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The maternal antibody against diphtheria, tetanus and pertussis showed distinct regional difference in China
Qinghong Meng1, Qinghui Qian2, Li Li3
1Key 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.
Insights
Neonates in less developed areas of China have lower diphtheria and tetanus antibody levels, highlighting disparities in passive immunity. Targeted maternal immunization strategies are crucial to improve infant protection in these regions.
Area of Science:
- Immunology
- Pediatrics
- Public Health
Background:
- Passive antibody transfer to fetuses is vital for neonatal protection until infant vaccination is effective.
- Significant gaps exist in understanding DTP (diphtheria, tetanus, pertussis) vaccine-associated antibody level discrepancies in neonates across different economic regions in China.
Purpose of the Study:
- To investigate and compare the levels of diphtheria, tetanus, and pertussis antibodies in neonates from economically disparate regions of China.
- To identify potential disparities in passive immunity conferred by maternal antibodies against DTP vaccine antigens.
Main Methods:
- A comparative study involving 200 neonates from Beijing (Shunyi Women and Children's Hospital) and 238 neonates from a southwestern mountainous area (Qianjiang Central Hospital) in 2018.
- Antibody levels specific to diphtheria (anti-Dtx IgG), tetanus (anti-Ttx IgG), and pertussis toxin (anti-Ptx IgG) were quantified using ELISA kits.
- Standard cutoff values were applied to assess protective antibody percentages and detectable rates.
Main Results:
- Neonates from Qianjiang exhibited significantly lower levels and protective rates of anti-Dtx IgG (0.04 IU/ml, 7.1%) and anti-Ttx IgG (0.07 IU/ml, 7.6%) compared to those from Shunyi (0.12 IU/ml, 30.5% and 0.18 IU/ml, 38.5%, respectively).
- Detectable rates for anti-Dtx IgG and anti-Ttx IgG were considerably lower in Qianjiang neonates (57.5% and 55.8%) versus Shunyi neonates (97.5% and 71.0%).
- Conversely, the detectable rate of anti-Ptx IgG was higher in Qianjiang neonates (39.9%) than in Shunyi neonates (30.5%), with two cases suggesting recent maternal pertussis infection.
Conclusions:
- Significant regional disparities in protective antibody rates against diphtheria and tetanus were observed, potentially linked to variations in vaccine coverage and pertussis exposure.
- The findings underscore the critical importance of Tdap (tetanus, diphtheria, acellular pertussis) booster immunization for pregnant women and women of childbearing age, particularly in underdeveloped areas.
- Maternal immunization programs are essential to ensure adequate passive immunity transfer and protect neonates in regions with lower socioeconomic status.
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.
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