Monkeypox-induced immunity and failure of childhood smallpox vaccination to provide complete protection
Monkeypox-induced immunity and failure of childhood smallpox vaccination to provide complete protection
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DOI：
10.1128/cvi.00148-07
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发表时间：
2007-10-01
影响因子：
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通讯作者：
Damon, Inger K.
中科院分区：
文献类型：
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作者：
Karem, Kevin L.;Reynolds, Mary;Damon, Inger K.
在2003年美国猴痘暴发后，从病例（按标准定义）和病例的家庭接触者中收集了血液标本和临床及流行病学数据，以评估预先存在（天花疫苗衍生）和获得性免疫在猴痘易感性和临床结果中的作用。在暴露后7 ~ 14周和1年测量正痘病毒特异性免疫球蛋白G （IgG）、IgM、CD4、CD8和b细胞应答。评估了免疫应答、天花疫苗接种、表皮学和临床数据之间的关系。参与者被分为四组：(i)接种疫苗病例，（ii）未接种疫苗病例，（iii）接种疫苗接触者，（iv）未接种疫苗接触者。无论接种情况如何，病例均呈正痘病毒特异性IgM、IgG、CD4、CD8和b细胞反应阳性。在一些未发生猴痘的接触者中观察到与感染相符的抗正痘病毒免疫反应。接种疫苗的接触者维持低水平的抗正痘病毒IgG、CD4和b细胞应答，大多数缺乏IgM或CD8应答。通过高抗正痘病毒IgG水平和儿童天花疫苗接种评估，先前存在的免疫力与轻度疾病相关（但不显著）。疫苗接种未能对人类猴痘提供完全保护。先前接种猴痘疫苗的病例表现为抗正痘病毒IgM和抗正痘病毒IgG、CD4、CD8或b细胞反应的变化，作为最近感染的标志。抗正痘病毒IgM和CD8反应最常见于猴痘病例（接种疫苗和未接种疫苗），IgG、CD4和记忆b细胞反应表明疫苗衍生免疫。免疫标记提供了一些接种疫苗和未接种疫苗个体无症状感染的证据。
Following the U.S. monkeypox outbreak of 2003, blood specimens and clinical and epidemiologic data were collected from cases, defined by standard definition, and household contacts of cases to evaluate the role of preexisting (smallpox vaccine-derived) and acquired immunity in susceptibility to monkeypox disease and clinical outcomes. Orthopoxvirus-specific immunoglobulin G (IgG), IgM, CD4, CD8, and B-cell responses were measured at similar to 7 to 14 weeks and 1 year postexposure. Associations between immune responses, smallpox vaccination, and epiderniologic and clinical data were assessed. Participants were categorized into four groups: (i) vaccinated cases, (ii) unvaccinated cases, (iii) vaccinated contacts, and (iv) unvaccinated contacts. Cases, regardless of vaccination status, were positive for orthopoxvirus-specific IgM, IgG, CD4, CD8, and B-cell responses. Antiorthopoxvirus immune responses consistent with infection were observed in some contacts who did not develop monkeypox. Vaccinated contacts maintained low levels of antiorthopoxvirus IgG, CD4, and B-cell responses, with most lacking IgM or CD8 responses. Preexisting immunity, assessed by high antiorthopoxvirus IgG levels and childhood smallpox vaccination, was associated (in a nonsignificant manner) with mild disease. Vaccination failed to provide complete protection against human monkeypox. Previously vaccinated monkeypox cases manifested antiorthopoxvirus IgM and changes in antiorthopoxvirus IgG, CD4, CD8, or B-cell responses as markers of recent infection. Antiorthopoxvirus IgM and CD8 responses occurred most frequently in monkeypox cases (vaccinated and unvaccinated), with IgG, CD4, and memory B-cell responses indicative of vaccine-derived immunity. Immune markers provided evidence of asymptomatic infections in some vaccinated, as well as unvaccinated, individuals.