中国针对白喉、破伤风和百日咳的母体抗体呈现出明显的区域性差异。
The maternal antibody against diphtheria, tetanus and pertussis showed distinct regional difference in China.
机构信息
Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
Department of Pediatrics, Qianjiang Central Hospital, Chongqing, 409000, China.
出版信息
BMC Pediatr. 2019 Dec 7;19(1):480. doi: 10.1186/s12887-019-1860-5.
BACKGROUND
Passive transferred antibodies to the fetus play an essential role on protecting neonates and young infants until infant vaccination is more efficacious. However, very little is known about the discrepancy of DTP vaccine associated antibodies level in neonates from different economic areas in China.
METHODS
In 2018, 200 neonates hospitalized in Shunyi Women and Children's Hospital in Beijing, and 238 neonates hospitalized in Qianjiang Central Hospital located in the southwestern mountainous areas were included in this study. Antibodies specific for the antigens covered by DTP vaccine were determined using ELISA Kits (Euroimmun, Lübeck, Germany). The cut off value of ≥0.1 IU/ml (anti-diphtheria, anti-Dtx), > 0.1 IU/ml (anti-tetanus, anti-Ttx) and > 40 IU/ml (anti-pertussis toxin, anti-Ptx) were used to assess the percentage of protected neonates, respectively.
RESULTS
The antibody levels in the neonates from Qianjiang (0.04 IU/ml for anti-Dtx IgG and 0.07 IU/ml for anti-Ttx IgG) were significantly lower than those from Shunyi (0.12 IU/ml for anti-Dtx IgG and 0.18 IU/ml for anti-Ttx IgG). The prevalence of protective anti-Dtx and anti-Ttx IgG were lower in the neonates from Qianjiang (7.1% for anti-Dtx IgG and 7.6% for anti-Ttx IgG) than in those from Shunyi (30.5% for anti-Dtx and 38.5% for anti-Ttx). The neonates from Qianjiang also had lower detectable rate of anti-Dtx (57.5%) and anti-Ttx IgG (55.8%) than neonates from Shunyi (97.5% for anti-Dtx and 71.0% for anti-Ttx). However, the detectable rate of anti-Ptx IgG in neonates from Qianjiang (39.9%) was higher significantly than in those from Shunyi (30.5%). Two neonates from Qianjiang have anti-PT IgG ≥100.0 IU/ml, which suggested that their mothers have a recent pertussis course.
CONCLUSIONS
The regional discrepancy of the protective antibody rates might be caused by different vaccine coverage and pertussis exposure, which suggested the importance of Tdap booster immunization for pregnant women or women at childbearing age, those living undeveloped areas in particular.
背景
被动转移到胎儿的抗体在保护新生儿和婴儿方面起着至关重要的作用，直到婴儿疫苗更有效。然而，对于中国不同经济地区的新生儿中 DTP 疫苗相关抗体水平的差异，我们知之甚少。
方法
2018 年，我们纳入了 200 名在北京顺逸妇儿医院住院的新生儿和 238 名在位于西南山区的潜江中心医院住院的新生儿。使用 ELISA 试剂盒（Euroimmun，吕贝克，德国）测定针对 DTP 疫苗覆盖抗原的抗体。使用≥0.1 IU/ml（抗白喉，抗-Dtx）、>0.1 IU/ml（抗破伤风，抗-Ttx）和>40 IU/ml（抗百日咳毒素，抗-Ptx）的截断值来评估保护性新生儿的百分比。
结果
来自潜江的新生儿的抗体水平（抗-Dtx IgG 为 0.04 IU/ml，抗-Ttx IgG 为 0.07 IU/ml）明显低于来自顺逸的新生儿（抗-Dtx IgG 为 0.12 IU/ml，抗-Ttx IgG 为 0.18 IU/ml）。来自潜江的新生儿保护性抗-Dtx 和抗-Ttx IgG 的流行率较低（抗-Dtx IgG 为 7.1%，抗-Ttx IgG 为 7.6%），而来自顺逸的新生儿则较高（抗-Dtx 为 30.5%，抗-Ttx 为 38.5%）。来自潜江的新生儿抗-Dtx（57.5%）和抗-Ttx IgG（55.8%）的可检测率也明显低于来自顺逸的新生儿（抗-Dtx 为 97.5%，抗-Ttx 为 71.0%）。然而，来自潜江的新生儿抗-Ptx IgG 的可检测率（39.9%）明显高于来自顺逸的新生儿（30.5%）。来自潜江的两名新生儿的抗-PT IgG≥100.0 IU/ml，这表明他们的母亲最近有百日咳病史。
结论
保护抗体率的区域差异可能是由不同的疫苗覆盖率和百日咳暴露引起的，这表明 Tdap 加强免疫对孕妇或育龄妇女，特别是生活在欠发达地区的妇女的重要性。
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