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Antibody response to accelerated Hib immunisation in preterm infants receiving dexamethasone for chronic lung disease
M J Robinson1, F Campbell, P Powell
1Neonatal Department, Hope Hospital, Salford.
Insights
Dexamethasone treatment in preterm infants with chronic lung disease significantly reduced antibody responses to Haemophilus influenzae immunisation. This suggests potential risks to vaccine efficacy in this vulnerable population.
Area of Science:
- Neonatal immunology
- Pediatric pulmonology
- Vaccinology
Background:
- Preterm infants often develop chronic lung disease, requiring treatments like dexamethasone.
- The impact of dexamethasone on vaccine response in these infants is not fully understood.
- Haemophilus influenzae type b (Hib) is a significant pathogen in young children.
Purpose of the Study:
- To investigate the effect of dexamethasone on the immune response to routine immunisation in preterm infants.
- Specifically, to assess antibody titres against Haemophilus influenzae following vaccination.
Main Methods:
- Serum samples were collected from 59 preterm infants before and after immunisation.
- Antibody levels against Haemophilus influenzae were quantified using an ELISA method.
- Geometric mean antibody titres were compared between infants who received dexamethasone and those who did not.
Main Results:
- Infants not receiving dexamethasone showed a substantial increase in antibody titres post-immunisation (0.16 to 4.63 mcg IgG/ml).
- Infants treated with dexamethasone exhibited a markedly diminished antibody response (0.10 to 0.51 mcg IgG/ml).
Conclusions:
- Dexamethasone administration in preterm infants with chronic lung disease appears to significantly impair the antibody response to Haemophilus influenzae immunisation.
- This finding highlights a potential concern for vaccine effectiveness in infants undergoing dexamethasone therapy.
Aim:
To study the effect of dexamethasone on the routine immunisation of preterm infants with chronic lung disease.
Methods:
Serum samples were obtained before and after immunisation from an unselected cohort of 59 preterm infants. Haemophilus influenzae antibodies were measured using an ELISA method and differences in the geometric mean values between the two groups of babies analysed.
Results:
Sixteen infants received no dexamethasone. Before and after immunisation antibody titres for those receiving no dexamethasone were 0.16 and 4.63 mcg IgG/ml. Corresponding values for those receiving dexamethasone were 0.10 and 0.51 mcg IgG/ml, respectively.
Conclusion:
Dexamethasone used in the treatment of chronic lung disease seems to significantly affect the antibody response of preterm infants to immunisation against Haemophilus influenzae.