Prevalence of pertussis antibodies in maternal delivery, cord, and infant serum
Prevalence of pertussis antibodies in maternal delivery, cord, and infant serum
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DOI：
10.1086/421033
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发表时间：
2004-07-15
影响因子：
6.4
通讯作者：
Baker, CJ
中科院分区：
文献类型：
--
作者：
Healy, CM;Munoz, FM;Baker, CJ
背景被动获得的母体抗体保护婴儿免受许多病原体的侵害。随着婴儿百日咳报告的增加，我们对1999 - 2000年母婴配对血清中百日咳抗体进行了评价。采用经验证的IgG特异性酶联免疫吸附试验（ELISA）测定了64例母-脐带血清对和64例婴儿血清中的61例的百日咳毒素（PT）、丝状血凝素（FHA）和菌毛蛋白（FHA）抗体。计算百日咳抗体的几何平均浓度（GMC）和脐带：母体GMC比值。母亲的平均年龄和妊娠期分别为29.7岁（范围：19 - 42岁）和39.3周（范围：35.6 - 40.9周），81%的母亲为白色。分娩时母体抗体的GMC（ELISA单位/mL）分别为PT 2.4、FHA 6.9和IgM 13。脐带GMC分别为PT、FHA和IVF母体分娩值的169%、178%和157%，表明活跃的胎盘转移（P <0.001）。每种抗原的百日咳特异性IgG值在2个月龄时衰减至检测阈值以下。尽管有有效的胎盘转移，但母亲百日咳抗体水平低，在婴儿血清中迅速衰减，使婴儿几乎没有抵抗百日咳的体液保护。这些数据支持母亲或新生儿接种无细胞百日咳疫苗的基本原理，以预防婴儿早期危及生命的百日咳。
Background. Passively acquired maternal antibodies protect infants from many pathogens. With increasing reports of infant pertussis, we evaluated pertussis antibodies in maternal-infant paired sera from 1999 - 2000.Methods. Antibodies to pertussis toxin ( PT), filamentous hemagglutinin (FHA), and fimbrial proteins (FIM) were measured by validated IgG-specific enzyme-linked immunosorbant assay ( ELISA) in 64 maternal - umbilical cord serum pairs and in 61 of 64 infant sera. Geometric mean concentrations (GMCs) of pertussis antibodies and cord: maternal GMC ratios were calculated.Results. Mean maternal age and gestation were 29.7 years ( range, 19 - 42) and 39.3 weeks ( range, 35.6 - 40.9), and 81% of mothers were white. GMCs of maternal antibodies at delivery ( ELISA units/mL) were 2.4 for PT, 6.9 for FHA, and 13 for FIM. Cord GMCs were 169%, 178%, and 157% of maternal delivery values for PT, FHA, and FIM, respectively, demonstrating active placental transfer (P < .001). Pertussis-specific IgG values for each antigen decayed to below the threshold of detection by age 2 months.Conclusions. Despite efficient placental transfer, low maternal pertussis antibody levels and their rapid decay in infant sera leave infants with little humoral protection against pertussis. These data support the rationale for maternal or neonatal immunization, with acellular pertussis vaccines, to prevent life-threatening pertussis in early infancy.