Whole-Cell or Acellular Pertussis Primary Immunizations in Infancy Determines Adolescent Cellular Immune Profiles

Front Immunol. 2018 Jan 24:9:51. doi: 10.3389/fimmu.2018.00051. eCollection 2018.

Abstract

Introduction: Pertussis is re-emerging worldwide, despite effective immunization programs for infants and children. Epidemiological studies show a more limited duration of protection against clinical pertussis in adolescents primed with acellular pertussis (aP) vaccines during infancy than those who have been primed with whole-cell pertussis (wP) vaccines. This study aimed to determine whether memory immune responses to aP, diphtheria, and tetanus vaccine antigens following booster vaccinations at 4 and 9 years of age differ between wP- versus aP-primed children.

Methods: In a cross-sectional study, blood was collected of DTwP- or diphtheria, tetanus, and aP (DTaP)-primed children before, 1 month, and 2 years after the preschool DTaP booster administered at 4 years of age (n = 41-63 per time point). In a longitudinal study, blood was sampled of DTwP- or DTaP-primed children before, 1 month, and 1 year after a preadolescent Tdap booster at 9 years of age (n = 79-83 per time point). Pertussis, diphtheria, and tetanus vaccine antigen-specific IgG levels, B-cell and T-cell responses were determined.

Results: After the preschool booster vaccination, IgG levels were significantly higher in aP-primed as compared with wP-primed children until 6 years of age. Before the preadolescent Tdap booster vaccination, humoral and cellular immune responses were similar in aP- and wP-primed children. However, the Tdap booster vaccination induced lower vaccine antigen-specific humoral, B-cell, and T-helper 1 (Th1) cell responses resulting in significantly lower Th1/Th2 ratios in aP-primed compared with wP-primed children.

Conclusion: The memory immune profiles at preadolescent age to all DTaP vaccine antigens are already determined by the wP or aP combination vaccines given in infancy, showing a beneficial Th1-dominated response after wP-priming. These immunological data corroborate epidemiological data showing that DTaP-primed adolescents are less protected against clinical pertussis than DTwP-primed children.

Keywords: (pre-)adolescents; T-helper 1/Th2 ratio; immune profiles; infant priming; pertussis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Antibodies, Bacterial / blood
  • Antibodies, Bacterial / immunology
  • B-Lymphocytes / immunology
  • B-Lymphocytes / metabolism
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Cytokines / immunology
  • Cytokines / metabolism
  • Diphtheria-Tetanus-acellular Pertussis Vaccines / administration & dosage
  • Diphtheria-Tetanus-acellular Pertussis Vaccines / immunology
  • Humans
  • Immunity, Cellular*
  • Immunization*
  • Immunization, Secondary
  • Immunoglobulin G / blood
  • Immunoglobulin G / immunology
  • Lymphocyte Count
  • Pertussis Vaccine / administration & dosage
  • Pertussis Vaccine / immunology*
  • T-Lymphocyte Subsets / immunology
  • T-Lymphocyte Subsets / metabolism
  • Vaccination
  • Whooping Cough / immunology*
  • Whooping Cough / prevention & control*

Substances

  • Antibodies, Bacterial
  • Cytokines
  • Diphtheria-Tetanus-acellular Pertussis Vaccines
  • Immunoglobulin G
  • Pertussis Vaccine

Associated data

  • EudraCT/2013-001864-50
  • NTR/NTR4089