针对脑膜炎奈瑟菌C群、B型流感嗜血杆菌、白喉、破伤风和百日咳的母体抗体的血清阳性率及胎盘转运情况。
Seroprevalence and placental transportation of maternal antibodies specific for Neisseria meningitidis serogroup C, Haemophilus influenzae type B, diphtheria, tetanus, and pertussis.
作者信息
de Voer Richarda M, van der Klis Fiona R M, Nooitgedagt Judith E, Versteegh Florens G A, van Huisseling Johannes C M, van Rooijen Debbie M, Sanders Elisabeth A M, Berbers Guy A M
机构信息
National Institute of Public Health and the Environment, Bilthoven, the Netherlands.
出版信息
Clin Infect Dis. 2009 Jul 1;49(1):58-64. doi: 10.1086/599347.
BACKGROUND
Maternal antibodies contribute to the protection of neonates from infectious diseases during the first months of life. The seroprevalence of antibodies specific for polysaccharide or protein antigens from vaccine-preventable pathogens was determined in paired maternal delivery and cord blood serum samples.
METHODS
Antibody concentrations specific for Neisseria meningitidis serogroup C polysaccharide, Haemophilus influenzae type B polysaccharide, diphtheria toxin, tetanus toxin, and pertussis toxin, filamentous hemagglutinin, and pertactin from Bordetella pertussis were determined by enzyme-linked inmmunosorbent assay (ELISA), fluorescent multiplex immunoassay, or serum bactericidal assay.
RESULTS
We investigated 197 paired maternal delivery and cord blood samples. The mean maternal age was 30.8 years, and the mean gestational age was 39.3 weeks. Cord geometric mean concentrations (GMCs) were 0.23 microg/mL for N. meningitidis serogroup C and 0.53 microg/mL for H. influenzae type B. Cord GMCs to diphtheria and tetanus were 0.16 and 1.06 IU/mL, respectively, and cord GMCs to pertussis toxin, filamentous hemagglutinin, and pertactin were 16.2, 34.8, and 17.7 ELISA U/mL (by ELISA), respectively. Cord GMCs to polysaccharide were, in general, 107% identical to maternal GMCs, whereas cord GMCs to proteins were a mean of 157% of maternal concentrations. In addition, the levels of anti-N. meningitidis serogroup C immunoglobulin G1 and G2 in cord blood were 145% and 109% of maternal concentrations, respectively.
CONCLUSIONS
Antibody concentrations directed toward polysaccharide were equal in maternal and cord blood, whereas antibody concentrations to proteins were 1.6 times higher in cord blood than in maternal blood. This is probably attributable to the less-active transportation of immunoglobulin G2 antibodies elicited by polysaccharide. Despite proper placental transfer, cord antibody concentrations are low, possibly placing neonates at risk before they receive their primary vaccinations.
CLINICAL TRIALS REGISTRATION
ISRCTN14204141 .
背景
母体抗体有助于在生命的最初几个月保护新生儿免受传染病侵害。在配对的母体分娩和脐带血血清样本中测定了针对疫苗可预防病原体的多糖或蛋白质抗原特异性抗体的血清阳性率。
方法
通过酶联免疫吸附测定（ELISA）、荧光多重免疫测定或血清杀菌测定，测定针对脑膜炎奈瑟菌C群多糖、B型流感嗜血杆菌多糖、白喉毒素、破伤风毒素、百日咳毒素、丝状血凝素和百日咳博德特氏菌的百日咳黏附素的抗体浓度。
结果
我们调查了197对母体分娩和脐带血样本。母体平均年龄为30.8岁，平均孕周为39.3周。脐带血中脑膜炎奈瑟菌C群的几何平均浓度（GMC）为0.23μg/mL，B型流感嗜血杆菌为0.53μg/mL。脐带血中白喉和破伤风的GMC分别为0.16和1.06 IU/mL，脐带血中百日咳毒素、丝状血凝素和百日咳黏附素的GMC分别为16.2、34.8和17.7 ELISA U/mL（通过ELISA）。脐带血中多糖的GMC通常与母体GMC相同，为107%，而脐带血中蛋白质的GMC平均为母体浓度的157%。此外，脐带血中抗脑膜炎奈瑟菌C群免疫球蛋白G1和G2的水平分别为母体浓度的145%和109%。
结论
针对多糖的抗体浓度在母体和脐带血中相等，而针对蛋白质的抗体浓度在脐带血中比母体血中高1.6倍。这可能归因于多糖引发的免疫球蛋白G2抗体的转运活性较低。尽管有适当的胎盘转运，但脐带血抗体浓度较低，这可能使新生儿在接受初次疫苗接种之前处于危险之中。
临床试验注册
ISRCTN14204141 。
Zotero 插件