摘要
目的 探讨鼻咽部携带肺炎球菌对接种肺炎球菌多糖结合疫苗(pneumococcal conjugate vaccine,PCV)后所携带血清型免疫应答的影响.方法 在PubMed和万方数据库中以"pneumococcal conjugate vaccine""nasopharyngeal carriage/colonization""hyporesponsiveness"为主要检索词,检索发表日期 2000年1月1日—2023年3月7日,语言为中英文的相关研究.结果 接种PCV前/期间鼻咽部携带6B、19F、23F、6A和18C型肺炎球菌的儿童的免疫应答率比未携带该血清型的儿童低6％～51％,免疫球蛋白G(immunoglobulin G,IgG)几何平均浓度(geometric mean concentration,GMC)比未携带该血清型的儿童低1.4～14.6倍.各研究间血清型9V、14和19A的结果不一致:3个血清型未携带/携带IgG GMC比值分别为0.6～1.2、0.7～3.2、0.8～1.4.抗体调理吞噬活性(opsonophagocytic activity,OPA)与细胞免疫应答的结果与IgG一致:接种PCV前或期间鼻咽部携带19F、23F、6A型肺炎球菌者同血清型OPA滴度低1.4～85.1倍;出生后2周内携带肺炎球菌的儿童在9月龄时,干扰素和白细胞介素10应答水平降低.结论 完成PCV免疫程序前携带肺炎球菌可降低所携带血清型的免疫应答,携带前接种PCV或PCV加强免疫可以减少携带对免疫原性的负面影响.
Abstract
Objective To explore the impacts of nasopharyngeal carriage of Streptococcus pneumoniae on the immune response to serotypes carried after vaccination with pneumococcal conjugate vaccine(PCV).Methods Literature searches in PubMed and Wanfang were conducted using key terms"pneumococcal conjugate vaccine","nasopharyngeal carriage/colonization",and"Hyporesponsiveness".A total of 10 relevant studies published between January 1,2000,and March 7,2023,in English and Chinese were identified for review.Results Children carrying serotypes 6B,19F,23F,6A,and 18C Streptococcus pneumoniae had immune response rates 6％-51％lower than that of children who did not carry this serotype prior to completion of PCV vaccination.The geometric mean concentration(GMC)of immunoglobulin G(IgG)for these serotypes 6B,19F,23F,6A,and 18C Streptococcus pneumoniae among carriers were 1.4-14.6 times lower than non-carriers.The results for serotypes 9 V,14,and 19 A were inconsistent among studies:the ratios of non-carriers to carriers of IgG GMC were 0.6-1.2,0.7-3.2,and 0.8-1.4,respectively.The opsonophagocytic activity(OPA)and cellular immune response results were consistent with IgG:individuals nasopharyngeally carrying serotypes 19F,23F,and 6A prior to or during PCV vaccination had OPA titers that were 1.4 to 85.1 times lower.Children who carried Streptococcus pneumoniae within the first two weeks after birth showed reduced levels of interferon and interleukin-10 responses at nine months of age.Conclusions NP carriage of Streptococcus pneumoniae could reduce the immunogenicity of carried serotypes targeted by PCV.Pre-vaccination or booster PCV administration in carriers may help mitigate the negative impact on immunogenicity.
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