Christine Jones1, Louisa Pollock2, Sara M Barnett3, Anna Battersby4, Beate Kampmann5. 1. Academic Department of Paediatrics, Imperial College London, 2nd Floor Wright Fleming Building, Norfolk Place, London W2 1PG, UK(4). Electronic address: cjones@sgul.ac.uk. 2. Vaccinology Theme, Medical Research Council Unit - The Gambia, PO Box 273, Banjul, Gambia(5). Electronic address: l.pollock@imperial.ac.uk. 3. Academic Department of Paediatrics, Imperial College London, 2nd Floor Wright Fleming Building, Norfolk Place, London W2 1PG, UK(4). Electronic address: s.barnett@imperial.ac.uk. 4. Academic Department of Paediatrics, Imperial College London, 2nd Floor Wright Fleming Building, Norfolk Place, London W2 1PG, UK(4); Vaccinology Theme, Medical Research Council Unit - The Gambia, PO Box 273, Banjul, Gambia(5). Electronic address: a.battersby@imperial.ac.uk. 5. Academic Department of Paediatrics, Imperial College London, 2nd Floor Wright Fleming Building, Norfolk Place, London W2 1PG, UK(4); Vaccinology Theme, Medical Research Council Unit - The Gambia, PO Box 273, Banjul, Gambia(5). Electronic address: b.kampmann@imperial.ac.uk.
Abstract
BACKGROUND AND AIMS: Trans-placentally acquired antibodies can protect infants from infection in the first months of life. However, high concentrations of antibody at birth may impact the infant's own immune response to primary immunization. We examine the relationship between concentration of specific antibody to Bordetella pertussis, Haemophilus influenzae type b (Hib), tetanus toxoid and pneumococcal antigens at birth and following primary immunization. METHODS: Healthy mother-infant pairs were recruited from a UK maternity unit. Peripheral blood samples were obtained at birth and 4 weeks after primary immunization. Specific antibody concentrations were determined using enzyme-linked immunosorbent assays. Pertussis antibody concentrations >50 IU/ml, Tetanus antibody levels >0.1 IU/ml and Hib antibody levels >0.15 mg/l were regarded as protective. RESULTS: Following primary immunization, 35/36 (97%) infants had specific antibody concentrations associated with protection against Hib, 32/36 (89%) against pertussis and 36/36 (100%) against tetanus. Concentrations of all specific antibodies were significantly higher than at birth (p<0.0001), except anti-tetanus toxoid, p=0.41. However, there was an inverse correlation between infant antibody concentration at birth and fold-increase in antibody concentration post-immunization for tetanus: rs -0.86 (95%CI -0.93 to -0.74), p<0.0001; pneumococcus: rs -0.82 (95% CI -0.91 to -0.67), p<0.0001; pertussis: rs -0.77 (95% CI -0.89 to -0.58), p<0.0001 and Hib: rs -0.66 (95%CI -0.82 to -0.42), p<0.0001. The highest concentrations of specific IgG at birth were associated with lower concentrations post-immunization for tetanus (p=0.009) and pneumococcus (p=0.03). This association was not observed for Hib (p=0.88) or pertussis (p=0.14). CONCLUSION: Higher antibody concentration at birth appeared to inhibit the response to infant immunization for tetanus and pneumococcus; the effect was less marked for Hib and pertussis. However, the majority of infants achieved high antibody levels post-immunization. This supports maternal immunization, as high levels of maternally derived antibody at birth may not inhibit infants' immunization responses in a clinically relevant manner.
BACKGROUND AND AIMS: Trans-placentally acquired antibodies can protect infants from infection in the first months of life. However, high concentrations of antibody at birth may impact the infant's own immune response to primary immunization. We examine the relationship between concentration of specific antibody to Bordetella pertussis, Haemophilus influenzae type b (Hib), tetanus toxoid and pneumococcal antigens at birth and following primary immunization. METHODS: Healthy mother-infant pairs were recruited from a UK maternity unit. Peripheral blood samples were obtained at birth and 4 weeks after primary immunization. Specific antibody concentrations were determined using enzyme-linked immunosorbent assays. Pertussis antibody concentrations >50 IU/ml, Tetanus antibody levels >0.1 IU/ml and Hib antibody levels >0.15 mg/l were regarded as protective. RESULTS: Following primary immunization, 35/36 (97%) infants had specific antibody concentrations associated with protection against Hib, 32/36 (89%) against pertussis and 36/36 (100%) against tetanus. Concentrations of all specific antibodies were significantly higher than at birth (p<0.0001), except anti-tetanus toxoid, p=0.41. However, there was an inverse correlation between infant antibody concentration at birth and fold-increase in antibody concentration post-immunization for tetanus: rs -0.86 (95%CI -0.93 to -0.74), p<0.0001; pneumococcus: rs -0.82 (95% CI -0.91 to -0.67), p<0.0001; pertussis: rs -0.77 (95% CI -0.89 to -0.58), p<0.0001 and Hib: rs -0.66 (95%CI -0.82 to -0.42), p<0.0001. The highest concentrations of specific IgG at birth were associated with lower concentrations post-immunization for tetanus (p=0.009) and pneumococcus (p=0.03). This association was not observed for Hib (p=0.88) or pertussis (p=0.14). CONCLUSION: Higher antibody concentration at birth appeared to inhibit the response to infant immunization for tetanus and pneumococcus; the effect was less marked for Hib and pertussis. However, the majority of infants achieved high antibody levels post-immunization. This supports maternal immunization, as high levels of maternally derived antibody at birth may not inhibit infants' immunization responses in a clinically relevant manner.
Authors: Merryn Voysey; Dominic F Kelly; Thomas R Fanshawe; Manish Sadarangani; Katherine L O'Brien; Rafael Perera; Andrew J Pollard Journal: JAMA Pediatr Date: 2017-07-01 Impact factor: 16.193
Authors: Ronald S Veazey; Yingjie Lu; Huanbin Xu; Widade Ziani; Lara A Doyle-Meyers; Marion S Ratterree; Xiaolei Wang Journal: J Med Primatol Date: 2017-06-06 Impact factor: 0.667
Authors: Richard H Beigi; Kimberly B Fortner; Flor M Munoz; Jeff Roberts; Jennifer L Gordon; Htay Htay Han; Greg Glenn; Philip R Dormitzer; Xing Xing Gu; Jennifer S Read; Kathryn Edwards; Shital M Patel; Geeta K Swamy Journal: Clin Infect Dis Date: 2014-12-15 Impact factor: 9.079