Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Functional Immunity to Cross-Reactive Serotype 6A Induced by Serotype 6B in Pneumococcal Polysaccharide Vaccine

폐구균 다당질 백신 내 혈청형 6B에 의해 유도되는 교차 반응 혈청형 6A에 대한 기능적 면역

  • Kim, Kyung Hyo (Department of Pediatrics, College of Medicine, Ewha Woman's University)
  • 김경효 (이화여자대학교 의과대학 소아과학교실)
  • Received : 2004.11.26
  • Accepted : 2004.12.31
  • Published : 2005.05.15
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Abstract

Purpose : Streptococcus pneumoniae serotype 6B and 6A are important pathogens in pneumococcal infections. It is commonly assumed that the 6B vaccines elicit antibodies cross-reacting with the 6A serotype and the cross-reactive antibodies protect against infections of 6A. To examine this assumption, we measured the opsonophagocytic capacity to serotype 6A and 6B in adults. Methods : Twenty-four adults were immunized with pneumococcal PS vaccine that contains 6B PS. Their preimmune and postimmune sera were studied for the capacity to opsonize 6B and 6A serotypes with opsonophagocytic killing assay. Results : Opsonization titers to 6B were significantly higher than those to 6A in preimmune and postimmune sera. Because significant increasesof opsonization titers were observed in adults with polysaccharide vaccines for 6A(cross-reactive) serotype as well as for 6B(vaccine) serotype, 6B PS in vaccine elicited cross-protective antibodies to 6A, but not in all cases. One adult did not have detectable levels of opsonization titers to 6A after immunization. Conclusion : Although 6B PS in pneumococcal PS vaccine elicits antibodies cross-reacting with 6A serotype in some adults, it may not occur always. This study should be extended to other age groups such as children and elderly people. The presence of the cross-protection should be directly determined in clinical trials of the pneumococcal vaccines as well as during the postlicensure monitoring surveys by serotyping the clinical isolates of pneumococci.

목 적 : 폐구균 혈청형 6B와 6A는 폐구균 감염의 중요한 원인균이다. 6B 백신은 다당질 구조의 유사성으로 6A와 교차 면역반응을 일으키며 6B에 의해 생성된 6A에 대한 항체는 감염에서 방어 작용을 할 수 있다고 생각되고 있다. 이를 규명하기 위해 성인에게 폐구균 백신 접종 후 형성된 6B와 6A에 대한 항체의 옵소닌 작용 능력을 측정하여 교차 면역반응을 연구하였다. 방 법 : 건강한 성인 24명에게 혈청형 6B만 포함된 폐구균 다당질 백신을 접종하고 접종 전과 접종 한달 후 혈청에서 혈청형 6B와 6A에 대한 특이 항체의 옵소닌 작용 역가를 OPKA로 측정하였다. 결 과 : 6B에 대한 옵소닌 작용 역가는 백신 접종 전과 접종 후 모두 6A에 대한 역가보다 의미있게 높았다. 백신 혈청형인 6B에 대해서 뿐 아니라 교차 반응하는 혈청형인 6A에 대해 다당질 백신 접종 후 성인에서 옵소닌 작용 역가가 의미 있게 증가하였으므로 백신에 포함된 6B 다당질은 6A에 대해서 교차 방어 항체를 유도하였으나 모든 경우에 해당되지는 않았다. 1명의 성인에서 접종 후에도 계속적으로 6A에 대한 옵소닌 작용 역가가 측정되지 않았다. 결 론 : 백신에 포함된 폐구균 혈청형 6B에 대한 다당질은 혈청형 6A에 대해 대부분 교차 면역 반응을 일으켜 기능적 항체 형성을 유발하지만 드문 경우 이런 교차 면역 반응이 형성되지 않는 경우도 있다. 앞으로 이에 대한 연구가 소아와 노인 등의 다른 연령 군에서도 시행되어야 할 것이다. 또한 교차 방어 형성의 유무는 폐구균 백신의 임상 연구와 백신 사용 후 분리되는 폐구균의 혈청형 검사를 통한 임상 연구에서 직접적으로 연구되어야 할 것이다.

Keywords

References

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