CROSS-PROTECTION BY B-SUBUNIT WHOLE CELL CHOLERA VACCINE AGAINST DIARRHEA ASSOCIATED WITH HEAT-LABILE TOXIN PRODUCING ENTERO-TOXIGENIC ESCHERICHIA-COLI - RESULTS OF A LARGE-SCALE FIELD TRIAL
CROSS-PROTECTION BY B-SUBUNIT WHOLE CELL CHOLERA VACCINE AGAINST DIARRHEA ASSOCIATED WITH HEAT-LABILE TOXIN PRODUCING ENTERO-TOXIGENIC ESCHERICHIA-COLI - RESULTS OF A LARGE-SCALE FIELD TRIAL
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DOI：
10.1093/infdis/158.2.372
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发表时间：
1988-08-01
影响因子：
6.4
通讯作者：
HOLMGREN, J
中科院分区：
文献类型：
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作者：
CLEMENS, JD;SACK, DA;HOLMGREN, J
霍乱毒素的B亚单位（BS）与产肠毒素性大肠杆菌（ETEC）的不耐热肠毒素（LT）具有相似的抗原性。因此，我们在孟加拉国农村儿童和妇女中进行了一项随机、双盲田间试验，评估了联合霍乱毒素BS/全细胞（BS-WC）口服霍乱疫苗是否对产LT的ETEC（LT-ETEC）腹泻具有交叉保护作用。24，770名服用两剂或两剂以上BS-WC疫苗的人与24，842名服用两剂或两剂以上灭活全细胞口服霍乱疫苗的对照组进行了比较。在短期（3个月）随访期间，BS-WC组的LT-ETEC腹泻发作次数比WC组少67%（P < 0.01），但在随后的9个月内没有明显减少。对导致危及生命的脱水的LT-ETEC腹泻的短期保护作用尤其显著（保护效力，86%; P < 0.05）。
The B subunit (BS) of cholera toxin and that of the heat-labile enterotoxin (LT) of enterotoxigenic Escherichia coli (ETEC) are antigenically similar. We therefore assessed whether a combined cholera toxin BS/whole-cell (BS-WC) oral vaccine against cholera conferred cross-protection against LT-producing ETEC (LT-ETEC) diarrhea in a randomized, double-blind field trial among rural Bangladeshi children and women. The 24,770 persons who ingested two or more doses of BS-WC vaccine were compared with 24,842 controls who took two or more doses of killed whole-cell (WC) oral cholera vaccine. Sixty-seven percent fewer episodes of LT-ETEC diarrhea were noted in the BS-WC group than in the WC group during short-term (three-month) follow-up (P < 0.01), but no reduction was evident during the ensuing nine months. Short-term protection was particularly notable against LT-ETEC diarrhea causing life-threatening dehydration (protective efficacy, 86%; P < 0.05).