老年人接种23价肺炎球菌多糖疫苗后特异性功能性抗体水平的监测

Monitoring of specific functional antibody levels in elderly individuals inoculated with 23-valent pneumococcal polysaccharide vaccine

目的监测老年人接种23价肺炎球菌多糖疫苗(pneumococcal capsular polysaccharide vaccine-23,PPV-23)后特异性功能性抗体的水平。方法选择沪籍60岁以上健康及结核病痊愈老年人接种PPV-23疫苗,采用肺炎链球菌荚膜多糖多型调理吞噬杀菌试验(multi-specificity opsonophagocyitosis killing assay,MOPA)分别对接种前、接种后1个月、6个月的13种血清型(1、3、4、5、6A、6B、7F、9V、14、18C、19A、19F、23F)肺炎球菌的抗体水平进行检测,并对两组人群接种后1个月、6个月的13种血清型OPA抗体水平(GMT)及抗体增长率进行统计学分析。结果大部分老年人接种PPV-23后1个月、6个月13种血清型的OPA抗体GMT均显著高于接种前(P<0.05),接种后6个月结核病痊愈者的1、3型与接种前差异无统计学意义(P>0.05),且接种后1个月与6个月的6A、6B、7F、18C、19F、23F型抗体差异无统计学意义(P>0.05)。接种后1个月13种血清型OPA抗体水平≥2倍增长率均≥60%(除结核病痊愈者1型为37.5%外),且两组人群差异无统计学意义(P>0.05);除结核病痊愈者1、3型外,两组人群各型别OPA抗体水平≥4倍增长率差异无统计学意义(P>0.05)。接种后6个月13种血清型OPA抗体水平≥2倍增长率在45%以上,且除1型外,两组人群间差异无统计学意义(P>0.05);除1型、18C型外,两组人群OPA抗体水平≥4倍增长率差异无统计学意义(P>0.05)。结论健康和结核病痊愈老年人接种PPV-23后可产生针对13种血清型的特异性功能性抗体,且可维持6个月,但结核病痊愈者接种PPV-23后1、3型的OPA抗体水平和持久性明显低于健康老年人。

Objective To monitor the level of specific functional antibodies in elderly individuals inoculated with 23- valent pneumococcal polysaceharide vaccine （PPV-23）. Methods Healthy individuals and those recovered from tuberculosis, with registered permanent residence in Shanghai and at age of more than 60 years, were vaccinated with PPV-23. The OPA antibody levels against 13 serotypes （1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 23F） of pneumococeus before as well as 1 and 6 months after vaccination were determined by multi-specificity opsonophagocytosis killing assay （MOPA）, and the GMTs and increasing rates of antibodies against the 13 serotypes 1 and 6 months after vaccination were analyzed statistically. Results The GMTs of OPA antibodies against 13 serotypes of pneumoeoecus in most of the elderly individuals 1 and 6 months after vaccination were significantly higher than those before vaccination （P 〈 0. 05）. However, the GMTs of antibodies against serotypes 1 and 3 six months after vaccination showed no significant difference with those before vaccination （P 〉 0. 05）. The GMTs of antibodies against serotypes 6A, 6B, 7F, 18C, 19F and 23F 6 months after vaccination showed no significant difference with those 1 month after vaccination （P 〉 0. 05 ）. Except that against serotype 1 in the individuals recovered from tuberculosis （37.5%）, the 2-fold increasing rates of GMTs of antibodies against all the 13 serotypes 1 month after vaccination were not less than 60%, which showed no significant difference in the healthy and recovered individuals （P 〉 0. 05）. Except those against serotypes 1 and 3 in the individuals recovered from tuberculosis, the d-fold increasing rates of GMTs of OPA antibodies against various serotypes showed no significant difference in the healthy and recovered individuals （P 〉 0. 05）. However, the 2-fold increasing rates of GMTs of OPA antibodies against the 13 serotypes were more than 45% and, except that against serotype 1, showed no significant difference in healthy and recovered individuals （P 〉 0. 05）. The 4-fold increasing rates of OPA antibody levels, except those against serotypes 1 and 18C, showed no significant difference in the healthy and recovered individuals （P 〉 0. 05）. Conclusion Specific functional antibodies against 13 serotypes of pneumococcus were induced by PPV-23 in healthy elderly individuals and the individuals recovered from tuberculosis, which last for 6 months. However, the levels and persistence of OPA antibodies against serotypes 1 and 3 in the recovered individuals were significantly lower than those in healthy individuals.