Further investigations of the IgE response to tetanus and diphtheria following covaccination with acellular rather than cellular Bordetella pertussis

RC Aalberse, C Grüber, M Ljungman… - Pediatric Allergy and …, 2019 - Wiley Online Library
RC Aalberse, C Grüber, M Ljungman, S Kakat, U Wahn, B Niggemann, LJ Nilsson
Pediatric Allergy and Immunology, 2019Wiley Online Library
Background It has previously been shown in an uncontrolled study that the IgE response to
vaccine antigens is downregulated by co‐vaccination with cellular Bordetella pertussis
vaccine. Methods In the present study, we compared in a controlled trial the humoral
immune response to diphtheria toxoid (D) and tetanus toxoid (T) in relation to co‐vaccinated
cellular or acellular B pertussis vaccine. IgE, IgG4, and IgG to D and T were analyzed at 2, 7,
and 12 months of age in sera of children vaccinated with D and T (DT, N= 68), cellular …
Background
It has previously been shown in an uncontrolled study that the IgE response to vaccine antigens is downregulated by co‐vaccination with cellular Bordetella pertussis vaccine.
Methods
In the present study, we compared in a controlled trial the humoral immune response to diphtheria toxoid (D) and tetanus toxoid (T) in relation to co‐vaccinated cellular or acellular B pertussis vaccine. IgE, IgG4, and IgG to D and T were analyzed at 2, 7, and 12 months of age in sera of children vaccinated with D and T (DT, N = 68), cellular (DTPw, N = 68), 2‐ or 5‐component acellular B pertussis vaccine (DTPa2, N = 64; DTPa5, N = 65).
Results
One month after vaccination, D‐IgE was detected in 10% sera of DTPw‐vaccinated children, whereas vaccination in the absence of whole‐cell pertussis resulted in 50%‐60% IgE positivity. Six months after vaccination, the IgE antibody levels were found to be more persistent than the IgG antibodies. These diphtheria findings were mirrored by those for tetanus. Only minor differences between vaccine groups were found with regard to D‐IgG and T‐IgG. No immediate‐type allergic reactions were observed.
Conclusion
Cellular (but not acellular) B pertussis vaccine downregulates IgE to co‐vaccinated antigens in infants. We assume that the absence of immediate‐type allergic reactions is due to the high levels of IgG antibodies competing with IgE antibodies.
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