Initial and subsequent response to pneumococcal polysaccharide and protein-conjugate vaccines administered sequentially to adults who have recovered from pneumococcal pneumonia.
Initial and subsequent response to pneumococcal polysaccharide and protein-conjugate vaccines administered sequentially to adults who have recovered from pneumococcal pneumonia.
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DOI：
10.1086/591629
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发表时间：
2008-10-01
期刊：
影响因子：
--
通讯作者：
Rodriguez-Barradas MC
中科院分区：
文献类型：
--
作者：
Musher DM;Rueda AM;Nahm MH;Graviss EA;Rodriguez-Barradas MC
肺炎球菌多糖疫苗（PPV）对高危成人的益处一直存在争议。我们对从肺炎球菌肺炎康复的成人进行了PPV、蛋白结合肺炎球菌疫苗（PCV），以及先用PCV进行免疫“启动”然后用PPV进行“加强”的研究。
受试者先接种PPV，6个月后接种PCV，或者顺序相反。在每次接种后的基线、4 - 8周和6个月时，对荚膜多糖的IgG和调理吞噬杀伤活性（OPK）进行研究。
在4 - 8周时，PPV和PCV刺激产生的IgG水平和OPK相似。接种PPV 6个月后，抗体降至基线水平，但接种PCV后仍有适度升高。在接种PPV 6个月后接种PCV，刺激IgG适度升高，但未达到接种PPV后的峰值。相比之下，在接种PCV 6个月后接种PPV，导致所有多糖的IgG和OPK大幅升高，符合加强效应。然而，在第二次接种6个月后，所有患者的IgG和OPK急剧下降，恢复到最初的基线水平。
在高危受试者中，PPV的效果是短暂的；PCV激发的反应更持久。在PCV之后使用PPV作为加强针会导致早期抗体升高，但此后IgG迅速下降，这与抑制细胞的诱导或免疫耐受相符。高危成人可能需要蛋白疫苗。
Controversy persists over the benefits of pneumococcal polysaccharide vaccine (PPV) in at-risk adults. We studied PPV, protein-conjugate pneumococcal vaccine (PCV), or immunologic ‘priming’ with PCV followed by ‘boosting’ with PPV in adults who recovered from pneumococcal pneumonia. Subjects received PPV followed in 6 months by PCV, or vice-versa. IgG to capsular polysaccharide and opsonophagocytic killing activity (OPK) were studied at baseline, 4–8 weeks and 6 months after each vaccination. PPV and PCV stimulated similar IgG levels and OPK at 4–8 weeks. Six months post-PPV, antibody declined to baseline but remained modestly elevated post-PCV. PCV given 6 months post-PPV stimulated modest IgG increases that failed to reach post-PPV peaks. In contrast, PPV 6 months after PCV caused dramatic increases in IgG and OPK to all polysaccharides, consistent with a booster effect. Six months after the second vaccination, however, IgG and OPK in all patients fell precipitously, returning toward original baseline levels. In high-risk subjects, the effect of PPV is short-lived; PCV stimulates a more prolonged response. PPV as a booster following PCV causes early antibody rises, but IgG declines rapidly thereafter, consistent with induction of suppressor cells or tolerance. Protein vaccines may be needed for high-risk adults.
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影响因子：
3.6
作者：
Black, S;Shinefield, H;Edwards, K
通讯作者：
Edwards, K
影响因子：
6.4
作者：
Ahmed, F;Steinhoff, MC;Nelson, KE
通讯作者：
Nelson, KE
影响因子：
5.5
作者：
Jackson, Lisa A.;Neuzil, Kathleen M.;Carlone, George M.
通讯作者：
Carlone, George M.
DOI：
10.1128/cdli.10.4.616-621.2003
发表时间：
2003-07-01
期刊：
CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY
影响因子：
--
作者：
Kim, KH;Yu, JU;Nahm, MH
通讯作者：
Nahm, MH
影响因子：
3.6
作者：
Gonzalez, BE;Hulten, KG;Mason, EO
通讯作者：
Mason, EO