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Effect of erythromycin treatment on antibody responses in pertussis
1Department of Infectious Diseases, Danderyd Hospital, Sweden.
Insights
Erythromycin treatment for pertussis (whooping cough) showed a slight, though not statistically significant, impact on antibody responses to Bordetella pertussis antigens. Antibody levels tended to be lower in treated children, but most developed significant responses regardless of treatment.
Area of Science:
- Pediatric Infectious Diseases
- Immunology
- Microbiology
Background:
- Pertussis, caused by Bordetella pertussis, remains a significant public health concern.
- Antibody response is crucial for immunity and recovery from pertussis.
- The role of early antibiotic treatment in modulating the immune response to pertussis is not fully understood.
Purpose of the Study:
- To investigate the effect of erythromycin treatment on antibody responses to Bordetella pertussis filamentous haemagglutinin (FHA) and pertussis toxin (PT).
- To determine if early erythromycin administration influences the development of antibody titers in children with pertussis.
Main Methods:
- Analysis of convalescent blood samples from 105 children diagnosed with pertussis.
- Comparison of antibody concentrations (IgG) to FHA and PT using ELISA and neutralization tests (NT) between erythromycin-treated and untreated groups.
- Assessment of antibody responses based on treatment timing (within 7 days vs. later).
Main Results:
- No significant differences in IgG antibody concentrations to FHA and PT were observed between treated and untreated children.
- A trend towards lower median antibody titers to both antigens was noted in the erythromycin-treated group.
- Early erythromycin treatment (within 7 days) did not significantly alter antibody response development but showed a tendency for lower titers.
Conclusions:
- Erythromycin treatment appears to have a minimal, non-significant effect on antibody responses to Bordetella pertussis antigens in children.
- The majority of children, irrespective of erythromycin treatment, mounted a significant antibody response to PT and FHA.
- Further research may be needed to elucidate the subtle immunomodulatory effects of erythromycin in pertussis.
Abstract:
The effect of erythromycin treatment on antibody responses to Bordetella pertussis filamentous haemagglutinin (FHA) and pertussis toxin (PT) was investigated in convalescent blood samples from 105 children with pertussis. Erythromycin had been given to 59 children, median age 3.2 years (range 0.3-9.9) on median day 7 (range 11-14) after onset of disease while the remaining 46 children, age 3.45 (0.6-8.1) were untreated. No significant differences in IgG antibody concentration were noted to FHA by ELISA and to PT, neither by NT nor by ELISA, but a tendency towards lower median titers was seen to both antigens and by both type of assays in the erythromycin-treated group. Similarly, early erythromycin treatment i.e. within 7 days of onset of symptoms, did not influence significantly of the development of the antibody responses but tended to lead to lower titer levels. A significant response to PT and FHA was found in about 90% of blood samples, irrespective of treatment. All 56 children with culture-confirmed B. pertussis infection had a significant response to PT. The study has thus shown a slight but not significant effect of erythromycin treatment on antibody responses in pertussis.