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Serum antibody responses in children with rotavirus diarrhea can serve as proxy for protection
J Xu1, P Dennehy, H Keyserling
1Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Emory University School of Medicine, Atlanta, Georgia, USA.
Insights
Serum immunoglobulin G (IgG) is the most reliable marker for rotavirus infection seroconversion and predicts protection against severe disease. Maternal antibodies can impact infant immune responses to rotavirus infection.
Area of Science:
- Immunology
- Virology
- Pediatrics
Background:
- Rotavirus is a leading cause of severe diarrheal disease in infants globally.
- Maternal antibodies can influence infant immune responses to infections.
- Understanding antibody markers for rotavirus infection is crucial for disease management.
Purpose of the Study:
- To investigate immunoglobulin M (IgM), IgA, and IgG antibody responses to rotavirus in infants.
- To determine if serum antibody titers can predict rotavirus disease severity.
- To assess the role of maternal antibodies in infant rotavirus infections.
Main Methods:
- Sera from 42 patients aged 1–30 months were analyzed for rotavirus-specific IgM, IgA, IgG, and IgG subclasses.
- Antibody titers in acute- and convalescent-phase sera were measured.
- Correlation between antibody levels and disease severity/duration was assessed.
Main Results:
- IgM was a reliable marker for acute rotavirus infection in patients aged ≥6 months.
- IgG seroconversion was observed in 81% of patients, making it the best overall infection predictor.
- Higher IgA responses were seen in children ≥12 months.
- Preexisting IgG titers ≥100 or ≥200 correlated with less severe or shorter diarrhea.
- IgG1 was the predominant IgG subclass detected.
Conclusions:
- Serum IgG is the most reliable marker for rotavirus infection seroconversion.
- Serum IgG serves as a consistent proxy for protection against severe rotavirus disease.
- Maternal IgG antibodies may inhibit viral replication and infant antibody responses in early life.
Abstract:
We examined sera from 42 patients 1 to 30 months of age for rotavirus immunoglobulin M (IgM), IgA, IgG, and IgG subclasses and sought to determine if serum antibody could serve as a reliable marker for prediction of disease severity. Infants in the first few months of life usually had high maternal IgG titers and, when they were infected with rotavirus, had low IgM titers or no IgM in acute-phase sera and poor seroconversions 3 weeks later, suggesting that maternal antibodies had inhibited viral replication and antibody responses. All patients > or =6 months of age had IgM in acute-phase sera, indicating that IgM is a good marker for acute rotavirus infection. IgG was the best overall predictor of an infection, as the convalescent-phase sera of 81% of the patients had a fourfold rise in the IgG titer. IgA titers in convalescent-phase sera and conversion rates were higher among patients > or =12 months of age than among children younger than 12 months. IgG1 was the predominant subclass detected in the acute-phase sera of some children and in all 28 convalescent-phase serum samples examined. Patients with preexisting acute-phase IgG titers of > or =100 or > or =200 had diarrhea that was less severe or of a shorter duration. These results indicate that serum IgG is the most reliable marker for seroconversion and is a consistent proxy for protection against severe disease.
