母源性抗-HBs对新生儿接种乙型肝炎疫苗的远期影响

目的:观察新生儿体内母源性乙型肝炎表面抗体(抗-HBs)对乙型肝炎疫苗接种后抗体应答的远期影响。方法:2006年10月-2007年1月在南京大学医学院附属鼓楼医院产前检查并住院分娩的单胎足月妊娠妇女中,选择抗-HBs阳性孕妇32例,抗-HBs阴性孕妇32例,其新生儿均按0、1、6方案接种重组(酵母)乙型肝炎疫苗,检测两组儿童乙型肝炎疫苗第3针接种后2年血清抗-HBs浓度。结果:新生儿接种乙型肝炎疫苗第3针后2年,母源性抗-HBs阴性组与阳性组儿童抗-HBs阳性率分别为90.6%与87.5%,其抗-HBs几何平均浓度分别为73.48mIU/ml与75.49mIU/ml,两组间抗-HBs阳性率与GMC的差异均无统计学意义(P=1.000,P=0.778);6例母源性抗-HBs>1000mIU/ml儿童中1例抗-HBs转阴(16.7%),而母源性抗-HBs<1000mIU/ml组和母源性抗-HBs组的儿童抗-HBs转阴率分别仅为7.69%和11.1%,但差异无统计学意(P=0.811)。结论:新生儿目前按照0,1,6方案接种乙型肝炎疫苗,能够有效保护其抵抗乙型肝炎病毒的感染;母源性抗-HBs对新生儿接种乙型肝炎疫苗...     

乙型肝炎疫苗与卡介苗、百白破混合菌苗的联合免疫效果观察

本文报道150名HBsAg阴性产妇所生新生儿在实施计划免疫的同时,1、2组分别接种10μg、20μg乙肝疫苗,3组不接种乙肝疫苗,以了解乙肝疫苗与卡介苗、百白破联合免疫的免疫应答。结果表明:1.2组抗-HBc达到有效保护的(P/N≥5)为93.18％和89.58％,无显著差异;两组均未检出HBV标志物,但是未注射乙肝疫苗组HBV感染达6.67％。乙肝疫苗与卡介苗、百白破联合免疫应答是好的,抗原间无干扰,从而证明乙肝疫苗不但能有效地控制乙型肝炎,并能纳入扩大免疫规划。     

广州市1992-2007年出生新生儿接种乙型肝炎疫苗免疫效果评估

为评估广州市新生儿乙型肝炎疫苗(HepB)接种纳入计划免疫管理后免疫效果。对1992-2007年出生并接种HepB的新生儿2877人,按1992-2001年和2002-2007年出生新生儿分为计划免疫管理前(Ⅰ组)、计划免疫管理后(Ⅱ组)2组,采血检测乙肝病毒表面抗原(HBsAg)、乙肝病毒表面抗体(抗-HBs)和乙肝病毒核心抗体(抗-HBc)。Ⅱ组HBsAg阳性率为0.48%比Ⅰ组的4.54%阳性率下降了80.65%,在统计学意义上有显著差异。抗-HBc阳性率也由36.07%下降为26.73%,Ⅱ组的抗-HBs阳性率为75.19%,高于I组水平。新生儿乙型肝炎疫苗纳入计划免疫管理后群体免疫效果良好,使用不同种类乙肝疫苗效果没有统计学差异。重组(酵母)乙型肝炎疫苗有较好的近期保护效果和免疫原性,与以前使用血源乙型肝炎疫苗效果相当。     

乙型肝炎血源疫苗不同剂量与不同途径免疫儿童的效果比较

比较了四组乙型肝炎血源疫苗不同剂量和不同免疫途径的免疫效果。每组对象为6～7岁儿童30～50人。每人三剂疫苗,程序为 0、1和6个月。其中10μg肝注组免疫三针后1个月和3年,抗HBs阳住率均为100％;而3μg肌注组仅为78％和40％;5μg肌注组和3μg皮内接种组的抗-HBs阳性率在89％～100％之问。免疫后18个月做抗-HBs相对定量,各组mIU/ml的GMT由高到低依次为10μg肌注组、3μg皮内组、5μg肌注组和3μg肌注组。由此可见,对学龄前HBV标志阴性的儿童进行免疫,在各组中以10μg疫苗肌注效果最佳,而3μg肌注无实用价值。如考虑到疫苗费用,则5μg肌注或3μg皮内注射也不失为可取的方法。     

阳江市健康人群乙型肝炎血清流行病学调查

目的了解阳江市健康人群乙型肝炎表面抗体(抗-HBs)水平,评价乙型肝炎疫苗免疫效果。方法采用整群随机抽样方法,在阳江市辖区内随机抽取20个乡镇的常住健康人群为调查对象。采用电化学发光免疫法定量检测抗-HBs水平,运用SPSS18.0和Excel 2007软件进行数据整理和分析。结果共采集1 054人份血清进行检测,人群中乙肝疫苗接种率为94.88%,抗-HBs阳性率为63.47%、抗-HBs高应答率及GMT分别为29.51%和2 3.47 m IU/m L。乙肝疫苗接种率显示,随着年龄的增长疫苗接种率越低;20岁以下和20岁以上人群疫苗接种率分别为98.35%和54.22%,且男性高于女性;各地区间疫苗接种率差异无统计学意义(χ2=5.99,P=0.11)。抗-HBs阳性率显示,1~14岁儿童抗-HBs阳性率为63.00%。其中,1~岁组儿童最高为87.20%,7~岁组最低为54.56%;江城区抗-HBs阳性率最高(70.61%),阳西县最低(56.60%)。1岁以下儿童的抗-HBs应答率和GMT均最高,分别为61.22%和(91.56±2.15)m IU/m L。5~岁组最低,分别为13.74%和(12.44±1.46)m IU/m L,差异均有显著的统计学意义(χ2=57.31,P=0.00,F=5.77,P=0.00)。结论阳江市健康人群乙肝疫苗接种率高,初步形成免疫屏障。积极开展20岁以下人群的加强免疫和成人的乙肝疫苗的接种工作。     

新生儿接种两种剂型乙型肝炎疫苗不同时间的免疫水平比较

目的:研究接种两种不同剂型的乙肝疫苗(Hepatitis B vaccine,Hep B)(包括10μg CHO基因工程乙肝疫苗(以下简称10μg Hep B)与5μg重组酵母乙肝疫苗(以下简称5μg Hep B))后不同时间,新生儿体内免疫水平的变化,为新生儿乙肝疫苗的接种提供科学依据。方法:选择2016年7月1日-2018年12月1日在青岛大学附属医院接种且按照0、1、6个月免疫程序完成乙型肝炎疫苗全程接种的,采用化学放光法测定血清中抗体水平,比较接种10μg与5μg Hep B后不同时间新生儿体内抗体变化。结果:接种1、6和12月后,10μg Hep B组新生儿低无应答率显著低于5μg Hep B组,而肝表面抗体滴度明显高于5μg Hep B组(P0.05);12个月后,两组新生儿乙肝表面抗体滴度均呈现下降趋势;10μg Hep B组新生儿乙肝表面抗体阳性率仍显著高于5μg Hep B组(P0.05)。结论:新生儿接种10μg Hep B的免疫效果优于5μg Hep B。     

乙型肝炎疫苗与卡介苗、百白破、脊髓灰质炎疫苗联合免疫的免疫应答观察

本文报道在对婴幼儿实施基础免疹(BCC、DPT和TOPV)的同时,接种国产血源乙肝疫苗的免疫应答。对八月龄的婴儿血清学检测结果表明:乙肝疫苗接种组1(10μg)、2(20μg)抗-HBs达到临界保护(P/N≥10.0)的分别为80.65％,78.49％,未检出HBV感染标志物;未接种乙肝疫苗组的HBV感染率边10.5％。血清学检测还表明乙肝疫苗与BCG、DPT和TOPV等生物制品联合免疫应答是好的,各抗原间无干扰作用,提示乙肝疫苗可列入扩大免疫规划,并将有效地控制乙肝病毒感染。     

对乙型肝炎疫苗的回忆应答

<正>Perrillo等曾探讨过机体对乙型肝炎疫苗初次接的回忆应答可能性。作者亦发现,在乙型肝炎疫苗(‘Hepavax-B’)接种后,产生不同类型免疫球蛋白。于免疫接种前,放射免疫测定血清HBsAg、抗HBs、抗HBc均阴性的136例受试者中,16例因在接种乙型肝炎疫苗(‘H-B-VAX’)40μg后第3～5周检出抗-HBs抗体(即免疫应答迅速),而选作乙型肝炎疫苗接种。已知该16     

乙型肝炎病毒疫苗免疫不应答群体中蛋白质组表达差异性的初步研究

以往研究显示,人群中约有10%无法通过接种乙型肝炎病毒(HBV)疫苗而产生保护性水平的应答。为研究HBV疫苗免疫后不应答发生的机制,本研究对108例经正常免疫程序(大连汉信产HBV疫苗,10μg/支,共接种3针)后不同应答水平人群的血浆蛋白质组差异进行分析,将其分为无应答(抗体效价检测结果为阴性)组和高应答(抗体效价约1 000mIU/ml)组。用多重亲和去除系统(MARS)亲和柱去除14种高丰度蛋白后,采用双向荧光差异电泳(2D-DIGE)与基质辅助激光解析电离串联飞行时间质谱(MALDI-TOFMS)相结合的方法,鉴定获得11种差异表达蛋白质。在这些差异表达蛋白质中,α1微球蛋白、激肽原1的表达在无应答人群中较高应答人群上调,而α1抗胰凝乳蛋白酶、维生素D结合蛋白、afamin、抗凝血酶Ⅲ和玻连蛋白表达下调。其中,α1抗胰凝乳蛋白酶、激肽原1和α1微球蛋白的差异性表达进一步得到酶联免疫吸附试验(ELISA)或蛋白免疫印迹法验证。以上蛋白质的表达情况与HBV疫苗免疫应答状况相关,可能成为检测HBV疫苗免疫应答水平的分子标记,为进一步研究免疫不应答机制奠定基础。     

重组(汉逊酵母)乙型肝炎疫苗副反应和抗体应答观察

观察重组(汉逊酵母)乙肝疫苗免疫儿童的副反应和抗体应答。按0、1、6月免疫程序,分别应用2批重组汉逊酵母疫苗和2批重组酿酒酵母疫苗,免疫221名6至12岁儿童,其中汉逊酵母疫苗1批(A)接种102人,另一批(B)接种26人,重组酿酒酵母疫苗1批(C)和另1批(D)分别接种74和19人。观察每次接种后的副反应和全程免疫一月后(T7)的抗体应答。儿童接种汉逊酵母疫苗后副反应发生率低,有个别出现发热反应,但均低于37.8℃,且为一过性。T7时4组儿童抗HBs血清阳转率均在96%以上,GMT范围在229.98～338.83IU/L之间。免疫A批疫苗儿童组抗体滴度(GMT)显著高于免疫C批疫苗组(270.33、229.98IU/L;P<0.05)。汉逊酵母乙肝疫苗具有较好的安全性,免疫儿童抗体应答水平较高。     

Plant immunization

Plant immunization is the process of activating natural defense system present in plant induced by biotic or abiotic factors. Plants are pre-treated with inducing agents stimulate plant defense responses that form chemical or physical barriers that are used against the pathogen invasion. Inducers used usually give the signals to rouse the plant defense genes ultimately resulting into induced systemic resistance. In many plant-pathogen interactions, R-Avr gene interactions results in localized acquired resistance or hypersensitive response and at distal ends of plant, a broad spectrum resistance is induced known as systemic acquired resistance (SAR). Various biotic or abiotic factors induce systemic resistance in plants that is phenotypically similar to pathogen-induced systemic acquired resistance (SAR). Some of the biotic or abiotic determinants induce systemic resistance in plants through salicylic acid (SA) dependent SAR pathway, others require jasmonic acid (JA) or ethylene. Host plant remains in induced condition for a period of time, and upon challenge inoculation, resistance responses are accelerated and enhanced. Induced systemic resistance (ISR) is effective under field conditions and offers a natural mechanism for biological control of plant disease.     

Applications and optimization of immunization procedures

Classical immunization protocols have produced an antibody-based humoral response that is very effective against susceptible infectious diseases. Immunization introduces an external substance to induce the host immune system to respond specifically. Typically an antigen is used, but DNA, or a primed, pre-existing leukocyte or antigen-presenting cell, can also be used. Immunization is currently being used or investigated for the prevention and treatment of infectious diseases, cancer, addictions, allergies, pregnancy, and autoimmune diseases. It is also being used to produce biologically active materials such as polyclonal and monoclonal antibodies, antivenins, and anti-toxins for treating a wide range of conditions. Animals have been integral to the development of immunization techniques, as producers of toxoids and antitoxins, as models (e.g., to validate materials and protocols used for immunization, to understand the impact of immunization itself on the immune system, and to help investigators devise methods for determining the efficacy of vaccines) and as beneficiaries themselves of vaccines and antitoxins. The choice of immunization protocols is complex, and results may be affected by many factors such as dose and concentration of antigen, choice of adjuvants, time between inoculation and response measurement, and method of detection. The immune system responses to an antigen are also complex and continue to develop with advancing age. Anatomical, physiological, and immune system differences between species influence responses to immunization, as do the purity and presentation of the antigens and adjuvants. When directly comparing results, animals should be sourced from the same supplier. This review highlights the many uses of immunization techniques and introduces important considerations for the choice of protocols and animal models.     

Genetic immunization of neonates

The vaccination of neonates is generally difficult due to immaturity of the immune system, higher susceptibility to tolerance and potential negative interference of maternal antibodies. Studies carried out in rodents and non-human primates showed that plasmid vaccines expressing microbial antigens, rather than inducing tolerance, triggered significant humoral and cellular immunity with a Th1 component. The ability of bacterial CpG motifs to activate immature antigen-presenting cells is critical for the neonatal immunogenicity of DNA vaccines. In addition, the endogenous production of antigen subsequent to transfection of antigen-presenting cells may explain the lack of inhibition by maternal antibodies of cellular responses. Together, these features make the plasmid vaccines an appealing strategy to prime immune responses against foreign pathogens, during early life. In combination with subsequent boosting using conventional vaccines, DNA vaccine-based regimens may provide a qualitatively superior immunity against microbes. Thorough understanding of immunomodulatory properties of plasmid-vectors may extend their use for early prophylaxis of inflammatory disorders.     

Resistance to immunization

Despite a well documented efficacy and a generally good adhesion of a large majority of the lay population and health care professionals as well, immunization is still the object of controversies. It affects several vaccines against hepatitis B, influenza, BCG, pertussis and measles. In most cases, polemics on vaccination result from a temporal association between a vaccination and the revelation of a serious disease, when the immunization is performed at the peak of incidence of the disease. Controversies can also be initiated by scientific publications, even though these are often biased, by a misinterpretation or the absence of official positions from the health care authorities, or by justice decisions, whose criteria differ from the scientists' ones and are therefore difficult to understand for the lay public. Furthermore, the scientific demonstration of the exclusion of a risk is difficult to obtain. In the past, it appeared to be very difficult to stop controversies. Improving the communication is the main issue, towards lay public as well as health care professionals. This implies to learn how to better use the media, to motivate and educate professionals who administer vaccine, and anticipate the eventuality of a temporal relationship between vaccination and occurrence of a serious disease by an improved management of the pharmacovigilance system.