Related Experiment Videos
Depression of delayed hypersensitivity responses in patients with pertussis
Insights
Acute pertussis (whooping cough) temporarily impairs cell-mediated immunity in children, evidenced by reduced delayed hypersensitivity responses. Immunity recovers within months, indicating pertussis infection
Area of Science:
- Immunology
- Pediatrics
- Infectious Diseases
Background:
- Bordetella pertussis components can impair cell-mediated immunity.
- Children with acute pertussis exhibit reduced tuberculin skin test positivity.
- Secondary infections are a significant cause of morbidity and mortality in pertussis.
Purpose of the Study:
- To investigate delayed hypersensitivity responses in children with acute pertussis.
- To compare immune responses during acute illness, convalescence, and in healthy controls.
Main Methods:
- Delayed hypersensitivity skin testing to seven antigens was performed on children with acute pertussis and controls.
- Responses were quantified by the number of positive antigens and total millimeters of induration.
- Pertussis patients were retested 1-3 months later during convalescence.
Main Results:
- Children with acute pertussis showed significantly reduced delayed hypersensitivity responses compared to controls (p < 0.001).
- Specific findings included fewer positive antigens and less total induration in pertussis patients.
- Convalescent pertussis patients exhibited immune responses comparable to the control group.
Conclusions:
- Acute Bordetella pertussis infection transiently suppresses cell-mediated immunity in children.
- Delayed hypersensitivity responses recover to normal levels within 1-3 months post-infection.
- This immune modulation may contribute to secondary infections observed in pertussis.
Abstract:
Components of Bordetella pertussis cause impairment of cell-mediated immunity in experimental animals and children with acute pertussis have been shown to have a reduced prevalence of positive tuberculin skin tests (13). Furthermore, secondary infection is one of the major causes of morbidity and mortality in this disease. On the basis of these observations, we have studied delayed hypersensitivity responses in children with B. pertussis infection and compared the results with responses elicited in the same patients one to three months later, as well as with responses in control children. During acute illness, each patient was tested for 48 hour delayed hypersensitivity response to seven antigens (tetanus and diphtheria toxoids and tuberculin, candida, streptococcus, trichophyton and proteus antigens) and glycerol control. Responses were quantitated by total number of antigens positive (greater than or equal to 2 mm) and total millimeters of response. The control group (N = 11) had 4.2 +/- 1.0 positive antigens and 13.3 +/- 2.7 total mm of response. In contrast, the patients with acute pertussis, (N = 6) had significantly reduced responses, with only 1.5 +/- 1.0 positive antigens and 5.4 +/- 3.2 total mm of response (each different from control, p less than 0.001). That this difference was due to the acute infection with B. pertussis is supported by the responses demonstrated on retest 1-3 months later. At that time, the convalescent patients had 3.3 +/- 1.0 antigens positive and 11.0 +/- 1.7 mm of induration, not significantly different from the control group. Four of the six pertussis patients were outpatients throughout their course and all recovered uneventfully.(ABSTRACT TRUNCATED AT 250 WORDS)