Transplacental transfer of maternal respiratory syncytial virus (RSV) antibody and protection against RSV disease in infants in rural Nepal.
Transplacental transfer of maternal respiratory syncytial virus (RSV) antibody and protection against RSV disease in infants in rural Nepal.
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DOI：
10.1016/j.jcv.2017.08.017
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发表时间：
2017-10
期刊：
影响因子：
--
通讯作者：
Englund JA
中科院分区：
文献类型：
--
作者：
Chu HY;Tielsch J;Katz J;Magaret AS;Khatry S;LeClerq SC;Shrestha L;Kuypers J;Steinhoff MC;Englund JA
在尼泊尔，通过胎盘转移RSV抗体是非常有效的。脐带血RSV抗体浓度与RSV发病年龄无关。估计的RSV抗体浓度与疾病严重程度无关。呼吸道合胞病毒(RSV)是引起儿童肺炎的最重要的病毒原因。RSV特异性抗体(Ab)保护婴儿免受疾病的侵袭，并可通过母体RSV疫苗接种的潜在策略来增加。描述在资源有限的环境中，RSV抗体对婴儿RSV感染风险的影响。在尼泊尔的一项前瞻性研究中，妇女在怀孕期间被招募，母亲和婴儿出生时采集脐带血。每周监测呼吸道疾病，从出生到180天。鼻拭子用聚合酶链式反应检测呼吸道合胞病毒，血清用呼吸道合胞病毒抗体微量中和试验。根据0.026对数/天的衰减率估计呼吸道合胞病毒感染时的抗体浓度。脐带血：母体RSV抗体转移率为1.03(0.88~1.19)，母婴RSV抗体浓度分别为log2 11.3和log2 11.7。脐带血RSV抗体log2为12.1，无RSV感染者为11.6(P=0.86)。在呼吸道合胞病毒感染的婴儿中，上呼吸道感染(n=8；log2 10.7)和下呼吸道感染(n=21；log2 9.8；P=0.37)感染时的RSV抗体估计浓度没有差异。脐带血RSV抗体浓度与初次RSV感染年龄无关(R=0.11；P=0.57)。在尼泊尔农村，通过胎盘将RSV抗体从母亲转移到胎儿是非常有效的，尽管较高的抗体浓度并不能预防婴儿更早或更严重的RSV感染。
Transplacental transfer of RSV antibody was highly efficient in Nepal. Cord blood RSV antibody concentrations were not associated with age at RSV illness. Estimated RSV antibody concentrations did not correlate with disease severity. Respiratory syncytial virus (RSV) is the most important viral cause of pneumonia in children. RSV-specific antibody (ab) protects infants from disease, and may be increased by a potential strategy of maternal RSV vaccination. To describe the effect of RSV antibody on RSV infection risk in infants in a resource-limited setting. In a prospective study in Nepal, women were enrolled during pregnancy and maternal and infant cord blood were collected at birth. Weekly surveillance for respiratory illness was performed from birth to 180 days. Nasal swabs were tested for RSV by PCR and serum was tested using an RSV antibody microneutralization assay. Antibody concentrations at time of RSV infection were estimated based on a decay rate of 0.026 log2/day. Cord:maternal RSV antibody transfer ratio was 1.03 (0.88–1.19), with RSV antibody concentration of log2 11.3 and log2 11.7 in 310 paired maternal and infant samples, respectively. Cord blood RSV antibody was log2 12.1 versus 11.6 in those with or without RSV infection (P = 0.86). Among infants with RSV infection, estimated RSV antibody concentration at time of infection did not differ in infants with upper (n = 8; log2 10.7) versus lower respiratory tract infection (n = 21; log2 9.8; P = 0.37). Cord blood RSV antibody concentrations did not correlate with age at primary RSV infection (R = 0.11; P = 0.57). Transplacental transfer of RSV antibody from mother to the fetus was highly efficient in mother-infant pairs in rural Nepal, though higher antibody concentrations were not protective against earlier or more severe RSV infection in infants.
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