OTITIS-MEDIA IN CHILDREN .1. THE SYSTEMIC IMMUNE-RESPONSE TO NONTYPABLE HEMOPHILUS-INFLUENZAE
OTITIS-MEDIA IN CHILDREN .1. THE SYSTEMIC IMMUNE-RESPONSE TO NONTYPABLE HEMOPHILUS-INFLUENZAE
复制标题
DOI：
10.1093/infdis/160.6.999
复制
发表时间：
1989-12-01
影响因子：
6.4
通讯作者：
OGRA, PL
中科院分区：
文献类型：
--
作者：
FADEN, H;BERNSTEIN, J;OGRA, PL
在2年的观察期间，21名婴儿经历了29次由非典型流感嗜血杆菌（NTHI）引起的渗出性中耳炎。在26%的受试者的急性血清中检测到杀菌抗体，平均滴度为0.8 ± 0.5。0.3（log2），并且在所有个体的恢复期血清中观察到平均滴度为4.0 ± 1.0。0.3（log2，P < .001）。血清杀菌抗体反应与年龄无关（r = 0.08，P > 0.05）。在整个观察期间，90%的儿童血清杀菌抗体浓度保持稳定。血清杀菌抗体的存在与中耳液中细菌数量的减少显著相关（P <0.025）。八名儿童经历了第二次发作的中耳炎与分泌液引起的不同血清型的NTHI。所有缺乏针对引起第二次发病的微生物的杀菌抗体的人在第二次发病时都具有针对第一种菌株的杀菌抗体。这些数据表明，分泌性中耳炎对NTHI的免疫应答是类型特异性的。由于不同菌株的NTHI在面对预先存在的异源杀菌抗体时发生第二次渗出性中耳炎，表明缺乏交叉保护。
Twenty-one infants experienced 29 episodes of otitis media with effusion caused by nontypable Haemophilus influenzae (NTHI) during 2 y of observation. Bactericidal antibody was detected in acute serum of 26% of the subjects at a mean titer of 0.8 .+-. 0.3 (log2) and was observed in convalescent serum of all of the individuals at a mean titer of 4.0 .+-. 0.3 (log2, P < .001). The serum bactericidal antibody response was not age-dependent (r = .08, P > .05). Serum concentrations of bactericidal antibody remained stable for the entire observation period in 90% of the children. The presence of serum bactericidal antibody correlated significantly with a reduction in the number of bacteria present in the middle ear fluid (P < .025). Eight children experienced a second episode of otitis media with effusion caused by a different serotype of NTHI. All those who lacked bactericidal antibody against the organism causing the second episode possessed bactericidal antibody against the first strain at the time of the second episode. These data suggest that the immune response to NTHI in otitis media with effusion is type-specific. The occurrence of second episodes of otitis media with effusion due to different strains of NTHI in the face of preexisting heterologous bactericidal antibody suggests a lack of cross-protection.