Kinetics of maternal pertussis-specific antibodies in infants of mothers vaccinated with tetanus, diphtheria and acellular pertussis (Tdap) during pregnancy
Kinetics of maternal pertussis-specific antibodies in infants of mothers vaccinated with tetanus, diphtheria and acellular pertussis (Tdap) during pregnancy
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DOI：
10.1016/j.vaccine.2020.06.050
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发表时间：
2020-08-18
期刊：
影响因子：
5.5
通讯作者：
Patel, Divya
中科院分区：
文献类型：
--
作者：
Healy, C. Mary;Rench, Marcia A.;Patel, Divya
背景：tdap诱导的母源抗体在婴儿中的动力学尚不清楚。前百日咳时代的数据表明，婴儿母亲百日咳抗体的半衰期约为5-6周。方法：2014年6月至2015年3月期间，在产妇接种Tdap疫苗前、4周后、分娩时（产妇和脐带）、婴儿3周和6周时采集34对母婴血液。多重荧光法测定百日咳毒素（PT）免疫球蛋白G （IgG）、丝状血凝素（FHA）、纤毛蛋白（FIM）和peractn （PRN）含量（IU/ml）。计算百日咳抗体的几何平均浓度（GMCs）、95%置信区间（ci）和半衰期。结果：34例平均妊娠30.7周（28-32.7周）的妇女接受Tdap治疗，平均年龄31.1岁。平均新生儿妊娠39.1周（36-41.1），平均出生体重3379 g（2580-4584）。接种百日咳疫苗4周后，接受PT、FHA、FIM和PRN治疗的女性中，分别有59%、41%、29%和44%的女性百日咳特异性IgG GMCs增加了4倍，然后下降。PT、FHA、FIM和PRN经胎盘转运比分别为1.35、1.41、1.31和1.36。从出生到6周，婴儿血清PT特异性IgG GMC从55.1 IU/ml（38.6-78.6）降至21.1 IU/ml (14.7-30.2)， PT水平>= 10 IU/ml的婴儿比例从97%降至67%。婴儿百日咳特异性IgG的半衰期PT为29.4 (95% CI 27.3-31.7)， FHA为29.8 (95% CI 27.7-32.2)， PRN为31.2 (95% CI 28.9-33.7)， FIM为35.8 （95% CI 30.1-44.3）。结论：母亲接种百日咳疫苗诱导的婴儿百日咳特异性抗体的半衰期（29-36天）比以往报道的要短。了解被动获得性抗体的持久性如何影响婴儿对百日咳的易感性和对初级疫苗接种的反应，对于完善预防策略至关重要。(C) 2020 Elsevier Ltd.版权所有。
Background: Kinetics of Tdap-induced maternally-derived antibodies in infants are poorly understood. Pre-Tdap era data suggest that maternal pertussis antibodies in infants have a half-life of approximately 5-6 weeks.Methods: 34 mother-infant pairs had blood collected before maternal Tdap vaccination, 4 weeks later, at delivery (maternal and cord), and at infant ages 3 and 6 weeks from June 2014-March 2015. Immunoglobulin G (IgG) to pertussis toxin (PT), filamentous hemagglutinin (FHA), fimbrial proteins (FIM) and pertactin (PRN) was quantified by multiplex luminex assay (IU/ml). Geometric mean concentrations (GMCs) with 95% confidence intervals (C.I.) and half-life of pertussis antibodies were calculated.Results: Tdap was administered to 34 women (mean age 31.1 years) at mean gestation 30.7 weeks (28-32.7). Mean neonatal gestation was 39.1 weeks (36-41.1) and mean birthweight was 3379 g (2580-4584). Four weeks post-Tdap vaccination, maternal pertussis-specific IgG GMCs increased >= 4-fold in 59%, 41%, 29% and 44% of women for PT, FHA, FIM and PRN, respectively, and then waned. The transplacental transport ratio of pertussis antibodies was 1.35 for PT, 1.41 for FHA, 1.31 for FIM and 1.36 for PRN. Between birth and age 6 weeks, infant serum GMC for PT-specific IgG decreased from 55.1 IUMIL (38.6-78.6) to 21.1 IU/ml (14.7-30.2), and the proportion of infants with PT levels >= 10 IU/ml fell from 97% to 67%. Half-life of pertussis-specific IgG in infants in days was 29.4 (95% CI 27.3-31.7) for PT, 29.8 (95% CI 27.7-32.2) for FHA, 31.2 (95% CI 28.9-33.7) for PRN, and 35.8 (95% CI 30.1-44.3) for FIM.Conclusion: The half-life of pertussis-specific antibodies in infants induced by maternal Tdap vaccination (29-36 days) is shorter than previously reported. Understanding how the durability of passively-acquired antibodies impacts infant susceptibility to pertussis and response to primary vaccination is critical to refine prevention strategies. (C) 2020 Elsevier Ltd. All rights reserved.