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Engelmaier A, Butterweck HA, Weber A. Stability assessment of anti-bacterial antibodies in immunoglobulin G-depleted serum with validated immunoassays. Immunotherapy 2023; 15:1459-1476. [PMID: 37753548 DOI: 10.2217/imt-2023-0127] [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] [Indexed: 09/28/2023] Open
Abstract
Aim: To investigate the stability of the anti-pneumococcal (PCP) and anti-haemophilus type B (Hib) immunoglobulins (IgGs) in human IgG-depleted serum samples frozen at -20°C. Materials & methods: Modified commercially available immunoassays (ELISAs) were bioanalytically validated. These ELISAs were used to measure levels of the two anti-bacterial IgG in samples kept at -20°C for up to 15 months. Human IgG-depleted serum was spiked with GAMMAGARD Liquid to obtain those samples. Results: Both ELISAs passed the validation test. Anti-PCP IgG and anti-Hib IgG were shown to be stable for at least 15 months at -20°C. Conclusion: These data confirm the stability of anti-bacterial IgG in human IgG-depleted serum and support the common practice of testing frozen samples.
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Affiliation(s)
- Andrea Engelmaier
- Baxalta Innovations GmbH, part of Takeda, Pharmaceutical Science, Vienna A-1220, Austria
| | - Harald A Butterweck
- Baxalta Innovations GmbH, part of Takeda, Plasma Derived Therapies R&D, Vienna A-1220, Austria
| | - Alfred Weber
- Baxalta Innovations GmbH, part of Takeda, Plasma Derived Therapies R&D, Vienna A-1220, Austria
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Gouveia-Alves F, Gouveia R, Ginani VC, Seber A, Kuramoto DA, Murad GFA, Spina FG, Petrilli AS, Zecchin VG, Granato C, Carlesse F, de Moraes-Pinto MI. Adherence and immune response to revaccination following hematopoietic stem cell transplantation at a pediatric onco-hematology reference center. Transpl Infect Dis 2018; 20:e12903. [PMID: 29668078 DOI: 10.1111/tid.12903] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 03/14/2018] [Accepted: 03/18/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Revaccination after hematopoietic stem cell transplantation (HSCT) is necessary to compensate for the loss of immunological memory. The aims of this study were to evaluate the adherence to revaccination schedule and the humoral immune response to different vaccine antigens in HSCT pediatric and young adult patients. METHODS Patients submitted to HSCT for over 3 years were recruited. After written informed consent, a questionnaire was filled in, the vaccination card was analyzed, a blood sample was collected and tested by ELISA for diphtheria, Haemophilus influenzae type b (Hib), hepatitis A, hepatitis B, tetanus, measles, rubella, and varicella antibodies. RESULTS Sixty-three patients (mean age at HSCT, 10.7 years) were evaluated. Forty-one (65%) were male; 34 (54%) had allogeneic and 29 (46%), autologous HSCT. Complete adherence to diphtheria revaccination was found in 79.4% patients and seropositivity was found in 92% of those who completed the revaccination schedule; for Hib, 68.3% adherence and 95.3% seropositivity were observed; for hepatitis A, 63.5% adherence and 92.5% seropositivity; for 3 doses of hepatitis B, 86.8% adherence and 79.2% seropositivity; for tetanus, 79.4% adherence and 100% seropositivity; for measles and rubella, 17.5% adherence and 100% seropositivity; for varicella, 7.9% adherence and 100% seropositivity. The existence of a Vaccination Center for Special Immunobiologicals in patients' municipality was positively associated with completed vaccine schedule; on the other hand, chronic GVHD was negatively associated with revaccination adherence. CONCLUSION Hematopoietic stem cell transplantation patients showed good seropositivity rates after complete vaccination schedule. However, a low coverage rate was observed for live attenuated antigens.
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Affiliation(s)
| | | | | | | | - Danielle A Kuramoto
- Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Gabriel F A Murad
- Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Fernanda G Spina
- Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Antonio S Petrilli
- Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Victor G Zecchin
- Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Celso Granato
- Department of Medicine, Universidade Federal de São Paulo, São Paulo, Brazil.,Fleury Group, São Paulo, Brazil
| | - Fabianne Carlesse
- Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
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Fayea NY, Fouda AE, Kandil SM. Immunization status in childhood cancer survivors: A hidden risk which could be prevented. Pediatr Neonatol 2017; 58:541-545. [PMID: 27543381 DOI: 10.1016/j.pedneo.2016.04.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 03/18/2016] [Accepted: 04/07/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND A limited number of studies have examined the vaccine-specific antibody status of children with cancer. There are disagreements over the guidelines for postcancer immunization strategy. METHODS Our study was an observational, cross-sectional retrospective review of data collected on children who were seen in the outpatient clinic at King Abdullah Medical City, Oncology Center, Jeddah, the Kingdom of Saudi Arabia. Our aim was to evaluate the seropositive status to vaccine-preventable diseases: measles, mumps, rubella, diphtheria, tetanus, polio, and Haemophilus influenzae type B (HIB) in childhood cancer survivors at our center in order to plan future vaccination for these children and establish a simple revaccination schedule. RESULTS Forty-seven patients (21 boys and 26 girls) were included in the study. Age at the time of cancer diagnosis (mean±standard deviation) was 5.68±3.79 years and age at test sampling was 10.68±3.79 years. Acute leukemia was the most common cancer (49% of patients), followed by lymphoma (28%), brain tumors (13%), and solid tumors (10%). Treatment intensities (according to the Treatment Intensity Rating Scale, version 3.0; ITR-3) were 2, 3, and 4 for 26 patients (55%), 20 patients (43%), and one patient (2.1%), respectively. We found that 93% of our patients were considered seronegative (unprotected) for at least one vaccine-preventable disease. The seronegative rates for measles, mumps, rubella, diphtheria, tetanus, polio, and HIB were 46.8%, 36.2%, 36.2%, 46.8%, 61.7%, 17.1%, and 42.6%, respectively. Criteria including age at diagnosis, age at sampling, type of malignancy, and treatment intensity were not significantly different between seropositive and seronegative patients. CONCLUSION Seronegative rates for vaccine-preventable diseases were very high in childhood cancer survivors, which represented a subpopulation of high-risk patients who could benefit from revaccination. We suggest a universal revaccination approach for all childhood cancer survivors, which is easily applicable and of low cost.
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Affiliation(s)
- Najwa Yahya Fayea
- Oncology Center Jeddah, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Ashraf Elsayed Fouda
- Pediatric Department, Mansoura Faculty of Medicine, Mansoura University Children Hospital, Mansoura University, Al-Mansoura, Egypt.
| | - Shaimaa Mohamed Kandil
- Pediatric Department, Mansoura Faculty of Medicine, Mansoura University Children Hospital, Mansoura University, Al-Mansoura, Egypt
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4
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Mousavi SF, Fatemi S, Siadat SD, Zahraei SM, Nikanpour E, Malekan MA, Khabiri AR, Janani AR. Development and Optimization of a Homemade ELISA Kit for Detection of Antibodies Against Haemophilus influenzae Type b. Jundishapur J Microbiol 2016; 9:e30629. [PMID: 27540453 PMCID: PMC4976622 DOI: 10.5812/jjm.30629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 11/09/2015] [Accepted: 12/02/2015] [Indexed: 11/27/2022] Open
Abstract
Background: Haemophilus influenzae type b (Hib) infection has high morbidity and mortality rate, especially in children under 5 years of age. Enzyme-linked immunosorbent assay (ELISA) technique is the most used method to detect antibodies against H. influenzae. Available commercial ELISA kits are expensive and not always readily available, particularly for epidemiological studies. Objectives: This study was performed to develop and optimize a homemade ELISA kit for the detection of Hib anti-polyribosylribitol phosphate (PRP) antibodies in children. Materials and Methods: To develop and optimize an indirect ELISA method, pure PRP was prepared. The PRP was coupled to bovine serum albumin, using sodium periodate. Then optimal conditions for ELISA, including coating antigen concentration and peroxidase labeled conjugate concentrations, incubation temperature and incubation time, were determined. To confirm the efficacy of optimized kit, 83 serum samples from non-vaccinated children, aged less than 6 years were collected and analyzed, using homemade and commercial ELISA. Results: The optimal conditions were considered to perform ELISA. Comparison between results obtained from optimized ELISA kit and commercial ELISA kit showed a good agreement. Conclusions: Taking into account these data, we elaborated a homemade ELISA kit that is an efficacious and cost-effective substitute for commercial kit, in disease control and diagnosis.
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Affiliation(s)
| | - Sara Fatemi
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, IR Iran
| | - Seyed Davar Siadat
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, IR Iran
| | | | - Elnaz Nikanpour
- Department of Bacteriology, Pasteur Institute of Iran, Tehran, IR Iran
| | | | - Ali Reza Khabiri
- Diagnosis Biotechnology Unit, Production and Research Complex, Pasteur Institute of Iran, Tehran, IR Iran
| | - Ali Reza Janani
- Department of Bacteriology, Pasteur Institute of Iran, Tehran, IR Iran
- Corresponding author: Ali Reza Janani, Department of Bacteriology, Pasteur Institute of Iran, Tehran, IR Iran. Tel: +98-2166953311, Fax: +98-2166405535, E-mail:
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5
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Dinelli MIS, Ono E, Viana PO, Spina FG, Weckx LY, Dos Santos AMN, Moraes-Pinto MID. Response to immunization in children born to renal transplant recipients using immunosuppressive drugs during gestation. Vaccine 2015; 34:404-407. [PMID: 26707214 DOI: 10.1016/j.vaccine.2015.12.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 12/03/2015] [Accepted: 12/08/2015] [Indexed: 11/15/2022]
Abstract
The use of immunosuppressive drugs can impair vaccination responses. When used during pregnancy, they may interfere with the development of the fetus's immune system. However, little is known regarding their influence on infant's response to vaccinations. Twenty-seven children born to renal transplant mothers (Tx) taking immunosuppressive drugs and 31 healthy children had the humoral immune response and reactogenicity to tetanus, Haemophilus influenzae type b (Hib) and 7 pneumococcal serotypes evaluated. The evolution of BCG vaccine scar was also registered. Antibodies were measured by ELISA. Lymphocyte immunophenotyping was performed on cord blood and at 7-8 months of age. Among Tx neonates, 82.4% had low B lymphocyte numbers at birth, and 29.4% had also low numbers of other lymphocyte subpopulations. Nevertheless, all children developed protective antibodies with similar antibody concentrations to the control group. Vaccine reactogenicity was similar in both groups and BCG healing was uneventful.
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Affiliation(s)
- Maria Isabel Saraiva Dinelli
- Department of Pediatrics, Federal University of São Paulo, Division of Pediatric Infectious Diseases, Rua Pedro de Toledo, 781/9° andar São Paulo 04039-032, SP, Brazil
| | - Erika Ono
- Department of Pediatrics, Federal University of São Paulo, Division of Pediatric Infectious Diseases, Rua Pedro de Toledo, 781/9° andar São Paulo 04039-032, SP, Brazil
| | - Patrícia Oliveira Viana
- Department of Pediatrics, Federal University of São Paulo, Division of Pediatric Infectious Diseases, Rua Pedro de Toledo, 781/9° andar São Paulo 04039-032, SP, Brazil
| | - Fernanda Garcia Spina
- Department of Pediatrics, Federal University of São Paulo, Division of Pediatric Infectious Diseases, Rua Pedro de Toledo, 781/9° andar São Paulo 04039-032, SP, Brazil
| | - Lily Yin Weckx
- Department of Pediatrics, Federal University of São Paulo, Division of Pediatric Infectious Diseases, Rua Pedro de Toledo, 781/9° andar São Paulo 04039-032, SP, Brazil
| | - Amélia Miyashiro Nunes Dos Santos
- Department of Pediatrics, Federal University of São Paulo, Division of Pediatric Infectious Diseases, Rua Pedro de Toledo, 781/9° andar São Paulo 04039-032, SP, Brazil
| | - Maria Isabel de Moraes-Pinto
- Department of Pediatrics, Federal University of São Paulo, Division of Pediatric Infectious Diseases, Rua Pedro de Toledo, 781/9° andar São Paulo 04039-032, SP, Brazil.
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Maternally acquired IgG immunity in neonates born to renal transplanted women. Vaccine 2015; 33:3104-9. [DOI: 10.1016/j.vaccine.2015.04.104] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 04/17/2015] [Accepted: 04/30/2015] [Indexed: 01/18/2023]
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Marshall ASJ, Barker CIS, Pulickal AS, Kibwana E, Gautam SC, Clutterbuck EA, Thorson SM, Shrestha S, Adhikari N, Pollard AJ, Kelly DF. The seroepidemiology of Haemophilus influenzae type b prior to introduction of an immunization programme in Kathmandu, Nepal. PLoS One 2014; 9:e85055. [PMID: 24465475 PMCID: PMC3898912 DOI: 10.1371/journal.pone.0085055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2013] [Accepted: 11/21/2013] [Indexed: 11/19/2022] Open
Abstract
Haemophilus influenzae type b (Hib) is now recognized as an important pathogen in Asia. To evaluate disease susceptibility, and as a marker of Hib transmission before routine immunization was introduced in Kathmandu, 71 participants aged 7 months-77 years were recruited and 15 cord blood samples were collected for analysis of anti-polyribosylribitol phosphate antibody levels by enzyme-linked immunosorbent assay. Only 20% of children under 5 years old had levels considered protective (>0.15 µg/ml), rising to 83% of 15-54 year-olds. Prior to introduction of Hib vaccine in Kathmandu, the majority of young children were susceptible to disease.
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Affiliation(s)
- Andrew S. J. Marshall
- Oxford Vaccine Group, Oxford University, and the NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom
- * E-mail:
| | - Charlotte I. S. Barker
- Oxford Vaccine Group, Oxford University, and the NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom
| | - Anoop S. Pulickal
- Oxford Vaccine Group, Oxford University, and the NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom
| | - Elizabeth Kibwana
- Oxford Vaccine Group, Oxford University, and the NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom
| | | | - Elizabeth A. Clutterbuck
- Oxford Vaccine Group, Oxford University, and the NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom
| | | | | | | | - Andrew J. Pollard
- Oxford Vaccine Group, Oxford University, and the NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom
| | - Dominic F. Kelly
- Oxford Vaccine Group, Oxford University, and the NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom
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8
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Howie SRC, Oluwalana C, Secka O, Scott S, Ideh RC, Ebruke BE, Balloch A, Sambou S, Erskine J, Lowe Y, Corrah T, Adegbola RA. The effectiveness of conjugate Haemophilus influenzae type B vaccine in The Gambia 14 years after introduction. Clin Infect Dis 2013; 57:1527-34. [PMID: 24046305 PMCID: PMC3814828 DOI: 10.1093/cid/cit598] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2013] [Accepted: 09/06/2013] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND The Gambia was the first country in Africa to introduce conjugate Haemophilus influenzae type b (Hib) vaccine, which, as in other developing countries but unlike industrialized countries, is delivered as a 3-dose primary series with no booster. This study assessed its effectiveness 14 years after introduction. METHODS Using methods standardized during >20 years in the study site, clinical and microbiological surveillance for invasive Hib disease (primarily meningitis) in the Western Region of The Gambia from 2007 to 2010 was complemented with studies of Hib carriage in children aged 1 to <2 years, Hib antibody levels in children aged <5 years, and Hib vaccine coverage and timing in children aged 1 to <2 years. RESULTS The incidence of Hib meningitis remained low (averaging 1.3 per 100 000 children aged <5 years annually), as did the Hib oropharyngeal carriage rate (0.9%). Hib antibody levels were protective in >99% of those surveyed, albeit with lower titers in older children; and coverage of conjugate Hib vaccination was high (91% having 3 doses at 1-2 years of age) using a schedule that was delivered at median ages of 2.6 months, 4.3 months, and 6 months for the first, second, and third doses, respectively. CONCLUSIONS Conjugate Hib vaccine was delivered on time in a 3-dose primary series without booster to a high proportion of eligible children and this was associated with effective disease control up to 14 years after introduction. It is important that surveillance continues in this first African country to introduce the vaccine to determine if effective control persists or if a booster dose becomes necessary as has been the case in industrialized countries.
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Affiliation(s)
| | | | | | - Susana Scott
- Disease Control and Elimination Theme, Medical Research Council Unit, Fajara, The Gambia
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, United Kingdom
| | | | | | - Anne Balloch
- Infection and Immunity Theme, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Sana Sambou
- Ministry of Health and Social Welfare, Banjul
| | | | - Yamundow Lowe
- Bacterial Diseases Programme, Medical Research Council Unit, Fajara, The Gambia
| | | | - Richard A. Adegbola
- Bacterial Diseases Programme, Medical Research Council Unit, Fajara, The Gambia
- GlaxoSmithKline Vaccines, Wavre, Belgium
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9
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Goldblatt D, Ashton L, Zhang Y, Antonello J, Marchese RD. Comparison of a new multiplex binding assay versus the enzyme-linked immunosorbent assay for measurement of serotype-specific pneumococcal capsular polysaccharide IgG. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2011; 18:1744-51. [PMID: 21813660 PMCID: PMC3187042 DOI: 10.1128/cvi.05158-11] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2011] [Accepted: 07/26/2011] [Indexed: 11/20/2022]
Abstract
The measurement of serotype-specific anti-capsular polysaccharide antibodies remains the mainstay of pneumococcal (Pn) vaccine evaluation. New methods that allow the simultaneous measurement of antibodies to several antigens in small volumes of serum, and that agree well with existing techniques, are urgently required to support the increasing number of concomitant vaccines delivered in the infant immunization schedules and the use of extended-valency Pn vaccines. We therefore compared a relatively new multiplexed platform for measuring anti-Pn antibodies with the existing WHO consensus enzyme-linked immunosorbent assay (ELISA). A panel of 50 pediatric samples (34 collected after receipt of a heptavalent pneumococcal conjugate vaccine [PCV7] and 16 without PCV7) was analyzed across two different laboratories using a new multiplex electrochemiluminescence (ECL)-based detection assay developed for the quantitation of IgG serotype-specific antipneumococcal antibodies, and the results were compared to those obtained using the WHO consensus ELISA. For the seven serotypes measured, there was good agreement between the techniques and laboratories. The most notable difference was found between the ECL assay and the ELISA: concentrations tended to be higher in the ECL assay. For serotypes 6B, 9V, 18C, and 23F, the average increases in concentration ranged from 48 to 102%. However, the agreement rates on the proportions of samples with concentrations surrounding 0.35 μg/ml were >82% for all serotypes tested. Agreement between the two laboratories running the ECL assay was generally good: agreement on proportions of samples with concentrations surrounding 0.35 μg/ml was in excess of 92%, and agreement on average antibody concentrations was within 31%. We conclude that the Meso Scale Discovery (MSD) platform provides a promising new technique for the simultaneous measurement of antipneumococcal antibodies.
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Affiliation(s)
- David Goldblatt
- Immunobiology Unit, University College London, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
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Staat MA, Stadler LP, Donauer S, Trehan I, Rice M, Salisbury S. Serologic testing to verify the immune status of internationally adopted children against vaccine preventable diseases. Vaccine 2010; 28:7947-55. [PMID: 20937322 DOI: 10.1016/j.vaccine.2010.09.069] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2010] [Revised: 09/17/2010] [Accepted: 09/22/2010] [Indexed: 10/19/2022]
Abstract
Definitive immunization guidelines for internationally adopted children are lacking. We examined whether these children had serologic evidence of protection against vaccine-preventable diseases. For children with ≥3 vaccine doses, overall protection was high for diphtheria (85%), tetanus (95%), polio (93%), hepatitis B (77%), and Hib (67%). For children ≥12 months of age with ≥1 dose of measles, mumps, or rubella vaccines, 95%, 72%, and 94% were immune, respectively. Children without immunization documentation had lower immunity. Serologic testing was useful in verifying the immunization status in internationally adopted children with and without documentation of immunizations.
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Affiliation(s)
- Mary Allen Staat
- Department of Pediatrics, International Adoption Center, Cincinnati Children’s Hospital Medical Center, 3333 BurnetAvenue, ML 7036, Cincinnati, OH 45229-3039, United States.
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11
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Ladhani S, Heath PT, Slack MPE, McIntyre PB, Diez-Domingo J, Campos J, Dagan R, Ramsay ME. Haemophilus influenzae serotype b conjugate vaccine failure in twelve countries with established national childhood immunization programmes. Clin Microbiol Infect 2009; 16:948-54. [PMID: 19889054 DOI: 10.1111/j.1469-0691.2009.02945.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The present study describes the clinical and immunological features of children with Hib vaccine failure, who were identified through national surveillance between 1996 and 2001 in Europe, Israel and Australia. True vaccine failure was defined as invasive Hib disease occurring ≥2 weeks after one dose, given after the first birthday, or ≥1 week after ≥2 doses, given at <1 year of age. Of the 423 cases (representing 0.2 cases per 100,000 child-years at risk) reported, 330 (78%) had received three doses in the first year of life and developed disease at a median age of 28 months. Of the remaining 93, 48 had received two doses in infancy, 34 had received four doses including a booster, and 11 had received a single dose after 12 months of age. These children developed disease at a median age of 12, 33 and 71 months, respectively. In total, 47 out of 258 children (18%) with available information had an underlying medical problem (including prematurity) and 53 out of 161 (33%) had immunoglobulin deficiency. Convalescent Hib antibody concentrations were above the putative protective concentration of 1.0 mg/L in 147/194 (76%) children; low concentrations were associated with both the presence of an underlying medical problem and young age at the time of Hib disease. Almost all children who received an additional vaccine dose developed antibodies at protective concentrations. Thus, Hib vaccine failure is rare, but can occur with any immunization schedule. Children with Hib vaccine failure should have immunoglobulin and convalescent Hib antibody concentrations measured after infection and receive additional vaccination, if required.
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Affiliation(s)
- S Ladhani
- Immunisation Department, Centre for Infections, Health Protection Agency, London, UK.
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12
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Immunology of combining CRM(197) conjugates for Streptococcus pneumoniae, Neisseria meningitis and Haemophilus influenzae in Chilean infants. Vaccine 2009; 27:2299-305. [PMID: 19428843 DOI: 10.1016/j.vaccine.2009.02.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2008] [Revised: 02/03/2009] [Accepted: 02/04/2009] [Indexed: 11/21/2022]
Abstract
We evaluated the immunogenicity and safety of an investigational combination of 9-valent pneumococcal conjugate vaccine (PCV9) and meningococcal group C conjugate (MnCC) vaccine (PCV9-MnCC) administered concomitantly with Haemophilus influenzae type b (Hib) conjugate vaccine, and of a combination of the three vaccines mixed together as a single injection (Hib-PCV9-MnCC), and compared them to separately administered PCV9 and MnCC dispensed to Chilean infants at 2, 4, and 6 months of age. The frequency of adverse events was similar among groups. Recipients of PCV9 alone or in combination with the other vaccines mounted significant antibody responses to the nine pneumococcal serotypes in PCV9, with >88% achieving protective levels of > or =0.35microg/mL. For serotypes 6B, 9V, and 5, recipients of PCV9 alone had significantly higher geometric mean concentrations (GMCs) than those of the other vaccine groups. Similarly, the GMC of anti-PRP antibodies was significantly lower among recipients of Hib-PCV9-MnCC than among those who received Hib vaccine separately from PCV9 or MnCC. In Chilean infants, PCV9, PCV9-MnCC, and Hib-PCV9-MnCC were highly immunogenic and safe. Overall, interactions of PCV9, MnCC and Hib affected the magnitude (GMC) of the primary antibody responses to some of the antigens, but not the percentage of subjects who achieved protective antibody thresholds.
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Newton S, Owusu-Agyei S, Ampofo W, Zandoh C, Adjuik M, Adjei G, Tchum S, Filteau S, Kirkwood BR. Vitamin A supplementation enhances infants' immune responses to hepatitis B vaccine but does not affect responses to Haemophilus influenzae type b vaccine. J Nutr 2007; 137:1272-7. [PMID: 17449592 DOI: 10.1093/jn/137.5.1272] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Vitamin A supplementation reduces child mortality and severe morbidity in less developed countries, and the Expanded Program on Immunization (EPI) offers an ideal opportunity to deliver supplements in developing countries. High-dose vitamin A supplementation has been shown to have no effect on the immunogenicity of oral polio vaccine, tetanus toxoid, pertussis, or on measles vaccine given at 9 mo, but a negative effect on measles vaccine administered at 6 mo and a potentiating effect on diphtheria vaccine. Its effect on the antibody response to hepatitis B and Haemophilus influenzae type b antigens has not yet been established. To assess these effects, the present trial was carried out in the Offinso district of Ghana; 1077 infants were enrolled shortly after birth and randomized either to receive or not to receive 15 mg retinol equivalent with vitamin A together with the pentavalent "diphtheria-polio-tetanus-Haemophilus influenzae b-hepatitis B" vaccine at 6, 10, and 14 wk of age. All mothers received a postpartum supplement of 120 mg retinol equivalent vitamin A as per national policy. Blood samples were taken from infants at 6 and 18 wk of age. The results are based on 888 infants (82.4%) who completed the trial. The vitamin A supplementation did not affect the immune response to Haemophilus influenzae type b, but there was a significant improvement in the immune response to hepatitis B vaccine (93.9 vs. 90.2%, P = 0.04). However, given the high percentage of infants with seroprotection in the control group, it is doubtful that inclusion of vitamin A in the EPI would be justified on these grounds alone.
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Affiliation(s)
- Sam Newton
- Kintampo Health Research Centre, Kintampo, Ghana.
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14
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Lee H, Park SE, Lim SY, Choi KM, Lee HJ, Kim KH. Antibody prsistence after Haemophilus influenzae type b (Hib) primary vaccination and response to boosters in Korean children. KOREAN JOURNAL OF PEDIATRICS 2007. [DOI: 10.3345/kjp.2007.50.5.449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Hyunju Lee
- Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Korea
- Center for Vaccine Evaluation and Study, Medical Research Institute, Ewha Womans University, Seoul, Korea
| | - So Eun Park
- Department of Pediatrics, College of Medicine, Pochon Cha University, Seoul, Korea
- Center for Vaccine Evaluation and Study, Medical Research Institute, Ewha Womans University, Seoul, Korea
| | - Soo Young Lim
- Department of Microbiology, College of Medicine, Ewha Womans University, Seoul, Korea
- Center for Vaccine Evaluation and Study, Medical Research Institute, Ewha Womans University, Seoul, Korea
| | - Kyong Min Choi
- Department of Pediatrics, College of Medicine, Kwandong University, Seoul, Korea
| | - Hoan Jong Lee
- Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
| | - Kyung Hyo Kim
- Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Korea
- Center for Vaccine Evaluation and Study, Medical Research Institute, Ewha Womans University, Seoul, Korea
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15
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Kim KH, Lim SY. Validation of enzyme immunoassay for the quantitative measurement of human IgG antibodies specific for Haemophilus influenzae Type b capsular polysaccharide. KOREAN JOURNAL OF PEDIATRICS 2007. [DOI: 10.3345/kjp.2007.50.2.143] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Kyung Hyo Kim
- Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Soo Young Lim
- Department of Microbiology, College of Medicine, Ewha Womans University, Seoul, Korea
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16
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Baggett HC, Hennessy TW, Bulkow L, Romero-Steiner S, Hurlburt D, Holder P, Parkinson AJ, Singleton RJ, Levine O, Carlone GM, Butler JC. Immunologic response to Haemophilus influenzae type b (Hib) conjugate vaccine and risk factors for carriage among Hib carriers and noncarriers in Southwestern Alaska. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2006; 13:620-6. [PMID: 16760318 PMCID: PMC1489551 DOI: 10.1128/cvi.00077-06] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Continued Haemophilus influenzae type b (Hib) carriage in rural Alaska contributes to the ongoing risk of invasive disease. Community-wide Hib carriage surveys were conducted in three villages in southwestern Alaska. Sixteen carriers and 32 age- and village-matched controls were enrolled and were vaccinated with Hib oligosaccharide-CRM(197) conjugate vaccine. Serum immunoglobulin G (IgG) concentration, antibody avidity, and serum bactericidal activity (SBA) were measured prior to Hib vaccination and 2 and 12 months after vaccination. We identified no demographic or behavioral factors associated with Hib colonization. Prior to vaccination, Hib carriers had a higher IgG geometric mean concentration than controls did (8.2 versus 1.6 microg/ml; P < 0.001) and a higher SBA geometric mean titer (7,132 versus 1,235; P = 0.006). Both groups responded to vaccination with increased IgG and SBA. These data illustrate the role of Hib colonization as an immunizing event and show that Hib carriers in communities with ongoing transmission have no evidence of reduced immune responsiveness that may have put them at risk for colonization.
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Affiliation(s)
- Henry C Baggett
- CDC, Division of Global Migration and Quarantine, MS E03, 1600 Clifton Rd., Atlanta, GA 30333, USA.
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17
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Black SB, Cimino CO, Hansen J, Lewis E, Ray P, Corsaro B, Graepel J, Laufer D. Immunogenicity and safety of measles-mumps-rubella, varicella and Haemophilus influenzae type b vaccines administered concurrently with a fourth dose of heptavalent pneumococcal conjugate vaccine compared with the vaccines administered without heptavalent pneumococcal conjugate vaccine. Pediatr Infect Dis J 2006; 25:306-11. [PMID: 16567981 DOI: 10.1097/01.inf.0000207409.92198.6f] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Prevnar [heptavalent pneumococcal conjugate vaccine (PCV7)] is licensed in the United States for routine administration in infants and may be coadministered with other infant vaccines. Safety and immunogenicity data on the coadministration of the fourth dose of PCV7 with measles-mumps-rubella (MMR), varicella and Haemophilus influenzae type b (Hib) vaccines are limited. METHODS Children 12-15 months of age received either MMR with PCV7 (group 1) or MMR without PCV7 (group 2). All subjects received Hib and varicella vaccines. Group 2 received PCV7 6-9 weeks after MMR vaccination. Sera for analysis of all non-PCV7 antibodies were collected just before administration of MMR vaccine and 6 weeks later. Optimal antigen responses were assessed with the use of predetermined antibody titers. The primary end point was >90% response rate (all antigens). Noninferiority was defined as <10% difference between groups. Local and systemic reactions and postvaccination adverse events were monitored and compared between groups. RESULTS A total of 694 subjects (347 per group) were enrolled. After immunization with MMR plus PCV7 concurrently, or MMR followed 6 weeks later by PCV7, the percentages of subjects seroconverting were significantly greater than 90% for all antigens. The difference between the 2 groups was significantly less than 10%. CONCLUSION The immune response to MMR, Hib and varicella vaccines, when administered concurrently with a 4th (booster) dose of PCV7, was noninferior to that of these vaccines when given without PCV7. These results support concomitant administration of PCV7 with MMR, varicella and Hib as part of the recommended immunization schedule for children 12-15 months of age.
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Affiliation(s)
- Steven B Black
- Kaiser Permanente Vaccine Study Center, Oakland, CA, USA.
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18
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Kim KH. Present status and prospects of Haemophilus influenzae type b(Hib) immunization. KOREAN JOURNAL OF PEDIATRICS 2006. [DOI: 10.3345/kjp.2006.49.3.242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Kyung Hyo Kim
- Department of Pediatrics, College of Medicine, Ewha Woman's University, Seoul, Korea
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19
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Romero-Steiner S, Holder PF, Gomez de Leon P, Spear W, Hennessy TW, Carlone GM. Avidity determinations for Haemophilus influenzae Type b anti-polyribosylribitol phosphate antibodies. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2005; 12:1029-35. [PMID: 16148167 PMCID: PMC1235792 DOI: 10.1128/cdli.12.9.1029-1035.2005] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Determination of antibody avidity measurements can be difficult in human serum depending on the population evaluated. We evaluated three approaches for the determination of antibody avidity for immunoglobulin G (IgG). These approaches were (i) elution of bound antibody with increasing concentrations of a chaotropic agent using a single serum dilution, (ii) binding interference of multiple serum dilutions by a single concentration of a chaotrope, and (iii) elution of multiple serum dilutions by a single concentration of a chaotrope. Parameters that affect the determination of avidity measurements and their limitations were evaluated with pre- and post-Haemophilus influenzae type b conjugate vaccination sera (n=89). We determined that elution of low-avidity antibodies present in multiple dilutions of the serum sample by a single concentration of a chaotrope (0.15 M sodium thiocyanate [NaSCN]) was optimal for the determination of avidity measurements throughout a wide range of IgG concentrations (0.94 to 304.6 microg/ml). The percent reduction in concentration as determined by the elution assay with 0.15 M NaSCN correlated highly (r=0.84) with weighted averages obtained by an elution assay with multiple solutions of NaSCN. The correlation (r=0.57) between elution and binding interference, when a single concentration of a chaotrope was used, was lower than the correlation between the two elution methods (r=0.84). We found that the serum dilution, the heterogeneity of the antibody population, and the concentration of the chaotrope were the primary variables affecting avidity determinations. In this study, we present multiple analysis methods depending on the methodology used. We also present the factors that affect the analysis of avidity determinations given the polyclonal nature of human sera. This experimental approach should benefit the evaluation of similar antibodies induced by other bacterial polysaccharide vaccines.
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Affiliation(s)
- Sandra Romero-Steiner
- MS A-36, Respiratory Diseases Immunology Section, Division of Bacterial and Mycotic Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
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20
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Plikaytis BD, Carlone GM. Statistical considerations for vaccine immunogenicity trials. Part 1: Introduction and bioassay design and analysis. Vaccine 2005; 23:1596-605. [PMID: 15694512 DOI: 10.1016/j.vaccine.2004.06.046] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2004] [Revised: 06/28/2004] [Accepted: 06/29/2004] [Indexed: 11/21/2022]
Abstract
The foundation for any vaccine immunogenicity trial is the identification of appropriate correlates for protection and the measurement of these quantities with well-designed bioassays. An important requirement for developing bioassay protocols is the standardization of each procedure, so it is performed in a uniform manner within a facility and, in the case of multicenter trials, across laboratories. It is also crucial to recognize that the selection and use of techniques used to quantify assay endpoints (e.g., antibody concentration) will affect their accuracy and precision and these methods must also be defined and uniformly applied within and across laboratories. This paper discusses a number of methodological issues related to bioassay design and analysis that would ultimately lead to highly accurate assay endpoint determinations with minimum variance that would be comparable across laboratories. Guidelines are presented for the development of bioassay and data analysis protocols. Strengthening vaccine immunogenicity trial protocols will ensure that these quantities are estimated with the greatest degree of reliability and facilitate the subsequent evaluation of new vaccine formulations. Following these guidelines will give other researchers as well as regulatory authorities more confidence in evaluating and comparing the differences in immunogenicity levels elicited by new and developing vaccines.
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Affiliation(s)
- Brian D Plikaytis
- Biostatistics and Information Management Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Mailstop C09, Atlanta, GA 30333, USA.
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21
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Cox JH, Ferrari G, Kalams SA, Lopaczynski W, Oden N, D'souza MP. Results of an ELISPOT proficiency panel conducted in 11 laboratories participating in international human immunodeficiency virus type 1 vaccine trials. AIDS Res Hum Retroviruses 2005; 21:68-81. [PMID: 15665646 DOI: 10.1089/aid.2005.21.68] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We used an external quality assurance (EQA) panel to assess laboratory competency and comparability when performing ELISPOT assays in support of human immunodeficiency virus type 1 (HIV-1) vaccine trials. Cell recovery, viability, and frequency of interferon-gamma (IFN-gamma)-secreting cells after antigen stimulation were obtained from 11 laboratories on a coded panel of 11 peripheral blood mononuclear cell samples. The median recovery and viability before plating for all samples were 35% and 86%, respectively, with notable interlaboratory and intrasample variability. Empirical as well as statistical analysis methods were used to define positive ELISPOT responses. Remarkable concordance between laboratories was obtained in defining a qualitative assessment of responder/nonresponder status to antigens, but the frequency of responding cells varied among the laboratories. This study highlights the need for better standardization of protocols and reagents to obtain reliable and reproducible data that may support immunogenicity studies, vaccine regulatory submissions, and licensure.
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Affiliation(s)
- Josephine H Cox
- U.S. Military HIV Research Program, Rockville, MD 20850, USA.
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22
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De Sousa dos Santos S, Lopes MH, Simonsen V, Caiaffa Filho HH. Haemophilus influenzae type b immunization in adults infected with the human immunodeficiency virus. AIDS Res Hum Retroviruses 2004; 20:493-6. [PMID: 15186523 DOI: 10.1089/088922204323087732] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The purpose of this study was to assess the influence of Haemophilus influenzae type b conjugate vaccine on HIV-1 RNA level, CD4 count, and anti-Hib polysaccharide (PRP) antibody concentration. Eighty HIV-infected adults were randomized to receive Hib conjugate vaccine or not. Twenty HIV-seronegative controls were also vaccinated. Blood samples were taken before and after vaccination, with a follow-up period of 6 months. HIV infection markers and anti-PRP antibodies were monitored. There was no change in either HIV-1 viremia or CD4 count after vaccination. Immunization immunogenicity was superior in HIV-uninfected than in HIV-infected individuals (p < 0.01). Hib vaccination was safe but induced suboptimal antibody response in HIV-infected adults.
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Affiliation(s)
- Sigrid De Sousa dos Santos
- Department of Infectious and Parasitic Diseases, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.
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23
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Schmitt HJ, Faber J, Lorenz I, Schmöle-Thoma B, Ahlers N. The safety, reactogenicity and immunogenicity of a 7-valent pneumococcal conjugate vaccine (7VPnC) concurrently administered with a combination DTaP-IPV-Hib vaccine. Vaccine 2003; 21:3653-62. [PMID: 12922095 DOI: 10.1016/s0264-410x(03)00389-x] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
To evaluate immune responses, safety and reactogenicity of the concomitant use of DTaP-IPV-Hib and the newly available 7-valent pneumococcal conjugate (7VPnC) vaccines when given as the primary immunization series in early infancy. A total of 231 healthy infants were enrolled at 11 German study centers and randomized to receive either 7VPnC plus DTaP-IPV-Hib vaccines concomitantly into opposite limbs at age 2, 3, 4 and 11-15 months (7VPnC group) or DTaP-IPV-Hib vaccine at the same ages plus a 7VPnC "catch-up vaccination" at ages 6, 7, 8 and 11-15 months (Control group). Blood samples were drawn before and 4 weeks after the first three vaccine doses and 4 weeks after the fourth dose. Local and general side effects (i.e. safety) were solicited by diary cards. Immune responses were determined by ELISA except for antibodies to polioviruses (neutralization assay). Post-dose 3, a significant antibody response against all seven pneumococcal vaccine-serotypes was observed in the 7VPnC group only. Post-dose 4 geometric mean concentrations (GMCs) were similar in both groups. GMCs for other vaccine antigens were comparable between groups except for diphtheria (higher in the 7VPnC group) and pertactin (lower in the 7VPnC group), although after three vaccine doses there was a 28-fold rise in GMCs from baseline. Both vaccines were generally well-tolerated although there were minor differences in the frequency of local reactions and somewhat more fever or drowsiness in the 7VPnC group. The use of DTaP-IPV-Hib and the 7VPnC vaccine was safe, well-tolerated and immunogenic when given concomitantly at age 2, 3 and 4 months or when given separately with 7VPnC as a catch-up vaccination at age 6, 7, 8 months and as a concomitant booster immunization at age 11-15 months.
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MESH Headings
- Antibodies, Bacterial/analysis
- Antibodies, Bacterial/biosynthesis
- Antibodies, Viral/analysis
- Antibodies, Viral/biosynthesis
- Child, Preschool
- Diphtheria-Tetanus-Pertussis Vaccine/administration & dosage
- Diphtheria-Tetanus-Pertussis Vaccine/adverse effects
- Diphtheria-Tetanus-Pertussis Vaccine/immunology
- Enzyme-Linked Immunosorbent Assay
- Female
- Haemophilus Vaccines/administration & dosage
- Haemophilus Vaccines/adverse effects
- Haemophilus Vaccines/immunology
- Herpesvirus 1, Bovine/immunology
- Herpesvirus Vaccines/administration & dosage
- Herpesvirus Vaccines/adverse effects
- Herpesvirus Vaccines/immunology
- Humans
- Immunization Schedule
- Immunization, Secondary
- Infant
- Male
- Pneumococcal Vaccines/administration & dosage
- Pneumococcal Vaccines/adverse effects
- Pneumococcal Vaccines/immunology
- Poliovirus Vaccines/administration & dosage
- Poliovirus Vaccines/adverse effects
- Poliovirus Vaccines/immunology
- Vaccines, Combined/administration & dosage
- Vaccines, Combined/adverse effects
- Vaccines, Combined/immunology
- Vaccines, Conjugate/administration & dosage
- Vaccines, Conjugate/adverse effects
- Vaccines, Conjugate/immunology
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Affiliation(s)
- H J Schmitt
- Pediatric Infectious Diseases, Johannes-Gutenberg-University, Langenbeckstr. 1, D-55101 Mainz, Germany.
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Romero-Steiner S, Pilishvili T, Sampson JS, Johnson SE, Stinson A, Carlone GM, Ades EW. Inhibition of pneumococcal adherence to human nasopharyngeal epithelial cells by anti-PsaA antibodies. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2003; 10:246-51. [PMID: 12626450 PMCID: PMC150525 DOI: 10.1128/cdli.10.2.246-251.2003] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2002] [Revised: 07/22/2002] [Accepted: 11/10/2002] [Indexed: 11/20/2022]
Abstract
The role of pneumococcal (Pnc) surface adhesin A (PsaA) in the adherence of Streptococcus pneumoniae (pneumococcus) to host cells is not well defined. We examined the effect of anti-PsaA antibodies in an inhibition of adherence assay using Detroit 562 nasopharyngeal human epithelial cells. Rabbit polyclonal (Pab) anti-recombinant PsaA (rPsaA) sera, a purified mouse monoclonal antibody (MAb) (MAb 6F62G8E12), and 22 healthy adult sera with known anti-PsaA IgG levels (obtained by enzyme-linked immunosorbent assay) were evaluated for their abilities to inhibit Pnc adherence to confluent monolayers (measured as percent reduction in CFU counts compared to those of uninhibited controls). Pnc adherence was dependent on capsular phenotype (no or low adherence for opaque strains). With an inoculum of 10(4) to 10(5) bacteria/well, the mean +/- standard deviation count in controls was 163 +/- 32 CFU/well for transparent strains. Low adherence was observed for a PsaA-minus mutant even at higher inoculum doses. Mean percent inhibitions of adherence with Pab and MAb were 54 and 50%, respectively. Adult sera showed inhibition in a dose-response fashion with a range of 98 to 8%, depending on the serum anti-PsaA antibody concentration. Absorption of Pab with rPsaA restored Pnc adherence to control levels. Absorption of sera with a PsaA-minus mutant did not result in a significant decrease (P >0.05) of inhibition of adherence activity. Additionally, nearly 100% of Pnc adherence was inhibited by lipidated rPsaA at 2.5 micro g/ml. Our data support the argument that PsaA is an adhesin that mediates Pnc adherence to human nasopharyngeal cells. This functional assay may be useful in evaluating antibodies elicited in response to PsaA vaccination.
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Affiliation(s)
- Sandra Romero-Steiner
- Division of Bacterial and Mycotic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
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25
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Schauer U, Stemberg F, Rieger CHL, Büttner W, Borte M, Schubert S, Möllers H, Riedel F, Herz U, Renz H, Herzog W. Levels of antibodies specific to tetanus toxoid, Haemophilus influenzae type b, and pneumococcal capsular polysaccharide in healthy children and adults. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2003; 10:202-7. [PMID: 12626443 PMCID: PMC150524 DOI: 10.1128/cdli.10.2.202-207.2003] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Antibody levels specific for capsular polysaccharides of Streptococcus pneumoniae and Haemophilus influenzae type b (Hib) and for tetanus toxoid were measured in serum samples of 386 age-stratified subjects. The study group consists of healthy adult blood donors and hospitalized children undergoing elective surgery, excluding individuals with a history of infection. In children, anti-tetanus toxoid antibody levels displayed two peaks of 1.20 IU/ml (20.4 mg/liter) and 1.65 IU/ml (28.1 mg/liter) related to the schedule of routine childhood immunization in the first year and at 8 years of age. Eighty percent of the antibodies are of the immunoglobulin G1 (IgG1) isotype. For pneumococcal capsular polysaccharide (PCP), the specific antibody levels represent the acquisition of natural immunity. The initial concentration of 9.2 mg/liter was low in infancy (0.5 to 1 years of age) and remained low until 3 to 4 years of age (14.6 mg/liter). During this period PCP antibodies were almost 100% of the IgG2 subclass. Thereafter, IgG anti-PCP antibody titers increased steadily to adult levels (59.5 mg/liter). The data are intended to provide reference ranges to aid in the interpretation of specific antibody determinations in the clinical setting.
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Affiliation(s)
- Uwe Schauer
- Klinik für Kinder- und Jugendmedizin der Ruhr Universität, Bochum, Germany.
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26
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Pickering JW, Martins TB, Schroder MC, Hill HR. Comparison of a multiplex flow cytometric assay with enzyme-linked immunosorbent assay for auantitation of antibodies to tetanus, diphtheria, and Haemophilus influenzae Type b. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2002; 9:872-6. [PMID: 12093688 PMCID: PMC120020 DOI: 10.1128/cdli.9.4.872-876.2002] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We developed a multiplexed indirect immunofluorescence assay for antibodies to Haemophilus influenza type b (Hib) polysaccharide and the toxoids of Clostridium tetani (Tet) and Corynebacterium diphtheriae (Dip) based on the Luminex multiple-analyte profiling system. A pooled serum standard was calibrated against World Health Organization standards for Dip and Tet and an international standard for Hib. The multiplexed Luminex assay was compared to individual enzyme-linked immunosorbent assays (ELISAs) for the same analytes. By both methods, 75 (92.6%) of 81 of random serum samples had protective levels of antibody to Tet (> or = 0.1 IU/ml). For Dip, 81.5% of the samples had protective antibody levels (> or = 0.1 IU/ml) by ELISA and 80.2% had protective antibody levels by Luminex. Protective levels (> or = 1.0 microg/ml) of antibody to Hib were found in 45.0% of the samples tested by ELISA and in 39.0% of the samples tested by Luminex. The correlations (R(2)) between ELISA and Luminex of the 81 samples were 0.96, 0.96, and 0.91 for Tet, Dip, and Hib, respectively. There was also similar agreement between Luminex and ELISA for sera collected before and 1 month after Tet, Dip, and Hib vaccine administration. Both methods detected strong postvaccination responses. The Luminex method is an attractive alternative to ELISA since it reduces labor and reagent costs, as well as assay time.
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Affiliation(s)
- Jerry W Pickering
- Associated Regional and University Pathologists, Institute for Clinical and Experimental Pathology, Salt Lake City, Utah 84108, USA.
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27
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Romero-Steiner S, Fernandez J, Biltoft C, Wohl ME, Sanchez J, Feris J, Balter S, Levine OS, Carlone GM. Functional antibody activity elicited by fractional doses of Haemophilus influenzae type b conjugate vaccine (polyribosylribitol phosphate-tetanus toxoid conjugate). CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2001; 8:1115-9. [PMID: 11687449 PMCID: PMC96235 DOI: 10.1128/cdli.8.6.1115-1119.2001] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We evaluated the functional activities of antibodies, serum bactericidal activity (SBA), and immunoglobulin G (IgG) antibody avidity indices, using sodium thiocyanate (NaSCN) elution, elicited after vaccination with fractional doses of the Haemophilus influenzae type b conjugate (polyribosylribitol phosphate [PRP] conjugated to tetanus toxoid [PRP-T]) vaccine. A cohort of 600 infants from the Dominican Republic were randomized to receive one of three regimens of the PRP-T vaccine at ages 2, 4, and 6 months: full doses (10 microg of PRP antigen), one-half doses (5.0 microg), and one-third doses (3.3 microg) (J. Fernandez et al., Am. J. Trop. Med. Hyg. 62:485-490, 2000). Sixty serum samples, collected at age 7 months, with > or =2.0 microg of anti-PRP IgG per ml were randomly selected for avidity determinations. Geometric mean IgG concentrations were 13, 14, and 17 microg/ml for infants who received the full-dose (n = 19), one-half-dose (n = 19), and one-third-dose (n = 22) regimens, respectively. SBA geometric mean titers (1/dilution) were 85.0, 82.0, and 76.1 in sera from infants receiving the full-, one-half-, and one-third-dose regimens, respectively. Avidity indices (mean +/- standard error weighted average of NaSCN molar concentration x serum dilution factor) were 71.9 +/- 9.4, 123.6 +/- 26.8, and 150.9 +/- 24.9 for the full-, one-half-, and one-third-dose regimens, respectively. Upon comparison, the only significant difference (P = 0.024) found was a greater avidity index for sera from infants receiving the one-third-dose regimen than for sera from infants receiving the the full-dose regimen. We conclude that fractional doses elicit similar functional antibody activities in infants with > or = 2 microg of anti-PRP IgG per ml, corresponding to 89, 90, and 97% of infants receiving three doses of either the full concentration or one-half or one-third of the labeled concentration, respectively. This approach offers an alternative strategy for the prevention of H. influenzae type b disease in countries with limited resources.
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Affiliation(s)
- S Romero-Steiner
- Immunology Section, Respiratory Diseases Branch, Division of Bacterial and Mycotic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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28
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Quataert S, Martin D, Anderson P, Giebink GS, Henrichsen J, Leinonen M, Granoff DM, Russell H, Siber G, Faden H, Barnes D, Madore DV. A multi-laboratory evaluation of an enzyme-linked immunoassay quantitating human antibodies to Streptococcus pneumoniae polysaccharides. Immunol Invest 2001; 30:191-207. [PMID: 11570640 DOI: 10.1081/imm-100105064] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
An enzyme-linked immunoassay (EIA) is described and evaluated which quantitates human antibodies to serotype specific S. pneumoniae polysaccharide (PnPs) in human sera. Based on the observations previously described by Koskela (1), native PnPs are used as coating antigens and sera are absorbed with a soluble pneumococcal absorbant material containing C-polysaccharide (CPs) to ensure measurement of serotype specific anti-PnPs antibodies. The robustness of this method was evaluated by ten laboratories using the same reagents, protocol, and five human serum samples. Reproducible antibody values were obtained for IgM, IgG, and IgA antibodies to five different PnPs serotypes, 3, 6B, 14, 19F, and 23F. The overall mean percent coefficients of variation in this interlaboratory study for all five selotype specific anti-PnPs determinations with the five coded sera were 30% for IgG, 3/% for IgM, and 36% for IgA. This assay can be standardized for quantitation of serotype specific anti-PnPs antibodies, allowing comparison of antibody values in vaccine trials evaluating pneumococcal vaccines.
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Affiliation(s)
- S Quataert
- Wyeth-Lederle Vaccines, Rochester, New York, USA
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29
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Bramley JC, Hall T, Finn A, Buttery RB, Elliman D, Lockhart S, Borrow R, Jones IG. Safety and immunogenicity of three lots of meningococcal serogroup C conjugate vaccine administered at 2, 3 and 4 months of age. Vaccine 2001; 19:2924-31. [PMID: 11282204 DOI: 10.1016/s0264-410x(00)00528-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The reactogenicity and immunogenicity of meningococcal serogroup C conjugate (MenC) vaccine was assessed in 322 infants vaccinated at 2, 3, and 4 months of age, with concomitant administration of mixed diphtheria-tetanus-whole-cell pertussis vaccine and Haemophilus influenzae type b conjugate vaccine (DTwP-Hib) and oral polio vaccine. All infants in whom post-vaccination meningococcal C anticapsular IgG levels were assayed (n = 265) attained > or = 2 microg ml(-1). Serum bactericidal titres were assayed for a proportion of subjects (n = 171), 98% of whom obtained a reciprocal titres > or = 8. Local reactions were less frequent at the MenC injection site than at the DTP-Hib site. Systemic events were frequent, but consistent with established DTwP-Hib experience. The study demonstrates that MenC vaccine is immunogenic and well tolerated in infants at manufacturing scale production levels.
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Affiliation(s)
- J C Bramley
- Scottish Centre for Infection and Environmental Health, Clifton House, Clifton Place, Glasgow G3 7LN, UK.
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30
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Rodrigo MJ, Vendrell M, Cruz MJ, Miravitlles M, Pascual C, Morell F, De Gracia J. Utility of the antibody response to a conjugated Haemophilus influenzae type B vaccine for diagnosis of primary humoral immunodeficiency. Am J Respir Crit Care Med 2000; 162:1462-5. [PMID: 11029362 DOI: 10.1164/ajrccm.162.4.9910088] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Antibody response to an Haemophilus influenzae type b (Hib)-conjugated vaccine was studied in 59 healthy adults (mean age: 32 yr) and 22 patients with humoral immunodeficiencies (mean age: 32 yr) to determine its usefulness in the diagnosis of defective antibody formation. Twenty of the healthy adults and nine of the patients were also immunized with a pneumococcal vaccine. Serum specific antibodies were measured by ELISA. Adequate response to both vaccines was defined using the lower limit of the two-tailed 90% probability interval of postimmunization specific IgG of the healthy adults. By using this cutoff, responders were considered to be those with an absolute increase in anti-Hib IgG titers higher than 2.28 microgram/ml, and in anti-Streptococcus pneumoniae IgG higher than 395 arbitrary units/ml. With these criteria, 85% (50 of 59) of the healthy adults responded with anti-Hib IgG and 75% (15 of 20) with anti-pneumococcal IgG. All healthy adults receiving both vaccines responded to at least one. None of the patients with humoral immunodeficiencies responded to either vaccine. Evaluation of the antibody response to both the Hib and pneumococcal vaccines may facilitate the diagnosis of humoral immunodeficiency and selection of patients to receive immunoglobulin therapy.
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Affiliation(s)
- M J Rodrigo
- Departments of Pneumology and Biochemistry (Immunology Unit), Hospital General Vall d'Hebron, Barcelona, Spain
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31
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Plikaytis BD, Goldblatt D, Frasch CE, Blondeau C, Bybel MJ, Giebink GS, Jonsdottir I, Käyhty H, Konradsen HB, Madore DV, Nahm MH, Schulman CA, Holder PF, Lezhava T, Elie CM, Carlone GM. An analytical model applied to a multicenter pneumococcal enzyme-linked immunosorbent assay study. J Clin Microbiol 2000; 38:2043-50. [PMID: 10834951 PMCID: PMC86724 DOI: 10.1128/jcm.38.6.2043-2050.2000] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Pneumococcal conjugate vaccines will eventually be licensed after favorable results from phase III efficacy trials. After licensure of a conjugate vaccine for invasive pneumococcal disease in infants, new conjugate vaccines will likely be licensed primarily on the basis of immunogenicity data rather than clinical efficacy. Analytical methods must therefore be developed, evaluated, and validated to compare immunogenicity results accurately within and between laboratories for different vaccines. At present no analytical technique is uniformly accepted and used in vaccine evaluation studies to determine the acceptable level of agreement between a laboratory result and the assigned value for a given serum sample. This multicenter study describes the magnitude of agreement among 12 laboratories quantifying an identical series of 48 pneumococcal serum specimens from 24 individuals (quality-control sera) by a consensus immunoglobulin G (IgG) enzyme-linked immunosorbent assay (ELISA) developed for this study. After provisional or trial antibody concentrations were assigned to the quality-control serum samples for this study, four methods for comparison of a series of laboratory-determined values with the assigned concentrations were evaluated. The percent error between assigned values and laboratory-determined concentrations proved to be the most informative of the four methods. We present guidelines that a laboratory may follow to analyze a series of quality-control sera to determine if it can reproduce the assigned antibody concentrations within an acceptable level of tolerance. While this study focused on a pneumococcal IgG ELISA, the methods that we describe are easily generalizable to other immunological assays.
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Affiliation(s)
- B D Plikaytis
- Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
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32
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Bulkow LR, Levine OS, Singleton R, Carlone GM, Pais L, Parkinson AJ. Enhanced immunogenicity of a sequential Haemophilus influenzae type B vaccine schedule in Alaska native infants. Pediatr Infect Dis J 1999; 18:1023-4. [PMID: 10571446 DOI: 10.1097/00006454-199911000-00021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- L R Bulkow
- National Center for Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK 99508, USA
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33
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Lukkarinen M, Parto K, Ruuskanen O, Vainio O, Käyhty H, Olander RM, Simell O. B and T cell immunity in patients with lysinuric protein intolerance. Clin Exp Immunol 1999; 116:430-4. [PMID: 10361230 PMCID: PMC1905322 DOI: 10.1046/j.1365-2249.1999.00868.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Lysinuric protein intolerance (LPI) is characterized by defective cellular transport of the dibasic amino acids, secondary dysfunction of the urea cycle, aversion to dietary protein, failure to thrive, hepatosplenomegaly and osteoporosis. Because several patients have suffered from recurrent respiratory infections and/or severe generalized varicella, and a few have developed systemic lupus, vasculitis or other autoimmune diseases, we have now evaluated the function of patients' immune systems. Serum concentrations of one to three IgG subclasses were decreased in 10 of the 12 patients studied. Antibody titres against diphtheria, tetanus and Haemophilus influenzae (Hib) were below the detection limit of the assay in four, three and eight of the 11 patients examined, respectively. (Re)vaccination of these 11 patients led to satisfactory responses against tetanus, but two patients still failed to develop measurable antibodies against diphtheria, two against Hib and six against one or more of the three serotypes of 23-valent pneumococcus vaccine. The proportions of T cells of all lymphocytes and the proliferative responses of the peripheral blood mononuclear cells were normal. In conclusion, humoral immune responses in some patients with LPI are defective and these patients may benefit from intravenous immunoglobulin therapy.
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Affiliation(s)
- M Lukkarinen
- Department of Paediatrics, University of Turku, Finland.
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34
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Madore DV, Quataert SA. Interlaboratory reproducibility of an enzyme-linked immunosorbent assay for quantitation of antibodies for Haemophilus influenzae type b polysaccharide. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 1999; 6:446. [PMID: 10490332 PMCID: PMC103743 DOI: 10.1128/cdli.6.3.446-446.1999] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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35
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Madore DV. Characterization of immune response as an indicator of Haemophilus influenzae type b vaccine efficacy. Pediatr Infect Dis J 1998; 17:S207-10. [PMID: 9781765 DOI: 10.1097/00006454-199809001-00027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Quantitation of antibodies to Haemophilus influenzae type b (Hib) polysaccharide has been an active area of investigation associated with the development of polysaccharide and subsequently polysaccharide-protein conjugate vaccines. These clinical studies indicate that there are several serologic parameters associated with Hib vaccine efficacy in infants. Efficacious vaccines elicit polysaccharide-specific antibodies in infants; they prime the immune system for an anamnestic response; the immune response is long-lived through the period of greatest risk for disease; and the elicited antibodies have functional activity as demonstrated in bactericidal and opsonophagocytic assays or protection in an infant rat challenge model. The immune response to different Hib vaccines varies both quantitatively and qualitatively. With the introduction of routine Hib vaccine immunization, vaccine performance can rely on these serologic parameters. Quantitative serologic assays, the radio-antigen binding and enzyme-linked immunosorbent assays, have been developed and standardized. The quality of the antigen as well as optimization of all assay steps and reagents are key to ensuring specific and reproducible antibody quantitation.
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Affiliation(s)
- D V Madore
- Wyeth-Lederle Vaccines and Pediatrics, West Henrietta, NY, USA
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36
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Rennels MB, Hohenboken MJ, Reisinger KS, Clements DA, Walter EB, Blatter MM, Nonenmacher J, Hackell JG. Comparison of acellular pertussis-diphtheria-tetanus toxoids and Haemophilus influenzae type b vaccines administered separately vs. combined in younger vs. older toddlers. Pediatr Infect Dis J 1998; 17:164-6. [PMID: 9493818 DOI: 10.1097/00006454-199802000-00019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- M B Rennels
- Department of Pediatrics and Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, USA.
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37
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Lynn F, Reed GF, Meade BD. Collaborative study for the evaluation of enzyme-linked immunosorbent assays used to measure human antibodies to Bordetella pertussis antigens. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 1996; 3:689-700. [PMID: 8914760 PMCID: PMC170432 DOI: 10.1128/cdli.3.6.689-700.1996] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Acellular pertussis vaccines are being evaluated in multiple clinical studies, and human immunogenicity data will likely be pivotal in the appraisal of vaccine responses between populations and the responses to different vaccine combinations. Antibody response to pertussis antigens is also used in the diagnosis of pertussis. An international study was designed to assess the comparability of data generated in different laboratories by enzyme-linked immunosorbent assays (ELISAs). Thirty-three participating laboratories were asked to quantitate specific antibody to pertussis toxin (PT), filamentous hemagglutinin (FHA), pertactin (PRN), or fimbrial proteins (FIM) in 21 samples. Samples were to be assayed in triplicate in five independent assays by each ELISA routinely performed in the laboratory to assess intra-assay, interassay, and population variability. The mean sample values were used to compare quantitative results among the laboratories. Thirteen of the 32 laboratories which submitted evaluable data for an assay to measure antibodies to PT, 12 of 30 laboratories with assays for FHA, 10 of 17 laboratories with assays for PRN, and 6 of 13 laboratories with assays for FIM maintained a coefficient of variation below 20% for 75% of the samples tested. Assays that measure antibodies to FIM appear to be less precise than the other assays. Precision varied among laboratories that used similar methods. The relative values of intra- and interassay variabilities were not consistent for a given assay within a laboratory, indicating that the sources of these variability components may be unrelated. Precision and agreement appeared less reliable for samples with low antibody levels. Ranking and regression analyses suggest that some laboratories generated comparable quantitative results, although direct comparison or combination of results from different laboratories remains difficult to support. Calibration to the U.S. Reference Pertussis Antisera appears to have been successful at standardizing the results in some laboratories. Statistical analyses are affected by assay precision and are not necessarily reliable sole predictors of biologically relevant differences in quantitative results. If results from different laboratories must be compared, appropriate studies of precision and quantitative agreement should be conducted to support the specific comparisons.
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Affiliation(s)
- F Lynn
- Laboratory of Pertussis, Food and Drug Administration, Rockville, Maryland 20852, USA.
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