Serotype-specific immunoglobulin G antibody responses to pneumococcal polysaccharide vaccine in children with sickle cell anemia: effects of continued penicillin prophylaxis.
Serotype-specific immunoglobulin G antibody responses to pneumococcal polysaccharide vaccine in children with sickle cell anemia: effects of continued penicillin prophylaxis.
复制标题
镰状细胞性贫血儿童对肺炎球菌多糖疫苗的血清型特异性免疫球蛋白 G 抗体反应：持续青霉素预防的效果。
DOI：
10.1016/s0022-3476(96)70026-4
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发表时间：
1996
期刊：
影响因子：
--
通讯作者：
Vichinsky,
中科院分区：
文献类型：
--
作者：
Bjornson,AB;Falletta,JM;Verter,JI;Buchanan,GR;Miller,ST;Pegelow,CH;Iyer,RV;Johnstone,HS;DeBaun,MR;Wethers,DL;Wang,WC;Woods,GM;Holbrook,CT;Becton,DL;Kinney,TR;Reaman,GH;Kalinyak,K;Grossman,NJ;Vichinsky,
目的：(1)确定5岁镰状细胞性贫血儿童对肺炎球菌多糖疫苗再免疫的血清型特异性IgG抗体反应；(2)确定持续青霉素预防是否对这些反应有任何不良影响。研究设计：在5岁生日前接受预防性青霉素治疗至少2年的镰状细胞性贫血儿童，在5岁时随机选择继续进行青霉素预防治疗或接受安慰剂治疗。这些儿童在儿童早期接种过一次或两次肺炎球菌多糖疫苗，并在随机分组时再次接种。结果：血清型特异性IgG抗体对再免疫的反应因肺炎球菌血清型而异，但总体为中等或较差；反应最差的是血清型6B。在继续进行青霉素预防或安慰剂治疗的受试者中，以及在再次免疫前接受一到两次肺炎球菌疫苗接种的受试者中，抗体反应相似。肺炎球菌菌血症的发生与感染血清型IgG抗体浓度低有关。结论：5岁时接受肺炎球菌多糖疫苗的镰状细胞性贫血儿童的再免疫可诱导有限的血清型特异性IgG抗体的产生，与既往肺炎球菌疫苗史无关。持续的青霉素预防不会干扰血清型特异性IgG抗体对再免疫的反应。[J]儿科杂志1996；129:828-35。
OBJECTIVES: (1) To determine serotype-specific IgG antibody responses to reimmunization with pneumococcal polysaccharide vaccine at age 5 years in children with sickle cell anemia and (2) to determine whether continued penicillin prophylaxis had any adverse effects on these responses. STUDY DESIGN: Children with sickle cell anemia, who had been treated with prophylactic penicillin for at least 2 years before their fifth birthday, were randomly selected at age 5 years to continue penicillin prophylaxis or to receive placebotreatment. These children had been immunized once or twice in early childhood with pneumococcal polysaccharide vaccine and were reimmunized at the time of randomization. RESULTS: Serotype-specific IgG antibody responses to reimmunization varied according to pneumococcal serotype but in general were mediocre or poor; the poorest response was to serotype 6B. The antibody responses were similar in subjects with continued penicillin prophylaxis or placebo treatment, and in subjects who received one or two pneumococcal vaccinations before reimmunization. The occurrence of pneumococcal bacteremia was associated with low IgG antibody concentrations to the infecting serotype. CONCLUSIONS: Reimmunization of children with sickle cell anemia who received pneumococcal polysaccharide vaccine at age 5 years induces limited production of serotype-specific IgG antibodies, regardless of previous pneumococcal vaccine history. Continued penicillin prophylaxis does not interfere with serotype-specific IgG antibody responses to reimmunization. (J Pediatr 1996;129:828-35)