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首页> 外文期刊>Vaccine >The immunological effect of revaccination with Bacille Calmette-Guerin vaccine at 19 months of age
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The immunological effect of revaccination with Bacille Calmette-Guerin vaccine at 19 months of age

机译：19个月大时接种杆菌卡介苗疫苗的免疫学作用

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Background: Bacille Calmette-Guerin (BCG) vaccination has important non-specific immune effects. In a randomized trial in Guinea-Bissau, BCG revaccination was associated with significantly increased survival in children who received diphtheria-tetanus-pertussis (DTP)-booster vaccine before enrolment and in children who did not receive micronutrient supplementation (MN). Within the trial we assessed the immunological effects of BCG revaccination. Methods: Children were randomized to BCG or nothing. Blood was sampled 6-11 weeks after randomization (early sample group) or 5-9 months later (late sample group). In vitro cytokine responses (interferon (IFN)-gamma, interleukin (IL)-13, tumor-necrosis-factor (TNF)-alpha, and IL-10) were assessed in whole blood cultures stimulated with lipopolysaccharide (LPS), purified protein derivative (PPD) or phytohaemagglutinin (PHA). Effect-modification by sex, DTP-booster vaccination and MN was studied. Results: Cytokines were measured in 345 infants. BCG was associated with significantly increased IFN-gamma (geometric mean ratio (GMR) = 4.54 (95% confidence interval: 3.13-6.58)) and IL-13 (GMR = 1.43 (1.00-2.05)) PPD responses, the effect being strongest in the early sample group. Across all three conditions BCG tended to increase IL-10 (LPS, PHA, PPD: GMR = 1.20, 1.12, 1.20), most pronounced in the late sample group. BCG reduced the TNF-alpha/IL-10 ratio in boys with DTP-booster at bleeding and increased it in those without (interaction test: p = 0.03). In children without MN, BCG was associated with reduced TNF-alpha response in the early sample group (p = 0.006), and increased IL-10 in the late sample group (p = 0.03). Conclusion: BCG revaccination resulted in a strong IFN-gamma response to PPD, which waned slightly over time. BCG also affected the pro-/anti-inflammatory balance, with reduced TNF-alpha and increased IL-10 responses to LPS, PHA and PPD. This effect depended on sex, DTP-booster vaccination and micronutrient supplementation, being most pronounced in children who had received DTP-booster before enrolment and children who had not received MN, i.e. the group of children which also had lower mortality after BCG revaccination
机译：背景：卡介苗（BCG）疫苗接种具有重要的非特异性免疫作用。在几内亚比绍的一项随机试验中，卡介苗重新接种与入组前接受白喉-破伤风-百日咳（DTP）-加强型疫苗的儿童和未接受微量营养素补充（MN）的儿童的存活率显着提高相关。在试验中，我们评估了卡介苗再接种的免疫学作用。方法：将儿童随机分为卡介苗或不接种。随机分配后6-11周（早期样品组）或5-9个月后（晚期样品组）采集血液。在脂多糖（LPS），纯化蛋白刺激下的全血培养物中评估了体外细胞因子反应（干扰素（IFN）-γ，白介素（IL）-13，肿瘤坏死因子（TNF）-α和IL-10）衍生物（PPD）或植物血凝素（PHA）。研究了按性别，DTP加强疫苗接种和MN进行的效果改善。结果：对345名婴儿进行了细胞因子测定。 BCG与IFN-γ（几何平均比（GMR）= 4.54（95％置信区间：3.13-6.58））和IL-13（GMR = 1.43（1.00-2.05））PPD反应显着增加有关，作用最强在早期样本组中。在所有这三种情况下，BCG倾向于增加IL-10（LPS，PHA，PPD：GMR = 1.20、1.12、1.20），在晚期样本组中最明显。卡介苗降低了具有DTP增强剂的男孩在出血时的TNF-α/ IL-10比值，而未加DTP的男孩则增加了（相互作用测试：p = 0.03）。在无MN的儿童中，BCG与早期样品组的TNF-α反应降低有关（p = 0.006），而晚期样品组的IL-10升高（p = 0.03）。结论：卡介苗再接种导致对PPD的强烈的IFN-γ反应，随时间逐渐减弱。卡介苗也影响了促炎/抗炎平衡，TNF-α降低，IL-10对LPS，PHA和PPD的反应增加。这种效应取决于性别，DTP疫苗接种和微量营养素补充，在入组前接受DTP疫苗接种的儿童和未接受MN的儿童（即在接种BCG疫苗后死亡率也较低的儿童组）中最为明显

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