Serum IgA and IgG functional antibodies and their subclasses to Streptococcus pneumoniae capsular antigen found in two aged-matched cohorts of children with and without otitis media with effusion
Serum IgA and IgG functional antibodies and their subclasses to Streptococcus pneumoniae capsular antigen found in two aged-matched cohorts of children with and without otitis media with effusion
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DOI：
10.1046/j.1365-2273.2003.00717.x
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发表时间：
2003-08-01
影响因子：
2.1
通讯作者：
Dunn, C
中科院分区：
文献类型：
--
作者：
Drake-Lee, AB;Hughes, RG;Dunn, C
急性中耳炎和渗出性中耳炎（OME）之间的关系尚不确定，OME的病因是多因素的。渗出性中耳炎可能是一种炎症性疾病;细菌和病毒感染都可能在这种炎症中发挥作用。肺炎链球菌、流感嗜血杆菌、金黄色葡萄球菌和卡他布兰汉氏菌四种细菌引起60%的感染，而S。肺炎占35%。伊加提供对多糖和脂多糖抗原的主要表面应答，其中伊加（2）是主要亚类。一旦粘膜被破坏，大部分保护作用由IgG提供。IgG（2）主要作用于细菌荚膜抗原。这项研究观察了两组50名患有和没有OME的儿童，年龄在3到10岁之间。目的是确定，首先，血清免疫球蛋白水平是否在两组中不同，其次，这些儿童是否对S.肺炎（PCP），最后，如果有一个伊加反应的成熟延迟。采用放射免疫扩散法测定总IgG、伊加及各亚类水平。使用ELISA法测定功能性伊加和IgG水平（每组25例患者）。用非参数检验分析结果。两组的免疫球蛋白水平均在正常水平范围内。IgG总抗PCP和IgG（2）抗PCP之间存在非常好的相关性（R > 0.9，p = 0.001）。两组血清IgG总抗PCP和IgG（2）抗PCP与伊加总抗PCP均呈良好的相关性（R > 0.85，p > 0.01）。这证实了两组患者之间的正常抗体应答。对照组和患者（50个样本）的年龄与循环功能性抗体滴度的增加相关（P = 0.001）。这是一个正常的年龄相关的反应。总之，研究结果与我们最初的假设相矛盾，即有和没有OME的儿童在表面保护方面存在细微差异。我们认为，复发性急性中耳炎的既往病史与3岁后OME的发生无关。
The relationship between acute otitis media and otitis media with effusion (OME) is uncertain and the aetiology of OME is multifactorial. Otitis media with effusion may be an inflammatory condition; both bacteria and viral infections could play a part in this inflammation. The four bacteria Streptococcus pneumoniae, Haemophilus influenza, Staphylococcus aureus and Branhamella catarrhalis cause 60% of the infections whereas S. pneumoniae accounts for up to 35%. IgA provides the dominant surface response to polysaccharide and lipopolysaccharide antigens, of which IgA(2) is the main subclass. Once the mucosa has been breached, most protection is provided by IgG. IgG(2) acts mainly against bacterial capsular antigens. This study looked at two groups of 50 children with and without OME who were aged between 3 and 10 years. The aims were to determine if, firstly, the levels of the serum immunoglobulins were different in the two groups, secondly whether these children made the appropriate antibody response to the capsular antigen to S. pneumoniae (PCP), and finally if there was a delay in the maturity of the IgA response. The total IgG, IgA and all subclass levels were measured using radial immunodiffusion. Levels of functional IgA and IgG were measured using ELISAs (25 patients in each group). The results were analysed with non-parametric tests. The immunoglobulin levels were within the normal levels for both groups. There were very good correlations between the IgG total anti-PCP and the IgG(2) anti-PCP (R > 0.9, p = 0.001). There was a good correlation between the levels of both IgG total and IgG(2) anti-PCP against IgA total anti-PCP in both groups (R > 0.85, p > 0.01). This confirms a normal antibody response between both groups of patients. The ages of the controls and patients (50 samples) were correlated with increasing titres of circulating functional antibodies (P = 0.001). This is highly suggestive of a normal age-related response. In conclusion, the findings were contradictory to our original hypothesis that there is a subtle difference in surface protection between children with and without OME. We believe that a previous history of recurrent acute otitis media is unrelated to the development of OME after 3 years of age.