Transiently increased IgE responses in infants and pre-schoolers receiving only acellular Diphtheria-Pertussis-Tetanus (DTaP) vaccines compared to those initially receiving at least one dose of cellular vaccine (DTwP) - Immunological curiosity or canary i

Holt, Patrick G., Snelling, Tom, White, Olivia J., Sly, Peter D., DeKlerk, Nicholas, Carapetis, Jonathan, Van den Biggelaar, Anita, Wood, Nicholas, McIntyre, Peter and Gold, Michael (2016) Transiently increased IgE responses in infants and pre-schoolers receiving only acellular Diphtheria-Pertussis-Tetanus (DTaP) vaccines compared to those initially receiving at least one dose of cellular vaccine (DTwP) - Immunological curiosity or canary i. Vaccine, 34 35: 4257-4262. doi:10.1016/j.vaccine.2016.05.048


Author Holt, Patrick G.
Snelling, Tom
White, Olivia J.
Sly, Peter D.
DeKlerk, Nicholas
Carapetis, Jonathan
Van den Biggelaar, Anita
Wood, Nicholas
McIntyre, Peter
Gold, Michael
Title Transiently increased IgE responses in infants and pre-schoolers receiving only acellular Diphtheria-Pertussis-Tetanus (DTaP) vaccines compared to those initially receiving at least one dose of cellular vaccine (DTwP) - Immunological curiosity or canary i
Journal name Vaccine   Check publisher's open access policy
ISSN 0264-410X
1873-2518
Publication date 2016-07-29
Sub-type Article (original research)
DOI 10.1016/j.vaccine.2016.05.048
Open Access Status Not yet assessed
Volume 34
Issue 35
Start page 4257
End page 4262
Total pages 6
Place of publication London, United Kingdom
Publisher Elsevier
Language eng
Abstract Several previous studies have highlighted the strong Th2-polarising and IgE-promoting activity of the DTaP vaccine, but there is no evidence that this has pathological consequences and accordingly there is no current interest amongst vaccine developers in reformulating DTaP to attenuate these properties. In light of an apparent resurgence in pertussis in many countries, and emerging evidence from other areas of paediatric immunology of IgE-mediated interference with host defence mechanisms, this issue requires more detailed clarification.
Formatted abstract
Background: Several previous studies have highlighted the strong Th2-polarising and IgE-promoting activity of the DTaP vaccine, but there is no evidence that this has pathological consequences and accordingly there is no current interest amongst vaccine developers in reformulating DTaP to attenuate these properties. In light of an apparent resurgence in pertussis in many countries, and emerging evidence from other areas of paediatric immunology of IgE-mediated interference with host defence mechanisms, this issue requires more detailed clarification.

Methods: We have re-evaluated the impact of DTaP-only versus mixed DTwP/DTaP vaccination on Th2-dependent “bystander” IgE responses in three cohorts of children under different priming conditions, encompassing both vaccine-targeted and unrelated antigens including food allergens.

Results: We confirm the generalised IgE-trophic activity of the DTaP vaccine in pre-schoolers and demonstrate similar (albeit transient) effects in infants. We additionally demonstrate that use of an alternative mixed infant priming schedule encompassing an initial dose of DTwP significantly attenuates this property.

Interpretation: Central to our interpretation of these findings are studies demonstrating: (i) mixed DTwP/DTaP priming improves resistance to pertussis disease and attenuates the IgE-stimulatory component of long term vaccine-specific memory; (ii) IgE-mediated mechanisms can interfere with innate antiviral immunity and accordingly exacerbate airway symptoms in infected children. These observations, taken together with the data presented here, suggest a plausible mechanistic link between baseline pertussis-specific IgE titres in DTaP vaccinees and susceptibility to pertussis disease, which merits testing. Retrospective IgE analyses on sera collected from children at the time of presentation with pertussis could resolve this issue.
Keyword Pertussis vaccine
IgE
Infancy
Allergy
Fc-Epsilon-Ri
Plasmacytoid dendritic cells
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
Child Health Research Centre Publications
 
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