biology, West Virginia University, Morgantown, WV, United States,Vaccine Development Center, West Virginia University Health Sciences Center, Morgantown, WV, United States
| | - Emel Sen-Kilic
- Department of Microbiology, Immunology, and Cell Biology, West Virginia University, Morgantown, WV, United States,Vaccine Development Center, West Virginia University Health Sciences Center, Morgantown, WV, United States
| | - Emily M. Grayson
- Department of Microbiology, Immunology, and Cell Biology, West Virginia University, Morgantown, WV, United States,Vaccine Development Center, West Virginia University Health Sciences Center, Morgantown, WV, United States
| | - Annalisa B. Huckaby
- Department of Microbiology, Immunology, and Cell Biology, West Virginia University, Morgantown, WV, United States,Vaccine Development Center, West Virginia University Health Sciences Center, Morgantown, WV, United States
| | - William T. Witt
- Department of Microbiology, Immunology, and Cell Biology, West Virginia University, Morgantown, WV, United States,Vaccine Development Center, West Virginia University Health Sciences Center, Morgantown, WV, United States
| | - Megan A. DeJong
- Department of Microbiology, Immunology, and Cell Biology, West Virginia University, Morgantown, WV, United States,Vaccine Development Center, West Virginia University Health Sciences Center, Morgantown, WV, United States
| | - M. Allison Wolf
- Department of Microbiology, Immunology, and Cell Biology, West Virginia University, Morgantown, WV, United States,Vaccine Development Center, West Virginia University Health Sciences Center, Morgantown, WV, United States
| | - F. Heath Damron
- Department of Microbiology, Immunology, and Cell Biology, West Virginia University, Morgantown, WV, United States,Vaccine Development Center, West Virginia University Health Sciences Center, Morgantown, WV, United States
| | - Mariette Barbier
- Department of Microbiology, Immunology, and Cell Biology, West Virginia University, Morgantown, WV, United States,Vaccine Development Center, West Virginia University Health Sciences Center, Morgantown, WV, United States,*Correspondence: Mariette Barbier,
| |
Collapse
|
10
|
A phase 2 randomized controlled dose-ranging trial of recombinant pertussis booster vaccines containing genetically inactivated pertussis toxin in women of childbearing age. Vaccine 2021; 40:2352-2361. [PMID: 34789403 PMCID: PMC9005647 DOI: 10.1016/j.vaccine.2021.10.076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 10/26/2021] [Accepted: 10/28/2021] [Indexed: 11/22/2022]
Abstract
Recombinant inactivated pertussis vaccines are safe in non-pregnant women. Lower-dose genetically-inactivated pertussis toxin has comparable immunogenicity. Monovalent recombinant pertussis vaccine shows favorable immunogenicity and safety.
Background A phase 2 randomized-controlled safety and immunogenicity trial evaluating different doses of recombinant acellular pertussis vaccine containing genetically-inactivated pertussis toxin (PTgen) was conducted in women of childbearing age in Thailand to identify formulations to advance to a trial in pregnant women. Methods A total of 250 women were randomized 1:1:1:1:1 to receive one dose of one of three investigational vaccines including low-dose recombinant pertussis-only vaccine containing 1 μg PTgen and 1 μg FHA (ap1gen), tetanus, reduced-dose diphtheria (Td) combined to ap1gen (Tdap1gen) or combined to recombinant pertussis containing 2 μg PTgen and 5 μg FHA (Tdap2gen), or one dose of licensed recombinant TdaP vaccine containing 5 μg PTgen and 5 μg FHA (Boostagen®, TdaP5gen) or licensed Tdap vaccine containing 8 μg of chemically inactivated pertussis toxoid (PTchem), 8 μg FHA, and 2.5 μg pertactin (PRN) (BoostrixTM, Tdap8chem). Serum Immunoglobulin G (IgG) antibodies against vaccine antigens were measured before and 28 days after vaccination by ELISA. To advance to a trial in pregnant women, formulations had to induce a PT-IgG seroresponse rate with a 95% confidence interval (95% CI) lower limit of ≥ 50%. Results Between 5 and 22 July 2018, a total of 250 women with median age of 31 years were enrolled. Post-vaccination PT-IgG seroresponse rates were 92% (95% CI 81–98) for ap1gen, 88% (95% CI 76–95) for Tdap1gen, 80% (95% CI 66–90) for Tdap2gen, 94% (95% CI 83–99) for TdaP5gen, and 78% (95% CI 64–88) for Tdap8chem. Frequencies of injection site and systemic reactions were comparable between the groups. No serious adverse events were reported during the 28-day post-vaccination period. Conclusions All recombinant acellular pertussis vaccines were safe and immunogenic in women of childbearing age, and all met pre-defined immunogenicity criteria to advance to a trial in pregnant women. Clinical Trial Registration: Thai Clinical Trial Registry, TCTR20180321004.
Collapse
|
11
|
Kang KR, Huh DH, Kim JA, Kang JH. Immunogenicity of a new enhanced tetanus-reduced dose diphtheria-acellular pertussis (Tdap) vaccine against Bordetella pertussis in a murine model. BMC Immunol 2021; 22:68. [PMID: 34641798 PMCID: PMC8506493 DOI: 10.1186/s12865-021-00457-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 09/28/2021] [Indexed: 11/13/2022] Open
Abstract
Background The necessity of the tetanus-reduced dose diphtheria-acellular pertussis (Tdap) vaccine in adolescence and adults has been emphasized since the resurgence of small-scale pertussis in Korea and worldwide due to the waning effect of the vaccine and variant pathogenic stains in the late 1990s. GreenCross Pharma (GC Pharma), a Korean company, developed the Tdap vaccine GC3111 in 2010. Recently, they enhanced the vaccine, GC3111, produced previously in 2010 to reinforce the antibody response against filamentous hemagglutinin (FHA). In this study, immunogenicity and efficacy of the enhanced Tdap vaccine compared and evaluated with two Tdap vaccines, GC3111 vaccine produced in 2010 previously and commercially available Tdap vaccine in a murine model. Methods Two tests groups and positive control group of Balb/c mice were primed with two doses of the diphtheria-tetanus-acellular pertussis (DTaP) vaccine followed by a single booster Tdap vaccine at 9 week using the commercially available Tdap vaccine or 2 Tdap vaccines from GC Pharma (GC3111, enhanced GC3111). Humoral response was assessed 1 week before and 2 and 4 weeks after Tdap booster vaccination. The enhanced GC3111 generated similar humoral response compare to the commercial vaccine for filamentous hemagglutinin (FHA). The interferon gamma (IFN-γ) (Th1), interleukin 5 (IL-5) (Th2) and interleukin 17 (IL-17) (Th17) cytokines were assessed 4 weeks after booster vaccination by stimulation with three simulators: heat inactivated Bordetella pertussis (hBp), vaccine antigens, and hBp mixed with antigens (hBp + antigen). A bacterial challenge test was performed 4 weeks after booster vaccination. Results Regarding cell-mediated immunity, cytokine secretion differed among the three simulators. However, no difference was found between two test groups and positive control group. All the vaccinated groups indicated a Th1 or Th1/Th2 response. On Day 5 post-bacterial challenge, B. pertussis colonies were absent in the lungs in two test groups and positive control group. Conclusions Our results confirmed the immunogenicity of GC Pharma’s Tdap vaccine; enhanced GC3111 was equivalent to the presently used commercial vaccine in terms of humoral response as well as cell-mediated cytokine expression. Supplementary Information The online version contains supplementary material available at 10.1186/s12865-021-00457-1.
Collapse
Affiliation(s)
- Kyu Ri Kang
- The Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Annex to Seoul Saint Mary Hospital, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Korea
| | - Dong Ho Huh
- The Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Annex to Seoul Saint Mary Hospital, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Korea
| | - Ji Ahn Kim
- The Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Annex to Seoul Saint Mary Hospital, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Korea
| | - Jin Han Kang
- The Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Annex to Seoul Saint Mary Hospital, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Korea. .,Department of Pediatrics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Korea.
| |
Collapse
|
12
|
Ozdil M, Sonmez C, Tugberk Bakar M, Alici Davutoglu E, Madazli R, Kilic S, Vural M, Perk Y. Pertussis antibody levels in infants and their mothers receiving combined tetanus-diphtheria toxoid and acellular pertussis vaccine during pregnancy in Turkey. Eur J Obstet Gynecol Reprod Biol 2021; 265:212-216. [PMID: 34534737 DOI: 10.1016/j.ejogrb.2021.08.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 08/14/2021] [Accepted: 08/31/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Pertussis is an important cause of morbidity and mortality in infants under two months of age and these high risk babies are dependent on maternally derived antibodies until completion of their first immunization series. This study aimed to evaluate the vaccine response of late preterm and term newborns as well as their mothers who underwent combined tetanus-diphtheria toxoid and acellular pertussis (Tdap) vaccination during pregnancy. STUDY DESIGN A total of 70 pregnant women were administered Tdap vaccine (Boostrix®, GSK) between 27 and 33 gestational weeks of pregnancy. The IgG antibodies against pertussis toxin (PT) and filamentous hemagglutinin (FHA) in maternal blood before vaccination and in both maternal and umbilical cord blood after vaccination were evaluated using the in-house ELISA method. The geometric mean concentrations (GMC) and placental transfer ratios of antibodies were measured. RESULTS Participants' with a mean age of 29.59 ± 4.70 years received Tdap vaccine at an average 28.6 ± 1.31 gestational weeks. Average pre and post vaccination levels of anti-PT IgG GMCs and anti-FHA IgG GMCs were 8.01 IU/ml vs 39.48 IU/ml (p = 0.001) and 122.24 IU/ml vs 183.97 IU/ml (p < 0.001), respectively. The anti-PT and anti-FHA IgG GMCs of cord blood after vaccination was 25.15 IU/ml and 118.77 IU/ml, respectively (p < 0.001 and p = 0.064). Placental transfer ratios of anti-PT ve anti-FHA IgG antibodies were detected as 0.65 and 0.62, respectively. CONCLUSION Immunization of pregnant women with Tdap at the third trimester results in high maternal and infant antibody levels. Maternal immunization during each pregnancy seems to be the best strategy in revealing the highest maternal and infant antibodies and in narrowing the gap between birth and immune system maturation in infants. Pregnant women in our country should also get the Tdap vaccine during pregnancy especially in the early third trimester.
Collapse
Affiliation(s)
- Mine Ozdil
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Neonatology, Istanbul, Turkey.
| | - Cemile Sonmez
- General Directorate of Public Health, Department of Microbiology Reference Laboratories and Biological Products, Vaccine Preventable Bacterial Diseases Serology Laboratory, Ankara, Turkey
| | - Murat Tugberk Bakar
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Public Health, Istanbul, Turkey
| | - Ebru Alici Davutoglu
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Obstetrics and Gynecology, Istanbul, Turkey
| | - Riza Madazli
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Obstetrics and Gynecology, Istanbul, Turkey
| | - Selcuk Kilic
- General Directorate of Public Health, Department of Microbiology Reference Laboratories and Biological Products, Vaccine Preventable Bacterial Diseases Serology Laboratory, Ankara, Turkey
| | - Mehmet Vural
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Neonatology, Istanbul, Turkey
| | - Yildiz Perk
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Neonatology, Istanbul, Turkey
| |
Collapse
|
13
|
Saso A, Kampmann B, Roetynck S. Vaccine-Induced Cellular Immunity against Bordetella pertussis: Harnessing Lessons from Animal and Human Studies to Improve Design and Testing of Novel Pertussis Vaccines. Vaccines (Basel) 2021; 9:877. [PMID: 34452002 PMCID: PMC8402596 DOI: 10.3390/vaccines9080877] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 07/28/2021] [Indexed: 12/14/2022] Open
Abstract
Pertussis ('whooping cough') is a severe respiratory tract infection that primarily affects young children and unimmunised infants. Despite widespread vaccine coverage, it remains one of the least well-controlled vaccine-preventable diseases, with a recent resurgence even in highly vaccinated populations. Although the exact underlying reasons are still not clear, emerging evidence suggests that a key factor is the replacement of the whole-cell (wP) by the acellular pertussis (aP) vaccine, which is less reactogenic but may induce suboptimal and waning immunity. Differences between vaccines are hypothesised to be cell-mediated, with polarisation of Th1/Th2/Th17 responses determined by the composition of the pertussis vaccine given in infancy. Moreover, aP vaccines elicit strong antibody responses but fail to protect against nasal colonisation and/or transmission, in animal models, thereby potentially leading to inadequate herd immunity. Our review summarises current knowledge on vaccine-induced cellular immune responses, based on mucosal and systemic data collected within experimental animal and human vaccine studies. In addition, we describe key factors that may influence cell-mediated immunity and how antigen-specific responses are measured quantitatively and qualitatively, at both cellular and molecular levels. Finally, we discuss how we can harness this emerging knowledge and novel tools to inform the design and testing of the next generation of improved infant pertussis vaccines.
Collapse
Affiliation(s)
- Anja Saso
- The Vaccine Centre, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London WC1 7HT, UK; (B.K.); (S.R.)
- Vaccines and Immunity Theme, MRC Unit, The Gambia at London School of Hygiene & Tropical Medicine, Banjul P.O. Box 273, The Gambia
| | - Beate Kampmann
- The Vaccine Centre, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London WC1 7HT, UK; (B.K.); (S.R.)
- Vaccines and Immunity Theme, MRC Unit, The Gambia at London School of Hygiene & Tropical Medicine, Banjul P.O. Box 273, The Gambia
| | - Sophie Roetynck
- The Vaccine Centre, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London WC1 7HT, UK; (B.K.); (S.R.)
- Vaccines and Immunity Theme, MRC Unit, The Gambia at London School of Hygiene & Tropical Medicine, Banjul P.O. Box 273, The Gambia
| |
Collapse
|
14
|
Ma L, Caulfield A, Dewan KK, Harvill ET. Pertactin-Deficient Bordetella pertussis, Vaccine-Driven Evolution, and Reemergence of Pertussis. Emerg Infect Dis 2021; 27:1561-1566. [PMID: 34014152 PMCID: PMC8153889 DOI: 10.3201/eid2706.203850] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Recent reemergence of pertussis (whooping cough) in highly vaccinated populations and rapid expansion of Bordetella pertussis strains lacking pertactin (PRN), a common acellular vaccine antigen, have raised the specter of vaccine-driven evolution and potential return of what was once the major killer of children. The discovery that most circulating B. pertussis strains in the United States have acquired new and independent disruptive mutations in PRN is compelling evidence of strong selective pressure. However, the other 4 antigens included in acellular vaccines do not appear to be selected against so rapidly. We consider 3 aspects of PRN that distinguish it from other vaccine antigens, which might, individually or collectively, explain why only this antigen is being precipitously eliminated. An understanding of the increase in PRN-deficient strains should provide useful information for the current search for new protective antigens and provide broader lessons for the design of improved subunit vaccines.
Collapse
|
15
|
Pitisuttithum P, Dhitavat J, Sirivichayakul C, Pitisuthitham A, Sabmee Y, Chinwangso P, Kerdsomboon C, Fortuna L, Spiegel J, Chauhan M, Poredi IK, van den Biggelaar AH, Wijagkanalan W, Viviani S, Mansouri S, Pham HT. Antibody persistence 2 and 3 years after booster vaccination of adolescents with recombinant acellular pertussis monovalent aP gen or combined TdaP gen vaccines. EClinicalMedicine 2021; 37:100976. [PMID: 34386749 PMCID: PMC8343263 DOI: 10.1016/j.eclinm.2021.100976] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/20/2021] [Accepted: 06/04/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Recombinant pertussis vaccines inducing long-lasting immune responses could help to control the rise in pertussis. We here report on persisting antibody responses 2 and 3 years after booster vaccination with a new generation recombinant acellular pertussis vaccine. METHODS Participants of a phase 2/3 randomised-controlled clinical trial with a monovalent pertussis vaccine containing genetically inactivated pertussis toxin (aPgen) or its tetanus and diphtheria toxoids combination (TdaPgen), or a chemically detoxified comparator vaccine (Tdapchem), (originally conducted between July and August 2015) were invited to participate in observational studies of persisting antibody responses 2 and 3 years after vaccination. Serum IgG against pertussis toxin (PT-IgG) and filamentous hemagglutinin (FHA-IgG) were assessed by ELISA, and PT-neutralising antibodies (PT-Nab) by Chinese Hamster Ovary cell assay. FINDINGS Waning of antibodies stabilised in aPgen and TdaPgen vaccinees 2 and 3 years after vaccination. Three years post-vaccination PT-neutralising antibodies remained 4·6-fold (95% Confidence Interval (CI) 2·6-8·1) and 3·7-fold (95% CI 2·2-6·1) higher, PT-IgG antibodies 3·0-fold (95% CI 2·2-4·1) and 2·5-fold (95% CI 1·9-3·3) higher, and FHA-IgG antibodies 1·8-fold (95% CI 1·3-2·5) and 1·6-fold (95% CI 1·2-2·1) higher than baseline in aPgen and TdaPgen recipients, respectively. In the Tdapchem group, PT-neutralising and PT-IgG and FHA-IgG antibodies were back at baseline levels 2 years post-vaccination. Three years post-vaccination seroconversion rates for PT-neutralising antibodies were 65·0% (95% CI 44·1-85·9) and 55·0% (95% CI 33·2-76·8) in aPgen and TdaPgen recipients, respectively. INTERPRETATION Considering the persistence of elevated antibody responses 3 years post-booster vaccination, genetically detoxified monovalent aPgen and TdaPgen vaccines can be expected to induce longer-lasting protection than chemically inactivated Tdap vaccines. FUNDING BioNet-Asia.
Collapse
Affiliation(s)
- Punnee Pitisuttithum
- Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand
| | - Jittima Dhitavat
- Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand
| | - Chukiat Sirivichayakul
- Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand
| | - Arom Pitisuthitham
- Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand
| | - Yupa Sabmee
- Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand
| | - Pailinrut Chinwangso
- BioNet-Asia Co., Ltd., 19 Soi Udomsuk 37, Sukhumvit 103 Road, Bangjak, Prakanong, Bangkok 10260, Thailand
| | - Chawanee Kerdsomboon
- BioNet-Asia Co., Ltd., 19 Soi Udomsuk 37, Sukhumvit 103 Road, Bangjak, Prakanong, Bangkok 10260, Thailand
| | - Librada Fortuna
- BioNet-Asia Co., Ltd., 19 Soi Udomsuk 37, Sukhumvit 103 Road, Bangjak, Prakanong, Bangkok 10260, Thailand
| | - Jane Spiegel
- BioNet-Asia Co., Ltd., 19 Soi Udomsuk 37, Sukhumvit 103 Road, Bangjak, Prakanong, Bangkok 10260, Thailand
| | - Mukesh Chauhan
- BioNet-Asia Co., Ltd., 19 Soi Udomsuk 37, Sukhumvit 103 Road, Bangjak, Prakanong, Bangkok 10260, Thailand
| | - Indrajeet Kumar Poredi
- BioNet-Asia Co., Ltd., 19 Soi Udomsuk 37, Sukhumvit 103 Road, Bangjak, Prakanong, Bangkok 10260, Thailand
| | | | - Wassana Wijagkanalan
- BioNet-Asia Co., Ltd., 19 Soi Udomsuk 37, Sukhumvit 103 Road, Bangjak, Prakanong, Bangkok 10260, Thailand
| | - Simonetta Viviani
- BioNet-Asia Co., Ltd., 19 Soi Udomsuk 37, Sukhumvit 103 Road, Bangjak, Prakanong, Bangkok 10260, Thailand
| | - Souad Mansouri
- BioNet-Asia Co., Ltd., 19 Soi Udomsuk 37, Sukhumvit 103 Road, Bangjak, Prakanong, Bangkok 10260, Thailand
- Corresponding author.
| | - Hong Thai Pham
- BioNet-Asia Co., Ltd., 19 Soi Udomsuk 37, Sukhumvit 103 Road, Bangjak, Prakanong, Bangkok 10260, Thailand
| |
Collapse
|
16
|
Jones CE, Calvert A, Southern J, Matheson M, Andrews N, Khalil A, Cuthbertson H, Hallis B, England A, Heath PT, Miller E. A phase IV, multi-centre, randomized clinical trial comparing two pertussis-containing vaccines in pregnant women in England and vaccine responses in their infants. BMC Med 2021; 19:138. [PMID: 34098951 PMCID: PMC8186138 DOI: 10.1186/s12916-021-02005-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 05/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pertussis vaccines containing three or five pertussis antigens are recommended in pregnancy in many countries, but no studies have compared the effect on infants' antigen-specific immunoglobulin G (IgG) concentrations. The aim of this study was to compare anti-pertussis IgG responses following primary immunization in infants of mothers vaccinated with TdaP5-IPV (low dose diphtheria toxoid, tetanus toxoid, acellular pertussis [five antigens] and inactivated polio) or TdaP3-IPV in pregnancy (three pertussis antigens). METHODS This multi-centre phase IV randomized clinical trial was conducted in a tertiary referral centre and primary care sites in England. Women were randomized to receive TdaP5-IPV (n = 77) or TdaP3-IPV (n = 77) at 28-32 gestational weeks. A non-randomized control group of 44 women who had not received a pertussis-containing vaccine in pregnancy and their 47 infants were enrolled post-partum. RESULTS Following infant primary immunization, there was no difference in the geometric mean concentrations (GMCs) of anti-pertussis toxin, filamentous haemagglutinin or pertactin IgG between infants born to women vaccinated with TdaP5-IPV (n = 67) or TdaP3-IPV (n = 63). However, the GMC of anti-pertussis toxin IgG was lower in infants born to TdaP5-IPV- and TdaP3-IPV-vaccinated mothers compared to infants born to unvaccinated mothers (n = 45) (geometric mean ratio 0.71 [0.56-0.90] and 0.78 [0.61-0.98], respectively); by 13 months of age, this difference was no longer observed. CONCLUSION Blunting of anti-pertussis toxin IgG response following primary immunization occurs in infants born to women vaccinated with TdaP5-IPV and TdaP3-IPV, with no difference between maternal vaccines. The blunting effect had resolved by 13 months of age. These results may be helpful for countries considering which pertussis-containing vaccine to recommend for use in pregnancy. TRIAL REGISTRATION ClinicalTrials.gov , NCT02145624 , registered 23 May 2014.
Collapse
Affiliation(s)
- Christine Elizabeth Jones
- Paediatric Infectious Diseases Research Group, St George's, University of London, London, UK. .,St George's University Hospitals NHS Foundation Trust, London, UK. .,Faculty of Medicine and Institute for Life Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Clinical and Experimental Sciences, Room LF102, F Level, South Academic Block, Tremona Road, Southampton, SO16 6YD, UK.
| | - Anna Calvert
- Paediatric Infectious Diseases Research Group, St George's, University of London, London, UK.,St George's University Hospitals NHS Foundation Trust, London, UK
| | - Jo Southern
- Immunisation and Countermeasures, National Infection Service, Public Health England, London, UK
| | - Mary Matheson
- National Infection Service, Public Health England, Porton, Salisbury, UK
| | - Nick Andrews
- Statistics, Modelling and Economics Department, Public Health England, London, UK
| | - Asma Khalil
- St George's University Hospitals NHS Foundation Trust, London, UK
| | - Hannah Cuthbertson
- National Infection Service, Public Health England, Porton, Salisbury, UK
| | - Bassam Hallis
- National Infection Service, Public Health England, Porton, Salisbury, UK
| | - Anna England
- National Infection Service, Public Health England, Porton, Salisbury, UK
| | - Paul T Heath
- Paediatric Infectious Diseases Research Group, St George's, University of London, London, UK.,St George's University Hospitals NHS Foundation Trust, London, UK
| | - Elizabeth Miller
- Immunisation and Countermeasures, National Infection Service, Public Health England, London, UK
| |
Collapse
|
17
|
Vaz-de-Lima LR, Sato APS, Pawloski LC, Fernandes EG, Rajam G, Sato HK, Patel D, Li H, de Castilho EA, Tondella ML, Schiffer J. Effect of maternal Tdap on infant antibody response to a primary vaccination series with whole cell pertussis vaccine in São Paulo, Brazil. Vaccine X 2021; 7:100087. [PMID: 33817624 PMCID: PMC8010450 DOI: 10.1016/j.jvacx.2021.100087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 02/04/2021] [Accepted: 02/12/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Maternal Tetanus, diphtheria, and acellular pertussis (Tdap) vaccination provides antibody transfer to newborn infants and may affect their antibody response to the primary vaccination series. This study aimed to assess the effect of Tdap vaccination during pregnancy on infant antibody response to the whole cell pertussis (DTwP) primary series. METHODS Plasma from 318 pregnant women (243 Tdap-vaccinated and 75 unvaccinated) and their infants (cord blood) was collected at delivery; infant blood was again collected at 2 and 7 months, before and after their primary DTwP series. Anti-pertussis toxin (PT), pertactin (PRN), filamentous hemagglutinin (FHA), fimbriae 2/3 (FIM) and adenylate cyclase toxin (ACT) IgG antibodies were quantified by a microsphere-based multiplex antibody capture assay and anti-PT neutralizing antibodies by the Real Time Cell analysis system. RESULTS Infant geometric mean concentrations (GMCs) of IgG anti-Tdap antigens were significantly higher (p < 0.001) among the Tdap-vaccinated (PT: 57.22 IU/mL; PRN: 464.86 IU/mL; FHA: 424.0 IU/mL), versus the unvaccinated group (4 IU/mL, 15.43 IU/mL, 31.99 IU/mL, respectively) at delivery. Anti-FIM and ACT GMCs were similar between the two groups. At 2 months of age, anti-PT, PRN, and FHA GMCs remained higher (p < 0.001) in the Tdap-vaccinated group (12.64 IU/mL; 108.76 IU/mL; 87.41 IU/mL, respectively) than the unvaccinated group (1.02 IU/mL; 4.46 IU/mL; 6.89 IU/mL). However, at 7 months, after receiving the third DTwP dose, the anti-PT GMC was higher (p = 0.016) in the unvaccinated group (7.91 IU/mL) compared to the vaccinated group (2.27 IU/mL), but without differences for anti-PRN, FHA, FIM and ACT GMCs. CONCLUSION Elevated antibody levels suggest that maternal Tdap vaccination might protect infants until 2 months of age. Reduced anti-PT levels at 7 months indicate potential blunting of immune response in infants. Surveillance would help determine if blunting alters vaccine immunity and impacts pertussis prevention in infants.
Collapse
Affiliation(s)
- Lourdes R.A. Vaz-de-Lima
- Centro de Imunologia, Instituto Adolfo Lutz, Coordenadoria de Controle de Doenças da Secretaria de Estado da Saúde, São Paulo, Brazil
| | - Ana Paula S. Sato
- Departmento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo – USP, Brazil
| | - Lucia C. Pawloski
- Division of Bacterial Diseases, NCIRD, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Eder G. Fernandes
- Divisão de Imunização, Centro de Vigilância Epidemiológica Prof. Alexandre Vranjac, Coordenadoria de Controle de Doenças da Secretaria de Estado da Saúde SP, Brazil
| | - Gowrisankar Rajam
- Division of Bacterial Diseases, NCIRD, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Helena K. Sato
- Divisão de Imunização, Centro de Vigilância Epidemiológica Prof. Alexandre Vranjac, Coordenadoria de Controle de Doenças da Secretaria de Estado da Saúde SP, Brazil
| | - Divya Patel
- Division of Bacterial Diseases, NCIRD, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Han Li
- Division of Bacterial Diseases, NCIRD, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Maria Lucia Tondella
- Division of Bacterial Diseases, NCIRD, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jarad Schiffer
- Division of Bacterial Diseases, NCIRD, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | |
Collapse
|
18
|
Crowcroft NS, Bolotin S, Li Y, Campbell H, Amirthalingam G. Infant pertussis and maternal immunity: The curious case of Canada. Vaccine 2021; 39:1977-1981. [PMID: 33750589 DOI: 10.1016/j.vaccine.2021.02.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 02/20/2021] [Accepted: 02/23/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND The United Kingdom (UK) and Canada use the same acellular pertussis vaccine and both experienced large pertussis outbreaks in the past, occurring in the 1980s in the UK and 1990s in Canada, yet current epidemiology differs. A national outbreak with infant deaths occurred in the UK in 2012, yet outbreaks remain localized and death from pertussis rare in Canada. AIM We explored whether past outbreaks in children may influence future risk when those children become parents. METHODS We conducted an ecological within-country birth cohort analysis in women of childbearing age of the relative risk of ever having pertussis infection by two points in time, 2002 and 2012, comparing with 1992 as the baseline. We used notified cases of pertussis in England and Wales and Canada to compare trends in relative risk. We projected forward to 2022 in Canada assuming incidence remained stable. RESULTS In Canada, the cumulative risk of previous pertussis was similar in 2002 and 2012 and, in both periods, was higher than in 1992. In England and Wales, the cumulative risk of pertussis fell stepwise from 1992 to 2012. Projecting forwards, the pattern of risk in Canada becomes similar to England and Wales in 2022. CONCLUSIONS Widespread pertussis outbreaks in children may reduce the risk of pertussis in infants when those children become parents. Further research is needed to determine the mechanism. As birth cohorts that experienced outbreaks grow past childbearing age, pertussis burden in infants in Canada may increase, following trends observed in England and Wales.
Collapse
Affiliation(s)
- Natasha S Crowcroft
- Dalla Lana School of Public Health, University of Toronto, Canada; Laboratory Medicine and Pathobiology, University of Toronto, Canada; ICES, Toronto, Canada.
| | - Shelly Bolotin
- Dalla Lana School of Public Health, University of Toronto, Canada; Laboratory Medicine and Pathobiology, University of Toronto, Canada; Public Health Ontario, Toronto, Canada
| | - Ye Li
- Dalla Lana School of Public Health, University of Toronto, Canada; ICES, Toronto, Canada
| | - Helen Campbell
- Immunisation and Countermeasures Division, Public Health England, United Kingdom
| | | |
Collapse
|
19
|
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.
Collapse
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.
| |
Collapse
|
20
|
Intranasal Immunization with Acellular Pertussis Vaccines Results in Long-Term Immunity to Bordetella pertussis in Mice. Infect Immun 2021; 89:IAI.00607-20. [PMID: 33318136 PMCID: PMC8097269 DOI: 10.1128/iai.00607-20] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 12/01/2020] [Indexed: 12/15/2022] Open
Abstract
Bordetella pertussis colonizes the respiratory mucosa of humans, inducing an immune response seeded in the respiratory tract. An individual, once convalescent, exhibits long-term immunity to the pathogen. Current acellular pertussis (aP) vaccines do not induce the long-term immune response observed after natural infection in humans. In this study, we evaluated the durability of protection from intranasal (i.n.) pertussis vaccines in mice. Mice that convalesced from B. pertussis infection served as a control group. Mice were immunized with a mock vaccine (phosphate-buffered saline [PBS]), aP only, or an aP base vaccine combined with one of the following adjuvants: alum, curdlan, or purified whole glucan particles (IRI-1501). We utilized two study designs: short term (challenged 35 days after priming vaccination) and long term (challenged 6 months after boost). The short-term study demonstrated that immunization with i.n. vaccine candidates decreased the bacterial burden in the respiratory tract, reduced markers of inflammation, and induced significant serum and lung antibody titers. In the long-term study, protection from bacterial challenge mirrored the results observed in the short-term challenge study. Immunization with pertussis antigens alone was surprisingly protective in both models; however, the alum and IRI-1501 adjuvants induced significant B. pertussis-specific IgG antibodies in both the serum and lung and increased numbers of anti-B. pertussis IgG-secreting plasma cells in the bone marrow. Our data indicate that humoral responses induced by the i.n. vaccines correlated with protection, suggesting that long-term antibody responses can be protective.
Collapse
|
21
|
Gresham LM, Marzario B, Dutz J, Kirchhof MG. An evidence-based guide to SARS-CoV-2 vaccination of patients on immunotherapies in dermatology. J Am Acad Dermatol 2021; 84:1652-1666. [PMID: 33482251 PMCID: PMC7816618 DOI: 10.1016/j.jaad.2021.01.047] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/08/2021] [Accepted: 01/15/2021] [Indexed: 12/15/2022]
Abstract
Immune-mediated diseases and immunotherapeutics can negatively affect normal immune functioning and, consequently, vaccine safety and response. The COVID-19 pandemic has incited research aimed at developing a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine. As SARS-CoV-2 vaccines are developed and made available, the assessment of anticipated safety and efficacy in patients with immune-mediated dermatologic diseases and requiring immunosuppressive and/or immunomodulatory therapy is particularly important. A review of the literature was conducted by a multidisciplinary committee to provide guidance on the safety and efficacy of SARS-CoV-2 vaccination for dermatologists and other clinicians when prescribing immunotherapeutics. The vaccine platforms being used to develop SARS-CoV-2 vaccines are expected to be safe and potentially effective for dermatology patients on immunotherapeutics. Current guidelines for the vaccination of an immunocompromised host remain appropriate when considering future administration of SARS-CoV-2 vaccines.
Collapse
Affiliation(s)
- Louise M Gresham
- Division of Dermatology, Department of Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, Canada
| | - Barbara Marzario
- Division of Dermatology, Department of Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, Canada
| | - Jan Dutz
- Department of Dermatology and Skin Sciences, University of British Columbia, Vancouver, Canada
| | - Mark G Kirchhof
- Division of Dermatology, Department of Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, Canada.
| |
Collapse
|
22
|
IL-17 mediates protective immunity against nasal infection with Bordetella pertussis by mobilizing neutrophils, especially Siglec-F + neutrophils. Mucosal Immunol 2021; 14:1183-1202. [PMID: 33976385 PMCID: PMC8379078 DOI: 10.1038/s41385-021-00407-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 03/26/2021] [Accepted: 04/15/2021] [Indexed: 02/04/2023]
Abstract
Understanding the mechanism of protective immunity in the nasal mucosae is central to the design of more effective vaccines that prevent nasal infection and transmission of Bordetella pertussis. We found significant infiltration of IL-17-secreting CD4+ tissue-resident memory T (TRM) cells and Siglec-F+ neutrophils into the nasal tissue during primary infection with B. pertussis. Il17A-/- mice had significantly higher bacterial load in the nasal mucosae, associated with significantly reduced infiltration of Siglec-F+ neutrophils. Re-infected convalescent mice rapidly cleared B. pertussis from the nasal cavity and this was associated with local expansion of IL-17-producing CD4+ TRM cells. Depletion of CD4 T cells from the nasal tissue during primary infection or after re-challenge of convalescent mice significantly delayed clearance of bacteria from the nasal mucosae. Protection was lost in Il17A-/- mice and this was associated with significantly less infiltration of Siglec-F+ neutrophils and antimicrobial peptide (AMP) production. Finally, depletion of neutrophils reduced the clearance of B. pertussis following re-challenge of convalescent mice. Our findings demonstrate that IL-17 plays a critical role in natural and acquired immunity to B. pertussis in the nasal mucosae and this effect is mediated by mobilizing neutrophils, especially Siglec-F+ neutrophils, which have high neutrophil extracellular trap (NET) activity.
Collapse
|
23
|
Cole LE, Zhang J, Pacheco KM, Lhéritier P, Anosova NG, Piolat J, Zheng L, Reveneau N. Immunological Distinctions between Acellular and Whole-Cell Pertussis Immunizations of Baboons Persist for at Least One Year after Acellular Vaccine Boosting. Vaccines (Basel) 2020; 8:vaccines8040729. [PMID: 33276673 PMCID: PMC7761625 DOI: 10.3390/vaccines8040729] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/19/2020] [Accepted: 11/26/2020] [Indexed: 01/17/2023] Open
Abstract
While both whole-cell (wP) and acellular pertussis (aP) vaccines have been highly effective at reducing the global pertussis disease burden, there are concerns that compared to wP vaccination, the immune responses to aP vaccination may wane more rapidly. To gain insights into the vaccine elicited immune responses, pre-adult baboons were immunized with either aP or wP vaccines, boosted with an aP vaccine, and observed over a nearly two-year period. Priming with a wP vaccine elicited a more Th17-biased response than priming with aP, whereas priming with an aP vaccine led to a more Th2-biased response than priming with wP. These differences were maintained after aP vaccine boost immunizations. Compared to aP, animals primed with a wP vaccine exhibited greater numbers of pertussis specific memory B cells. While aP and wP vaccine priming initially elicited similar levels of anti-pertussis toxin antibody, titers declined more rapidly in aP vaccine primed animals leading to a 4-fold difference. Both wP and aP vaccine immunization could induce serum bactericidal activity (SBA); however, only one wP vaccine immunization was required to elicit SBA while multiple aP vaccine immunizations were required to elicit lower, less durable SBA titers. In conclusion, when compared to aP vaccine, priming with wP vaccine elicits distinct cellular and humoral immune responses that persist after aP vaccine boosting.
Collapse
Affiliation(s)
- Leah E. Cole
- Sanofi Pasteur, Cambridge, MA 02139, USA; (J.Z.); (K.M.P.); (N.G.A.)
- Correspondence: (L.E.C.); (N.R.); Tel.: +1-617-866-4473 (L.E.C.); +33-4-37-66-8510 (N.R.)
| | - Jinrong Zhang
- Sanofi Pasteur, Cambridge, MA 02139, USA; (J.Z.); (K.M.P.); (N.G.A.)
| | - Kristl M. Pacheco
- Sanofi Pasteur, Cambridge, MA 02139, USA; (J.Z.); (K.M.P.); (N.G.A.)
| | | | | | - Julie Piolat
- Sanofi Pasteur, 69280 Marcy L’Etoile, France; (P.L.); (J.P.)
| | | | - Nathalie Reveneau
- Sanofi Pasteur, 69280 Marcy L’Etoile, France; (P.L.); (J.P.)
- Correspondence: (L.E.C.); (N.R.); Tel.: +1-617-866-4473 (L.E.C.); +33-4-37-66-8510 (N.R.)
| |
Collapse
|
24
|
Chatzis O, Blanchard-Rohner G, Mondoulet L, Pelletier B, De Gea-Hominal A, Roux M, Huttner A, Hervé PL, Rohr M, Matthey A, Gutknecht G, Lemaître B, Hayem C, Pham HT, Wijagkanalan W, Lambert PH, Benhamou PH, Siegrist CA. Safety and immunogenicity of the epicutaneous reactivation of pertussis toxin immunity in healthy adults: a phase I, randomized, double-blind, placebo-controlled trial. Clin Microbiol Infect 2020; 27:878-885. [PMID: 32896653 DOI: 10.1016/j.cmi.2020.08.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Protection induced by acellular vaccines can be short, requiring novel immunization strategies. Objectives of this study were to evaluate safety and capacity of a recombinant pertussis toxin (PTgen) -coated Viaskin® epicutaneous patch to recall memory responses in healthy adults. METHODS This double-blind, placebo-controlled randomized trial (Phase I) assessed the safety and immunogenicity of PTgen administered on days 0 and 14 to healthy adults using Viaskin® patches applied directly or after epidermal laser-based skin preparation. Patch administration was followed by Boostrix®dTpa on day 42. Antibodies were assessed at days 0, 14, 28, 42 and 70. RESULTS Among 102 volunteers enrolled, 80 received Viaskin-PT (Viaskin-PT 25 μg (n = 25), Viaskin-PT 50 μg (n = 25), laser + Viaskin-PT 25 μg (n = 5), laser + Viaskin-PT 50 μg (n = 25)), Viaskin-placebo (n = 10) or laser + Viaskin-placebo (n = 2). Incidence of adverse events was similar across groups (any local event: 21/25 (84.0%), 24/25 (96.0%), 4/5 (80.0%), 24/25 (96.0%), 8/10 (80.0%), 10/12 (83.0%), respectively). Direct application induced no detectable response. On day 42, PT-IgG geometric mean concentrations were significantly higher following laser + Viaskin-PT 25 μg and 50 μg (139.87 (95% CI 87.30-224.10) and 121.76 (95% CI 95.04-156.00), respectively), than laser + Viaskin-placebo (59.49, 95% CI 39.37-89.90). Seroresponse rates were higher following laser + Viaskin-PT 25 μg (4/5 (80.0%), 95% CI 28.4-99.5) and 50 μg (22/25 (88.0%), 95% CI 68.8-97.5) than laser + Viaskin-placebo (0/12 (0.0%), 95% CI 0.0-26.5). CONCLUSIONS Viaskin-PT applied after laser-based epidermal skin preparation showed encouraging safety and immunogenicity results: anti-PT booster responses were not inferior to those elicited by Boostrix®dTpa. This study is registered at ClinicalTrials.gov (NCT03035370) and was funded by DBV Technologies.
Collapse
Affiliation(s)
- O Chatzis
- Centre for Vaccinology, University Hospitals of Geneva, Switzerland
| | - G Blanchard-Rohner
- Centre for Vaccinology, University Hospitals of Geneva, Switzerland; Division of General Paediatrics, Department of Paediatrics, University Hospitals of Geneva, Switzerland
| | | | | | - A De Gea-Hominal
- Centre for Vaccinology, University Hospitals of Geneva, Switzerland
| | - M Roux
- DBV Technologies, Montrouge, France
| | - A Huttner
- Centre for Vaccinology, University Hospitals of Geneva, Switzerland; Division of Infectious Diseases, University Hospitals of Geneva, Switzerland
| | | | - M Rohr
- Division of General Paediatrics, Department of Paediatrics, University Hospitals of Geneva, Switzerland
| | - A Matthey
- Centre for Clinical Research, University Hospitals of Geneva, Switzerland
| | - G Gutknecht
- Centre for Clinical Research, University Hospitals of Geneva, Switzerland
| | - B Lemaître
- Laboratory of Vaccinology, University Hospitals of Geneva, Switzerland
| | - C Hayem
- DBV Technologies, Montrouge, France
| | - H T Pham
- BioNet-Asia Co., Ltd, Bangkok, Thailand
| | | | - P H Lambert
- Centre for Vaccinology, University Hospitals of Geneva, Switzerland
| | | | - C A Siegrist
- Centre for Vaccinology, University Hospitals of Geneva, Switzerland; Division of General Paediatrics, Department of Paediatrics, University Hospitals of Geneva, Switzerland.
| |
Collapse
|
25
|
Dewan KK, Linz B, DeRocco SE, Harvill ET. Acellular Pertussis Vaccine Components: Today and Tomorrow. Vaccines (Basel) 2020; 8:vaccines8020217. [PMID: 32414005 PMCID: PMC7349526 DOI: 10.3390/vaccines8020217] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/05/2020] [Accepted: 05/07/2020] [Indexed: 12/21/2022] Open
Abstract
Pertussis is a highly communicable acute respiratory infection caused by Bordetella pertussis. Immunity is not lifelong after natural infection or vaccination. Pertussis outbreaks occur cyclically worldwide and effective vaccination strategies are needed to control disease. Whole-cell pertussis (wP) vaccines became available in the 1940s but have been replaced in many countries with acellular pertussis (aP) vaccines. This review summarizes disease epidemiology before and after the introduction of wP and aP vaccines, discusses the rationale and clinical implications for antigen inclusion in aP vaccines, and provides an overview of novel vaccine strategies aimed at better combating pertussis in the future.
Collapse
Affiliation(s)
- Kalyan K. Dewan
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA; (K.K.D.); (B.L.)
| | - Bodo Linz
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA; (K.K.D.); (B.L.)
| | | | - Eric T. Harvill
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA; (K.K.D.); (B.L.)
- Correspondence:
| |
Collapse
|
26
|
Plotkin SA. Updates on immunologic correlates of vaccine-induced protection. Vaccine 2019; 38:2250-2257. [PMID: 31767462 DOI: 10.1016/j.vaccine.2019.10.046] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/15/2019] [Accepted: 10/17/2019] [Indexed: 02/06/2023]
Abstract
Correlates of protection (CoPs) are increasingly important in the development and licensure of vaccines. Although the study of CoPs was initially directed at identifying a single immune function that could explain vaccine efficacy, it has become increasingly clear that there are often multiple functions responsible for efficacy. This review is meant to supplement prior articles on the subject, illustrating both simple and complex CoPs.
Collapse
Affiliation(s)
- Stanley A Plotkin
- Emeritus Professor of Pediatrics, University of Pennsylvania, Vaxconsult, 4650 Wismer Rd., Doylestown, PA 18902, United States.
| |
Collapse
|
27
|
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.
Collapse
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
| |
Collapse
|
28
|
Narchi H, Osman W, George JA, Almekhaini LA, Souid AK, Alsuwaidi AR. Pertussis seronegativity in pregnant women in the city of Al Ain, United Arab Emirates. Int J Infect Dis 2019; 89:96-101. [PMID: 31493522 DOI: 10.1016/j.ijid.2019.08.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 08/21/2019] [Accepted: 08/29/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE As the current recommendation of administering Tdap (tetanus-diphtheria-acellular pertussis) to all pregnant women has not been widely implemented in the United Arab Emirates (UAE), we aimed to ascertain the prevalence of pertussis seronegativity during pregnancy. METHODS IgG antibodies against Bordetella pertussis toxin (PT) were measured in 213 women attending the antenatal clinic at Oasis hospital, Al Ain, UAE. Results were compared by maternal age, nationality and gestational age with the Kruskal-Wallis test for IgG-PT levels and the Chi-squared test for serology status. RESULTS The mean age±SD of the participants was 30.4±5.6 years, mean gestational age±SD of 25.5±3.3 weeks. Serum concentration of IgG-PT <10IU/ml were found in 160 out of 213 women (75%; 95% confidence interval 69%, 81%). There was no significant difference in the geometric mean of serum IgG-PT concentration across maternal age (P=0.80) or nationality (P=0.90). There were no differences in the prevalence of seronegativity with maternal age (P=0.65) or nationality (P=0.90). CONCLUSION With a high prevalence of pertussis seronegativity in pregnant women, there is a potential benefit of introducing pertussis vaccination during pregnancy into our national immunization program.
Collapse
Affiliation(s)
- Hassib Narchi
- Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates.
| | - Wafa Osman
- Department of Obstetrics and Gynecology, Oasis Hospital, Al Ain, United Arab Emirates.
| | - Junu A George
- Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates.
| | - Lolowa A Almekhaini
- Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates.
| | - Abdul-Kader Souid
- Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates.
| | - Ahmed R Alsuwaidi
- Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates.
| |
Collapse
|
29
|
Wilk MM, Borkner L, Misiak A, Curham L, Allen AC, Mills KHG. Immunization with whole cell but not acellular pertussis vaccines primes CD4 T RM cells that sustain protective immunity against nasal colonization with Bordetella pertussis. Emerg Microbes Infect 2019; 8:169-185. [PMID: 30866771 PMCID: PMC6455184 DOI: 10.1080/22221751.2018.1564630] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Protective immunity wanes rapidly after immunization of children with acellular pertussis (aP) vaccines and these vaccines do not prevent nasal colonization or transmission of Bordetella pertussis in baboons. In this study, we examined the role of tissue-resident memory T (TRM) cells in persistent protective immunity induced by infection or immunization with aP and whole-cell pertussis (wP) vaccines in mice. Immunization of mice with a wP vaccine protected against lung and nasal colonization, whereas an aP vaccine failed to protect in the nose. IL-17 and IFN-γ-secreting CD69+CD4+ TRM cells were expanded in the lung and nasal tissue after B. pertussis challenge of mice immunized with wP, but not aP vaccines. However, previous infection induced the most persistent protection against nasal colonization and this correlated with potent induction of nasal tissue TRM cells, especially IL-17-secreting TRM cells. Blocking T cell migration to respiratory tissue during immunization with a wP vaccine impaired bacterial clearance, whereas transfer of TRM cells from convalescent or wP-immunized mice conferred protection to naïve mice. Our findings reveal that previous infection or wP vaccination are significantly more effective than aP vaccination in conferring persistent protective immunity against B. pertussis and that this is mediated by respiratory TRM cells.
Collapse
Affiliation(s)
- Mieszko M Wilk
- a Immune Regulation Research Group, School of Biochemistry and Immunology , Trinity Biomedical Sciences Institute, Trinity College Dublin , Dublin , Ireland
| | - Lisa Borkner
- a Immune Regulation Research Group, School of Biochemistry and Immunology , Trinity Biomedical Sciences Institute, Trinity College Dublin , Dublin , Ireland
| | - Alicja Misiak
- a Immune Regulation Research Group, School of Biochemistry and Immunology , Trinity Biomedical Sciences Institute, Trinity College Dublin , Dublin , Ireland
| | - Lucy Curham
- a Immune Regulation Research Group, School of Biochemistry and Immunology , Trinity Biomedical Sciences Institute, Trinity College Dublin , Dublin , Ireland
| | - Aideen C Allen
- a Immune Regulation Research Group, School of Biochemistry and Immunology , Trinity Biomedical Sciences Institute, Trinity College Dublin , Dublin , Ireland
| | - Kingston H G Mills
- a Immune Regulation Research Group, School of Biochemistry and Immunology , Trinity Biomedical Sciences Institute, Trinity College Dublin , Dublin , Ireland
| |
Collapse
|
30
|
Vaz-de-Lima LRA, Sato HK, Fernandes EG, Sato APS, Pawloski LC, Tondella ML, de Brito CA, Luna EJA, Carvalhanas TRMP, de Castilho EA. Association between the timing of maternal vaccination and newborns' anti-pertussis toxin antibody levels. Vaccine 2019; 37:5474-5480. [PMID: 31153689 DOI: 10.1016/j.vaccine.2019.04.079] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 04/03/2019] [Accepted: 04/25/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Pertussis remains an important global public health concern, despite the presence of extensive immunization programs. Incidence and severity of pertussis are typically higher in neonates and young infants. As a strategy to protect these young infants, maternal vaccination with Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) has been recommended in Brazil. The objective of this study was to evaluate the effects of Tdap vaccination during pregnancy on the anti-pertussis toxin (PT) IgG response in mothers and their infants at birth. MATERIAL AND METHODS Maternal and cord blood samples were collected from vaccinated (n = 243) and unvaccinated (n = 75) pregnant women, at the time of delivery, from July 2015 to August 2016 in São Paulo, Brazil. Anti-PT IgG antibodies were quantified by Enzyme-Linked Immunosorbent Assay (ELISA) and geometric mean concentrations (GMC) were calculated. Relationship between timing of vaccination and antibody concentrations were evaluated. RESULTS Maternal and cord blood GMCs among the vaccinated group were 5.4 and 5.6 fold higher [66.5 International Units (IU)/mL and 89.8 IU/mL] compared to the unvaccinated group (12.4 IU/mL and 16.1 IU/mL), respectively (p < 0.001). Higher anti-PT IgG GMCs were observed when vaccination occurred ≥60 days before delivery compared to <60 days, suggesting that vaccination early in the third trimester may be more effective than later in pregnancy. CONCLUSION Tdap maternal vaccination results in significantly higher anti-PT IgG in newborn infants and supports the current recommendation of the Brazilian Immunization Program.
Collapse
Affiliation(s)
| | - Helena Keico Sato
- Divisão de Imunização, Centro de Vigilância Epidemiológica Prof. Alexandre Vranjac, Coordenadoria de Controle de Doenças da Secretaria de Estado da Saúde de São Paulo, Brazil
| | - Eder Gatti Fernandes
- Divisão de Imunização, Centro de Vigilância Epidemiológica Prof. Alexandre Vranjac, Coordenadoria de Controle de Doenças da Secretaria de Estado da Saúde de São Paulo, Brazil
| | - Ana Paula Sayuri Sato
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, Brazil
| | - Lucia C Pawloski
- Pertussis and Diphtheria Laboratory, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, United States
| | - Maria Lucia Tondella
- Pertussis and Diphtheria Laboratory, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, United States
| | | | | | - Telma Regina M P Carvalhanas
- Divisão de Doenças de Transmissão Respiratória, Centro de Vigilância Epidemiológica Prof. Alexandre Vranjac, Coordenadoria de Controle de Doenças da Secretaria de Estado da Saúde SP, Brazil
| | - Euclides A de Castilho
- Departamento de Medicina Preventiva, Faculdade de Medicina da Universidade de São Paulo, Brazil
| | | |
Collapse
|
31
|
Neonatal Immunity to Bordetella pertussis Infection and Current Prevention Strategies. J Immunol Res 2019; 2019:7134168. [PMID: 30882004 PMCID: PMC6387735 DOI: 10.1155/2019/7134168] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 12/22/2018] [Accepted: 01/03/2019] [Indexed: 01/10/2023] Open
Abstract
Bordetella pertussis is the bacterial agent of whooping cough, an infectious disease that is reemerging despite high vaccine coverage. Newborn children are the most affected, not only because they are too young to be vaccinated but also due to qualitative and quantitative differences in their immune system, which makes them more susceptible to infection and severe manifestations, leading to a higher mortality rate comparing to other groups. Until recently, prevention consisted of vaccinating children in the first year of life and the herd vaccination of people directly in touch with them, but the increase in cases demands more effective strategies that can overcome the developing immune response in early life and induce protection while children are most vulnerable.
Collapse
|
32
|
Lambert EE, Buisman AM, van Els CACM. Superior B. pertussis Specific CD4+ T-Cell Immunity Imprinted by Natural Infection. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1183:81-98. [PMID: 31321753 DOI: 10.1007/5584_2019_405] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Pertussis remains endemic in vaccinated populations due to waning of vaccine-induced immunity and insufficient interruption of transmission. Correlates of long-term protection against whooping cough remain elusive but increasing evidence from experimental models indicates that the priming of particular lineages of B. pertussis (Bp) specific CD4+ T cells is essential to control bacterial load. Critical hallmarks of these protective CD4+ T cell lineages in animals are suggested to be their differentiation profile as Th1 and Th17 cells and their tissue residency. These features seem optimally primed by previous infection but insufficiently or only partially by current vaccines. In this review, evidence is sought indicating whether infection also drives such superior Bp specific CD4+ T cell lineages in humans. We highlight key features of effector immunity downstream of Th1 and Th17 cell cytokines that explain clearing of primary Bp infections in naïve hosts, and effective prevention of infection in convalescent hosts during secondary challenge. Outstanding questions are put forward that need answers before correlates of human Bp infection-primed CD4+ T cell immunity can be used as benchmark for the development of improved pertussis vaccines.
Collapse
Affiliation(s)
- Eleonora E Lambert
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Anne-Marie Buisman
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Cécile A C M van Els
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
| |
Collapse
|
33
|
Human Immune Responses to Pertussis Vaccines. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1183:99-113. [PMID: 31342460 DOI: 10.1007/5584_2019_406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Pertussis still represents a major cause of morbidity and mortality worldwide. Although vaccination is the most powerful tool in preventing pertussis and despite nearly 70 years of universal childhood vaccination, incidence of the disease has been rising in the last two decades in countries with high vaccination coverage. Two types of vaccines are commercially available against pertussis: whole-cell pertussis vaccines (wPVs) introduced in the 1940s and still in use especially in low and middle-income countries; less reactogenic acellular pertussis vaccines (aPVs), licensed since the mid-1990s.In the last years, studies on pertussis vaccination have highlighted significant gaps and major differences between the two types of vaccines in the induction of protective anti-pertussis immunity in humans. This chapter will discuss the responses of the immune system to wPVs and aPVs, with the aim to enlighten critical points needing further efforts to reach a good level of protection in vaccinated individuals.
Collapse
|
34
|
Papp KA, Haraoui B, Kumar D, Marshall JK, Bissonnette R, Bitton A, Bressler B, Gooderham M, Ho V, Jamal S, Pope JE, Steinhart AH, Vinh DC, Wade J. Vaccination Guidelines for Patients With Immune-Mediated Disorders on Immunosuppressive Therapies. J Cutan Med Surg 2018; 23:50-74. [PMID: 30463418 PMCID: PMC6330697 DOI: 10.1177/1203475418811335] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND: Patients with immune-mediated diseases on immunosuppressive therapies have more infectious episodes than healthy individuals, yet vaccination practices by physicians for this patient population remain suboptimal. OBJECTIVES: To evaluate the safety and efficacy of vaccines in individuals exposed to immunosuppressive therapies and provide evidence-based clinical practice recommendations. METHODS: A literature search for vaccination safety and efficacy in patients on immunosuppressive therapies (2009-2017) was conducted. Results were assessed using the Grading of Recommendation, Assessment, Development, and Evaluation system. RESULTS: Several immunosuppressive therapies attenuate vaccine response. Thus, vaccines should be administered before treatment whenever feasible. Inactivated vaccines can be administered without treatment discontinuation. Similarly, evidence suggests that the live zoster vaccine is safe and effective while on select immunosuppressive therapy, although use of the subunit vaccine is preferred. Caution regarding other live vaccines is warranted. Drug pharmacokinetics, duration of vaccine-induced viremia, and immune response kinetics should be considered to determine appropriate timing of vaccination and treatment (re)initiation. Infants exposed to immunosuppressive therapies through breastmilk can usually be immunized according to local guidelines. Intrauterine exposure to immunosuppressive agents is not a contraindication for inactivated vaccines. Live attenuated vaccines scheduled for infants and children ⩾12 months of age, including measles, mumps, rubella, and varicella, can be safely administered as sufficient time has elapsed for drug clearance. CONCLUSIONS: Immunosuppressive agents may attenuate vaccine responses, but protective benefit is generally maintained. While these recommendations are evidence based, they do not replace clinical judgment, and decisions regarding vaccination must carefully assess the risks, benefits, and circumstances of individual patients.
Collapse
Affiliation(s)
- Kim A Papp
- 1 K Papp Clinical Research, Waterloo, ON, Canada.,2 Probity Medical Research, Waterloo, ON, Canada
| | - Boulos Haraoui
- 3 Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Deepali Kumar
- 4 University Health Network, Toronto, ON, Canada.,5 Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - John K Marshall
- 6 Department of Medicine and Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | | | - Alain Bitton
- 8 McGill University Health Centre, Montreal, QC, Canada
| | - Brian Bressler
- 9 Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.,10 St Paul's Hospital, Vancouver, BC, Canada
| | - Melinda Gooderham
- 2 Probity Medical Research, Waterloo, ON, Canada.,11 Faculty of Medicine, Queen's University, Kingston, ON, Canada
| | - Vincent Ho
- 9 Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Shahin Jamal
- 12 Vancouver Coastal Health, Vancouver, BC, Canada
| | - Janet E Pope
- 13 Faculty of Medicine, University of Western Ontario, London, ON, Canada.,14 St Joseph's Health Care, London, ON, Canada
| | - A Hillary Steinhart
- 5 Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,15 Mount Sinai Hospital, Toronto, ON, Canada
| | - Donald C Vinh
- 8 McGill University Health Centre, Montreal, QC, Canada.,16 Research Institute, McGill University Health Centre, Montreal, QC, Canada
| | - John Wade
- 9 Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.,17 Vancouver General Hospital, Vancouver, BC, Canada
| |
Collapse
|
35
|
Third-Trimester Maternal Vaccination Against Pertussis and Pertussis Antibody Concentrations. Obstet Gynecol 2018; 131:364-369. [PMID: 29324612 DOI: 10.1097/aog.0000000000002438] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare pertussis antibody concentrations in maternal venous serum (at the time of delivery) and umbilical cord arterial serum among women vaccinated with the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine from either 27-30 6/7 weeks of gestation or from 31-35 6/7 weeks of gestation. METHODS We conducted a prospective cohort study of pregnant women divided into two groups based on when Tdap was administered: 27-30 6/7 weeks of gestation and 31-35 6/7 weeks of gestation. Paired maternal and umbilical cord samples were obtained at the time of delivery to determine immunoglobulin G (IgG) concentrations to pertussis toxin and pertactin. RESULTS Eighty-eight pregnant women were enrolled. Cord serum pertussis toxin IgG concentrations were approximately twice maternal serum pertussis toxin IgG concentrations (91.6 vs 48.6 enzyme-linked immunoassay [ELISA] units/mL, P<.01) and were significantly correlated (Pearson correlation coefficient=0.85, P<.01). There was no significant difference in maternal serum pertussis toxin IgG concentrations (48.6 vs 48.6 ELISA units/mL, P=.99), cord serum pertussis toxin IgG concentrations (92.1 vs 90.7 ELISA units/mL, P=.95), and cord serum pertactin IgG concentrations (798 vs 730 international units/mL, P=.73) between the two groups. Furthermore, there was no correlation between time from vaccination to delivery and these three parameters. Cord serum pertussis toxin IgG concentrations were greater than 10 ELISA units/mL (ie, in the protective range) in 87% and 97% of those vaccinated from 27-30 6/7 weeks of gestation and from 31-35 6/7 weeks of gestation, respectively (P=.13). CONCLUSION Maternal vaccination against pertussis between 27 and 36 weeks of gestation was associated with a high percentage of newborns with antibody concentrations conferring protection and did not vary by gestational age at vaccination.
Collapse
|
36
|
Pitisuttithum P, Chokephaibulkit K, Sirivichayakul C, Sricharoenchai S, Dhitavat J, Pitisuthitham A, Phongsamart W, Boonnak K, Lapphra K, Sabmee Y, Wittawatmongkol O, Chauhan M, Wijagkanalan W, Hommalai G, Fortuna L, Chinwangso P, Poredi IK, van den Biggelaar AHJ, Pham HT, Viviani S. Antibody persistence after vaccination of adolescents with monovalent and combined acellular pertussis vaccines containing genetically inactivated pertussis toxin: a phase 2/3 randomised, controlled, non-inferiority trial. THE LANCET. INFECTIOUS DISEASES 2018; 18:1260-1268. [PMID: 30266329 DOI: 10.1016/s1473-3099(18)30375-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 06/04/2018] [Accepted: 06/05/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND The immunogenicity of acellular pertussis vaccines and persistence of immunity after vaccination might be improved by using genetically inactivated pertussis toxin (PTgen) instead of chemically inactivated pertussis toxin (PTchem) because of the preservation of conformational epitopes. We assessed the safety and immunogenicity of two vaccines containing PTgen 1 year after vaccination. METHODS We did a phase 2/3 non-inferiority, randomised, controlled trial involving 450 adolescents (age 12-17 years) enrolled between July 6, 2015, and Aug 20, 2015. Participants were randomised 1:1:1 to receive one dose of vaccine containing PTgen and filamentous haemagglutinin (FHA) either in a monovalent formulation (aP[PTgen/FHA]) or in a combined formulation with tetanus and reduced-dose diphtheria toxoids (TdaP[PTgen/FHA]) or to receive a commercial vaccine containing reduced-dose PTchem (Tdap) as a comparator. We report a secondary trial outcome, namely antibody persistence 1 year after vaccination, assessed per protocol in 150 randomly preselected participants (50 per group). Seroconversion was defined as antibody titres at least four times greater than at baseline. Safety was assessed in all trial participants. This study is registered in the Thai Clinical Trial Registry, number TCTR20150703002. FINDINGS Between June 5, 2016, and Aug 9, 2016, 442 (98%) of 450 enrolled participants attended a 1-year follow-up visit. After 1 year, persistent seroconversion for pertussis toxin neutralising antibodies was seen in 38 (76%, 95% CI 64-88) participants in the aP(PTgen/FHA) group and 41 (81%, 70-92) in the TdaP(PTgen/FHA) group, but in only four (8%, 1-16) in the Tdap comparator group. Seroconversion rates for IgG antibodies against pertussis toxin and FHA were also greater in the aP(PTgen/FHA) group (82%, 95% CI 71-93 and 64%, 51-77, respectively) and TdaP(PTgen/FHA) group (75%, 63-87 and 56%, 42-70, respectively) than in the Tdap group (4%, 0-9, p<0·0001, and 28%, 16-41, p=0·0007, respectively). 13 serious adverse events were reported in 12 participants and all were judged to be unrelated to the study vaccines. Five pregnancies were reported during follow-up, none of which had any maternal or neonatal complications. INTERPRETATION A monovalent and a combined recombinant acellular pertussis vaccine containing PTgen induced antibody responses that were greater and sustained for longer than those achieved with the Tdap comparator vaccine. New recombinant pertussis vaccines containing PTgen might offer new opportunities to limit pertussis resurgence and can be widely used, including in pregnant women. FUNDING BioNet-Asia.
Collapse
Affiliation(s)
- Punnee Pitisuttithum
- Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, Ratchathewi, Bangkok, Thailand
| | - Kulkanya Chokephaibulkit
- Paediatric Infectious Diseases Unit, Department of Paediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkoknoi, Bangkok, Thailand
| | - Chukiat Sirivichayakul
- Department of Tropical Paediatrics, Faculty of Tropical Medicine, Mahidol University, Ratchathewi, Bangkok, Thailand
| | - Sirintip Sricharoenchai
- Paediatric Infectious Diseases Unit, Department of Paediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkoknoi, Bangkok, Thailand
| | - Jittima Dhitavat
- Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, Ratchathewi, Bangkok, Thailand
| | - Arom Pitisuthitham
- Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, Ratchathewi, Bangkok, Thailand
| | - Wanatpreeya Phongsamart
- Paediatric Infectious Diseases Unit, Department of Paediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkoknoi, Bangkok, Thailand
| | - Kobporn Boonnak
- Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, Ratchathewi, Bangkok, Thailand
| | - Keswadee Lapphra
- Paediatric Infectious Diseases Unit, Department of Paediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkoknoi, Bangkok, Thailand
| | - Yupa Sabmee
- Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, Ratchathewi, Bangkok, Thailand
| | - Orasri Wittawatmongkol
- Paediatric Infectious Diseases Unit, Department of Paediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkoknoi, Bangkok, Thailand
| | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Brooks JI, Bell CA, Rotondo J, Gilbert NL, Tunis M, Ward BJ, Desai S. Low levels of detectable pertussis antibody among a large cohort of pregnant women in Canada. Vaccine 2018; 36:6138-6143. [PMID: 30181046 DOI: 10.1016/j.vaccine.2018.08.066] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 03/28/2018] [Accepted: 08/27/2018] [Indexed: 11/15/2022]
Abstract
Newborns and infants less than 6 months of age continue to be at highest risk of severe outcomes from pertussis infection. Pertussis vaccination during the last trimester of pregnancy can confer protection to newborns as a result of trans-placental transfer of pertussis antibodies. In several countries, pertussis vaccination in pregnancy is recommended routinely and Canada's National Advisory Committee on Immunization issued similar routine recommendations in February 2018. Using second trimester biobanked plasma samples (n = 1752) collected between 2008 and 2011, we measured the pre-existing anti-pertussis toxin (PT) levels in a large cohort of second-trimester pregnant women using a commercial ELISA test. We found that 97.5% of these women had anti-PT IgG titres below 35 IU/mL. Women with higher incomes had slightly higher anti-PT levels but 96% still had titres <35 IU/ml. In conclusion, almost all of the pregnant women in this large cohort had anti-PT levels low enough to suggest susceptibility to pertussis infection in both the mothers and their newborn infants.
Collapse
Affiliation(s)
- James I Brooks
- Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, Canada; Division of Infectious Diseases, University of Ottawa, Ottawa, Canada
| | - Christopher A Bell
- Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, Canada
| | - Jenny Rotondo
- Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, Canada
| | - Nicolas L Gilbert
- Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, Canada
| | - Matthew Tunis
- Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, Canada
| | - Brian J Ward
- Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Shalini Desai
- Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, Canada.
| |
Collapse
|
38
|
Hovingh ES, Kuipers B, Bonačić Marinović AA, Jan Hamstra H, Hijdra D, Mughini Gras L, van Twillert I, Jongerius I, van Els CACM, Pinelli E. Detection of opsonizing antibodies directed against a recently circulating Bordetella pertussis strain in paired plasma samples from symptomatic and recovered pertussis patients. Sci Rep 2018; 8:12039. [PMID: 30104573 PMCID: PMC6089961 DOI: 10.1038/s41598-018-30558-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 08/02/2018] [Indexed: 01/20/2023] Open
Abstract
Correlates of protection (CoPs) against the highly contagious respiratory disease whooping cough, caused by Bordetella pertussis, remain elusive. Characterizing the antibody response to this pathogen is essential towards identifying potential CoPs. Here, we evaluate levels, avidity and functionality of B. pertussis-specific-antibodies from paired plasma samples derived from symptomatic and recovered pertussis patients, as well as controls. Natural infection is expected to induce protective immunity. IgG levels and avidity to nine B. pertussis antigens were determined using a novel multiplex panel. Furthermore, opsonophagocytosis of a B. pertussis clinical isolate by neutrophils was measured. Findings indicate that following infection, B. pertussis-specific antibody levels of (ex-) pertussis patients waned, while the avidity of antibodies directed against the majority of studied antigens increased. Opsonophagocytosis indices decreased upon recovery, but remained higher than controls. Random forest analysis of all the data revealed that 28% of the opsonophagocytosis index variances could be explained by filamentous hemagglutinin- followed by pertussis toxin-specific antibodies. We propose to further explore which other B. pertussis-specific antibodies can better predict opsonophagocytosis. Moreover, other B. pertussis-specific antibody functions as well as the possible integration of these functions in combination with other immune cell properties should be evaluated towards the identification of CoPs against pertussis.
Collapse
Affiliation(s)
- Elise S Hovingh
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.,Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Betsy Kuipers
- 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
| | - Hendrik Jan Hamstra
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Danielle Hijdra
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Lapo Mughini Gras
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.,Department of Infectious Diseases and Immunology, Utrecht University, Utrecht, The Netherlands
| | - Inonge van Twillert
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Ilse Jongerius
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.,Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht, The Netherlands.,Department of Immunopathology, Sanquin Research and Landsteiner Laboratory of the Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Cecile A C M van Els
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Elena Pinelli
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
| |
Collapse
|
39
|
Characterization of Individual Human Antibodies That Bind Pertussis Toxin Stimulated by Acellular Immunization. Infect Immun 2018; 86:IAI.00004-18. [PMID: 29581192 PMCID: PMC5964521 DOI: 10.1128/iai.00004-18] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 03/21/2018] [Indexed: 01/05/2023] Open
Abstract
Despite high vaccination rates, the incidence of whooping cough has steadily been increasing in developing countries for several decades. The current acellular pertussis (aP) vaccines all include the major protective antigen pertussis toxin (PTx) and are safer, but they appear to be less protective than infection or older, whole-cell vaccines. To better understand the attributes of individual antibodies stimulated by aP, we isolated plasmablast clones recognizing PTx after booster immunization of two donors. Five unique antibody sequences recognizing native PTx were recovered and expressed as recombinant human IgG1 antibodies. The antibodies all bind different epitopes on the PTx S1 subunit, B oligomer, or S1-B subunit interface, and just one clone neutralized PTx in an in vitro assay. To better understand the epitopes bound by the nonneutralizing S1-subunit antibodies, comprehensive mutagenesis with yeast display provided a detailed map of the epitope recognized by antibodies A8 and E12. Residue R76 is required for antibody A8 binding and is present on the S1 surface but is only partially exposed in the holotoxin, providing a structural explanation for A8's inability to neutralize holotoxin. The B-subunit-specific antibody D8 inhibited PTx binding to a model receptor and neutralized PTx in vitro as well as in an in vivo leukocytosis assay. This is the first study, to our knowledge, to identify individual human antibodies stimulated by the acellular pertussis vaccine and demonstrates the feasibility of using these approaches to address outstanding issues in pertussis vaccinology, including mechanisms of accelerated waning of protective immunity despite repeated aP immunization.
Collapse
|
40
|
Liang JL, Tiwari T, Moro P, Messonnier NE, Reingold A, Sawyer M, Clark TA. Prevention of Pertussis, Tetanus, and Diphtheria with Vaccines in the United States: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2018; 67:1-44. [PMID: 29702631 PMCID: PMC5919600 DOI: 10.15585/mmwr.rr6702a1] [Citation(s) in RCA: 189] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
This report compiles and summarizes all recommendations from CDC's Advisory Committee on Immunization Practices (ACIP) regarding prevention and control of tetanus, diphtheria, and pertussis in the United States. As a comprehensive summary of previously published recommendations, this report does not contain any new recommendations and replaces all previously published reports and policy notes; it is intended for use by clinicians and public health providers as a resource. ACIP recommends routine vaccination for tetanus, diphtheria, and pertussis. Infants and young children are recommended to receive a 5-dose series of diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccines, with one adolescent booster dose of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine. Adults who have never received Tdap also are recommended to receive a booster dose of Tdap. Women are recommended to receive a dose of Tdap during each pregnancy, which should be administered from 27 through 36 weeks’ gestation, regardless of previous receipt of Tdap. After receipt of Tdap, adolescents and adults are recommended to receive a booster tetanus and diphtheria toxoids (Td) vaccine every 10 years to assure ongoing protection against tetanus and diphtheria.
Collapse
Affiliation(s)
- Jennifer L Liang
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - Tejpratap Tiwari
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - Pedro Moro
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, CDC
| | - Nancy E Messonnier
- Office of the Director, National Center for Immunization and Respiratory Diseases, CDC
| | | | - Mark Sawyer
- University of California, San Diego; La Jolla, California
| | - Thomas A Clark
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| |
Collapse
|
41
|
Thiriard A, Raze D, Locht C. Diversion of complement-mediated killing by Bordetella. Microbes Infect 2018; 20:512-520. [PMID: 29454132 DOI: 10.1016/j.micinf.2018.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 02/02/2018] [Accepted: 02/03/2018] [Indexed: 01/06/2023]
Abstract
The complement cascade participates in protection against bacterial infections, and pathogens, including Bordetella pertussis, have developed complement-evading strategies. Here we discuss current knowledge on B. pertussis complement evasion strategies and the role of antibody-dependent complement-mediated killing in protection against B. pertussis infection pointing out important knowledge gaps for further research to improve current pertussis vaccines.
Collapse
Affiliation(s)
- Anaïs Thiriard
- Université de Lille, CNRS UMR 8204, Inserm U1019, CHU Lille, Institut Pasteur de Lille, Centre for Infection and Immunity of Lille, F-59000 Lille, France
| | - Dominique Raze
- Université de Lille, CNRS UMR 8204, Inserm U1019, CHU Lille, Institut Pasteur de Lille, Centre for Infection and Immunity of Lille, F-59000 Lille, France
| | - Camille Locht
- Université de Lille, CNRS UMR 8204, Inserm U1019, CHU Lille, Institut Pasteur de Lille, Centre for Infection and Immunity of Lille, F-59000 Lille, France.
| |
Collapse
|
42
|
Bialek R. Ist der Pertussis-Impfschutz messbar? Monatsschr Kinderheilkd 2018. [DOI: 10.1007/s00112-017-0363-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
43
|
Kowalzik F, Faber J, Knuf M. Benchmark statt gesicherter Grenzwert. Monatsschr Kinderheilkd 2017. [DOI: 10.1007/s00112-017-0421-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
44
|
Ahmad SM, Alam J, Afsar NA, Huda N, Kabir Y, Qadri F, Raqib R, Stephensen CB. Comparisons of the effect of naturally acquired maternal pertussis antibodies and antenatal vaccination induced maternal tetanus antibodies on infant's antibody secreting lymphocyte responses and circulating plasma antibody levels. Hum Vaccin Immunother 2017; 12:886-93. [PMID: 27176823 DOI: 10.1080/21645515.2015.1136759] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
The goal of this study was to explore the effects of trans-placental tetanus toxoid (TT) and pertussis (PT) antibodies on an infant's response to vaccination in the context of antenatal immunization with tetanus but not with pertussis. 38 mothers received a single dose of TT vaccine during pregnancy. Infants received tetanus and pertussis vaccines at 6, 10 and 14 wk of age. TT and PT anti-IgG secretion by infant lymphocytes was measured at 15 wk. Plasma antibodies were measured at 6 wk (pre-vaccination), 15 wk and 1 y of age. Prior to vaccination, TT and PT antibody were detected in 94.6% and 15.2% of infants. At 15 wk anti-TT-IgG and anti-PT-IgG in plasma was increased by 7-9 fold over pre-vaccination levels, while at 1 y plasma anti-TT-IgG was decreased by approximately 5-fold from the peak and had returned to near the pre-vaccination level. At 1 y plasma anti-PT-IgG was decreased by 2-fold 1 yfrom the 15 wk level. However, 89.5% and 82.3% of infants at 1 y had protective levels of anti-TT and anti-PT IgG, respectively. Pre-vaccination plasma IgG levels were associated with lower vaccine-specific IgG secretion by infant lymphocytes at 15 wk (p < 0.10). This apparent inhibition was seen for anti-TT-IgG at both 15 wk (p < 0.05) and t 1 y (p < 0.10) of age. In summary, we report an apparent inhibitory effect of passively derived maternal antibody on an infants' own antibody response to the same vaccine. However, since the cut-off values for protective titers are low, infants had protective antibody levels throughout infancy.
Collapse
Affiliation(s)
| | - Jahangir Alam
- a Center for Vaccine Sciences, icddr,b Mohakhali , Dhaka , Bangladesh
| | - Nure Alam Afsar
- a Center for Vaccine Sciences, icddr,b Mohakhali , Dhaka , Bangladesh
| | - Nazmul Huda
- a Center for Vaccine Sciences, icddr,b Mohakhali , Dhaka , Bangladesh.,b US Department of Agriculture Western Human Nutrition Research Center , Davis , CA , USA
| | - Yearul Kabir
- c Department of Biochemistry and Molecular Biology , University of Dhaka , Dhaka , Bangladesh
| | - Firdausi Qadri
- a Center for Vaccine Sciences, icddr,b Mohakhali , Dhaka , Bangladesh
| | - Rubhana Raqib
- a Center for Vaccine Sciences, icddr,b Mohakhali , Dhaka , Bangladesh
| | - Charles B Stephensen
- b US Department of Agriculture Western Human Nutrition Research Center , Davis , CA , USA
| |
Collapse
|
45
|
Sricharoenchai S, Sirivichayakul C, Chokephaibulkit K, Pitisuttithum P, Dhitavat J, Pitisuthitham A, Phongsamart W, Boonnak K, Lapphra K, Sabmee Y, Wittawatmongkol O, Chinwangso P, Poredi IK, Petre J, Thai PH, Viviani S. A genetically inactivated two-component acellular pertussis vaccine, alone or combined with tetanus and reduced-dose diphtheria vaccines, in adolescents: a phase 2/3, randomised controlled non-inferiority trial. THE LANCET. INFECTIOUS DISEASES 2017; 18:58-67. [PMID: 29066131 DOI: 10.1016/s1473-3099(17)30612-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 08/02/2017] [Accepted: 09/22/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Increasing evidence shows that protection induced by acellular pertussis vaccines is short-lived, requiring repeated booster vaccination to control pertussis disease. We aimed to assess the safety and immunogenicity of a recombinant acellular pertussis vaccine containing genetically inactivated pertussis toxin and filamentous haemagglutinin, as either a monovalent vaccine (aP[PTgen/FHA]) or in combination with tetanus and reduced-dose diphtheria vaccines (TdaP[PTgen/FHA]), versus a licensed tetanus and reduced-dose diphtheria and acellular pertussis combination vaccine (Tdap). METHODS We did this phase 2/3, randomised controlled non-inferiority trial at two sites in Bangkok, Thailand. Healthy adolescents (aged 12-17 years) were randomly assigned (1:1:1), via a computer-generated randomisation list with block sizes of three, to receive one dose (0·5 mL) of aP(PTgen/FHA), TdaP(PTgen/FHA), or Tdap (comparator). Clinical research staff responsible for participant randomisation, vaccine preparation and administration, and accountability were aware of group allocation. However, allocation was concealed from all other site study staff, data management personnel, statisticians, laboratory staff, and study participants. The primary outcome was non-inferior immunogenicity of TdaP(PTgen/FHA) to Tdap based on seroconversion rates (a four-fold increase or more) for pertussis toxin and filamentous haemagglutinin IgG antibodies 28 days after vaccination, with a predefined 10% margin of equivalence. We did analysis by per protocol. This study is registered with the Thai Clinical Trial Registry, number TCTR20150703002. FINDINGS Between July 6 and Aug 20, 2015, we allocated 450 participants to receive one dose of TdaP(PTgen/FHA) (n=150), aP(PTgen/FHA) (n=150), or comparator Tdap (n=150). 28 days after vaccination, seroconversion rates for anti-pertussis toxin IgG were 96·6% (95% CI 93·8-99·5; n=144) in the TdaP(PTgen/FHA) group and 55·0% (47·1-63·0; n=82) in the comparator Tdap group (difference 41·6%, 95% CI 33·1-50·1; p<0·0001). Seroconversion rates for anti-filamentous haemagglutinin were 82·6% (95% CI 76·5-88·6; n=123) in the TdaP(PTgen/FHA) group and 54·4% (46·4-62·4; n=81) in the comparator group (difference 28·2%, 95% CI 18·1-38·2 p<0·0001). 28 days after vaccination, seroconversion rates in the aP(PTgen/FHA) group were 96·0% (95% CI 92·8-99·1; n=142) for anti-pertussis toxin IgG and 93·2% (89·2-97·3; n=138) for anti-filamentous haemagglutinin IgG. These findings support the non-inferior immunogenicity of TdaP(PTgen/FHA) over comparator Tdap. Reactogenicity and incidence of adverse events were similar between groups. INTERPRETATION The new TdaP(PTgen/FHA) vaccine is safe and induces higher pertussis responses 28 days after vaccination than does the available licensed Tdap booster vaccine. Results of our trial led to the licensure of new acellular pertussis vaccines containing genetically inactivated pertussis toxin in Thailand. The availability of recombinant monovalent pertussis vaccines that induce high antibody responses provides the medical community and consumers with the opportunity to vaccinate against pertussis when immunisation against diphtheria and tetanus is not required or not desired. Studies are underway to pave the way for licensure studies of this acellular pertussis vaccine in other countries. FUNDING BioNet-Asia.
Collapse
Affiliation(s)
- Sirintip Sricharoenchai
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Madiol University, Bangkok Noi, Bangkok, Thailand
| | - Chukiat Sirivichayakul
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Ratchathewi, Bangkok, Thailand
| | - Kulkanya Chokephaibulkit
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Madiol University, Bangkok Noi, Bangkok, Thailand
| | - Punnee Pitisuttithum
- Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, Ratchathewi, Bangkok, Thailand
| | - Jittima Dhitavat
- Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, Ratchathewi, Bangkok, Thailand
| | - Arom Pitisuthitham
- Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, Ratchathewi, Bangkok, Thailand
| | - Wanatpreeya Phongsamart
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Madiol University, Bangkok Noi, Bangkok, Thailand
| | - Kobporn Boonnak
- Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, Ratchathewi, Bangkok, Thailand
| | - Keswadee Lapphra
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Madiol University, Bangkok Noi, Bangkok, Thailand
| | - Yupa Sabmee
- Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, Ratchathewi, Bangkok, Thailand
| | - Orasri Wittawatmongkol
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Madiol University, Bangkok Noi, Bangkok, Thailand
| | | | | | - Jean Petre
- BioNet-Asia, Bangjak, Prakanong, Bangkok, Thailand
| | | | | |
Collapse
|
46
|
Ortiz K, Sampathkumar RS, Ansari AA, Byrareddy SN. Preliminary studies on the use of pertussis toxin for the modulation of intravaginal SIV transmission in rhesus macaques. J Med Primatol 2017; 46:327-331. [PMID: 28940591 DOI: 10.1111/jmp.12316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Pertussis toxin (PTX) blocks GPCR signaling resulting in the inhibition of chemotaxis/cell adhesion. It was reasoned that inhibition of cell trafficking may be an approach to prevent HIV/SIV transmission. METHODS In this study, PTX in HEC gel was applied to the vaginal wall of monkeys that were then challenged intravaginally with SIVmac251. RESULTS Results of these studies showed that 2 of 4 animals were resistant to infection. Furthermore, infection was correlated with a marked increase in the plasma and cervicovaginal lavage levels of select chemokines and cytokines. CONCLUSIONS Results from this preliminary feasibility study dictate that further studies that include a larger number of animals are required to optimize this protocol and establish the efficacy of this approach. In addition, such future studies will provide important information on the role of specific chemokines that play a role in lymphocyte trafficking within the genital tract and serve as additional therapeutic targets.
Collapse
Affiliation(s)
- Kristina Ortiz
- Department of Pathology & Lab Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Rebecca S Sampathkumar
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, USA
| | - Aftab A Ansari
- Department of Pathology & Lab Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Siddappa N Byrareddy
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, USA
| |
Collapse
|
47
|
Maertens K, Tran TMP, Hens N, Van Damme P, Leuridan E. Effect of Prepregnancy Pertussis Vaccination in Young Infants. J Infect Dis 2017; 215:1855-1861. [PMID: 28863468 DOI: 10.1093/infdis/jix176] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 04/10/2017] [Indexed: 11/14/2022] Open
Abstract
Background Maternal antibodies to pertussis can hamper infant immune responses to pertussis vaccines. The effect a maternal tetanus, diphtheria, acellular pertussis (Tdap) vaccine booster between 2 consecutive pregnancies is investigated. Methods A prospective study was conducted in Belgium during 2008-2014 on the kinetics of maternal pertussis antibodies in unvaccinated women and their infants (group A; 86 mother-infant pairs) and in siblings born after the women received Tdap vaccine (group B; 58 mother-infant pairs). Levels of antibody to pertussis toxin, antibody to filamentous hemagglutinin, and antibody to pertactin were measured in maternal blood before and after vaccination and at both deliveries, in cord blood from both siblings, and in infants before and after they received a priming series of acellular pertussis containing vaccines. Results Levels of pertussis antibodies in all group B siblings at birth were significantly higher than those in their siblings at birth, even as the interval since maternal vaccination increased. Blunting of the infant pertussis vaccine response was detected in group B siblings. We estimated the maximum interval between repeat Tdap vaccine doses in adult women that would yield a beneficial effect for the consecutive infant. Conclusions Prepregnancy Tdap vaccination significantly increases maternal antibody concentrations in consecutive infants. However, similar to the effect of Tdap vaccination during pregnancy, immune responses of later-born infants born to mothers who received a prepregnancy immunization, are blunted.
Collapse
Affiliation(s)
| | - Thao Mai Phuong Tran
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Hasselt University,Belgium
| | - Niel Hens
- Center for Health Economic Research and Modeling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp.,Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Hasselt University, Belgium
| | | | | |
Collapse
|
48
|
Abu Raya B, Edwards KM, Scheifele DW, Halperin SA. Pertussis and influenza immunisation during pregnancy: a landscape review. THE LANCET. INFECTIOUS DISEASES 2017; 17:e209-e222. [DOI: 10.1016/s1473-3099(17)30190-1] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 01/25/2017] [Accepted: 02/07/2017] [Indexed: 12/21/2022]
|
49
|
Nozawa H, Shoji K, Uda K, Nakamura T, Kubota M, Ishiguro A, Miyairi I. Pertussis without apparent cough in a disabled girl with a tracheostomy. J Infect Chemother 2017. [PMID: 28623110 DOI: 10.1016/j.jiac.2017.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Pertussis is characterized by intense, prolonged coughing in children often followed by a distinctive whooping sound on inspiration. However, the clinical manifestations and natural course of pertussis in disabled children are largely unknown. We experienced a case of pertussis in a disabled girl who had previously undergone a tracheostomy and laryngotracheal separation. She presented with increased tracheal secretions and required hospitalization but did not develop a cough. Pertussis was suspected from the sputum Gram stain, which revealed numerous, short gram-negative rods that did not grow on chocolate agar. A nucleic acid amplification test was positive for Bordetella pertussis and the patient improved on azithromycin. Pertussis may present without its cardinal symptoms in disabled children.
Collapse
Affiliation(s)
- Hisataka Nozawa
- Department of Postgraduate Education and Training, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, Japan
| | - Kensuke Shoji
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, Japan
| | - Kazuhiro Uda
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, Japan
| | - Tomoo Nakamura
- Department of General Pediatrics & Interdisciplinary Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, Japan
| | - Mitsuru Kubota
- Department of General Pediatrics & Interdisciplinary Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, Japan
| | - Akira Ishiguro
- Department of Postgraduate Education and Training, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, Japan
| | - Isao Miyairi
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, Japan.
| |
Collapse
|
50
|
Torzsa P, Devadiga R, Tafalla M. Seroprevalence of Bordetella pertussis antibodies in adults in Hungary: results of an epidemiological cross-sectional study. BMC Infect Dis 2017; 17:242. [PMID: 28376739 PMCID: PMC5379708 DOI: 10.1186/s12879-017-2356-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 03/28/2017] [Indexed: 01/08/2023] Open
Abstract
Background Pertussis (whooping cough) is well known to be underreported, particularly among adults, who can act as an infectious reservoir, potentially putting susceptible newborns at risk of serious illness. The purpose of this study was to estimate the seroprevalence of pertussis in adults in Hungary. Methods This epidemiological, cross-sectional study was conducted in adults in five general practitioners’ practices in Hungary. Serum anti-pertussis toxin immunoglobulin G (anti-PT IgG) antibody levels were analyzed using enzyme-linked immunosorbent assay. Sera were classified following manufacturer’s instructions as: strongly indicative of current/recent infection (≥1.5 optical density [OD] units); indicative of current/recent infection (≥1.0 OD units); seropositive (>0.3 OD units); or seronegative (≤0.3 OD units). Logistic regression was performed to describe the associations between seroprevalence and various characteristics. Results Between 24th April 2014 and 24th April 2015, 1999 adults (60.6% female; mean age 47.4 ± 17.7 years) were included in the analysis. A total of 14.8% were seropositive for anti-PT IgG, 1.1% had a level indicative of current/recent infection, and 0.1% had a level strongly indicative of current/recent infection. Logistic regression showed significant relationships between increased rates of seropositivity and: age ≥60 years (odds ratio [OR], 1.97; 95% confidence interval [CI], 1.39–2.80; p = .0002) or 18–29 years (OR, 1.67; 95% CI, 1.13–2.46; p = .0094) vs. 45–59 years; former smoker (OR, 1.46; 95% CI, 1.08–1.97; p = .014) or current smoker (OR, 1.38; 95% CI, 1.01–1.89; p = .045) vs. never smoker; and male (OR, 1.30; 95% CI, 1.01–1.68; p = .041) vs. female. Also, between increased rates of probable current/recent infection and current smoker (OR, 7.50; 95% CI, 2.32–24.31; p = .0008) or former smoker (OR, 4.07; 95% CI, 1.21–13.64; p = .023) vs. never smoker. Conclusions Approximately 85% of the adults studied were seronegative and therefore susceptible to pertussis infection. Approximately 1% had anti-PT IgG levels indicative of current/recent pertussis infection, which could potentially be transmitted to susceptible young infants. Vaccination of adults is a key way to indirectly protect infants. Trial registration Clinical Trials.gov NCT02014519. Prospectively registered 12 December 2013.
Collapse
Affiliation(s)
- Péter Torzsa
- Faculty of Medicine, Department of Family Medicine, Semmelweis University, Kútvölgyi út 4, Budapest, 1125, Hungary
| | | | | |
Collapse
|