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Local reactions and IgE antibodies to pertussis toxin after acellular diphtheria-tetanus-pertussis immunization
1Department of Paediatrics, Turku University Hospital, FIN-20520, Turku, Finland.
Insights
Acellular pertussis vaccines can induce immunoglobulin E (IgE) antibodies to pertussis toxin, particularly after booster doses. Local reactions following booster immunization are linked to higher PT-IgE and IgG antibody levels.
Area of Science:
- Immunology
- Vaccinology
- Pediatrics
Background:
- Acellular pertussis vaccines (DTPa) are widely used for immunization.
- Understanding local reactions and immune responses to vaccine components is crucial.
Purpose of the Study:
- To investigate local reactions and pertussis toxin-specific immunoglobulin E (PT-IgE) antibody levels in children after DTPa vaccination.
- To explore the relationship between local reactions, PT-IgE, and other antibody responses.
Main Methods:
- A cohort of 150 infants received primary DTPa immunization, with 104 receiving a booster.
- Serum samples were analyzed for PT-IgE using a modified RAST.
- Local reactions and antibody levels (PT-IgE, pertactin IgG, diphtheria IgG) were assessed.
Main Results:
- Local reactions were infrequent after primary immunization (1%-5%) but increased after booster (21%).
- PT-IgE detection rose significantly from 18% after primary to 86% after booster immunization.
- Children with local reactions showed higher pre- and post-booster PT-IgE and IgG levels.
Conclusions:
- Acellular pertussis immunization, especially boosters, induces IgE antibodies to pertussis toxin.
- Local side-effects appear linked to multifactorial immunological mechanisms involving PT-IgE and other IgG responses.
Abstract:
Local reactions and pertussis toxin specific immunoglobulin E antibodies (PT-IgE) were investigated in healthy children following primary and booster immunization with a combined diphtheria tetanus acellular pertussis vaccine (DTPa) including pertussis toxin, filamentous haemagglutinin and pertactin. A primary series of DTPa was administered to 150 infants, and 104 of them received a booster dose of DTPa combined with inactivated polio vaccine at 2 years of age. PT-IgE was measured in serum samples from 72 children using a modified nitrocellulose RAST. Primary immunization was associated with low incidence of local reactions (1%-5%). After the booster dose 21% of children had a local reaction >/=20 mm. Local reactions after the booster dose tended to be more common in children who had experienced reaction at primary immunization. PT-IgE was detected in 18% and 86% of children following primary and booster vaccinations, respectively. Allergic and non-allergic children did not differ in PT-IgE responses. After primary immunization, elevated PT-IgE levels were found more often in children with a family history of allergy than in those without known allergy in the family. Children with local reactions had significantly higher pre- and post-booster PT-IgE levels and median post-booster pertactin IgG and diphtheria-IgG levels than children without local reactions. Conclusion Acellular pertussis immunization induces IgE antibodies to pertussis toxin, especially after booster vaccination. The higher median pre- and post-booster levels of pertussis toxin specific immunoglobulin E and post-booster levels of IgG to pertactin and diphtheria in children with local side-effects reflect a multifactorial immunological mechanism of such reactions.