Priming with Whole-Cell versus Acellular Pertussis Vaccine

New England Journal of Medicine (Impact Factor: 55.87). 02/2013; 368(6):581-2. DOI: 10.1056/NEJMc1212006
Source: PubMed
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    • "Therefore, it is 60 possible that the immune responses induced by 3-5 antigens from the single isolate used to 61 manufacture the aP vaccine do not protect against at least some of the current circulating 62 strains. Secondly, the waning protective immunity observed following immunization with aP 63 vaccines suggests that these vaccines fail to generate effective immunological memory (Klein 64 et al., 2012), (Sheridan et al., 2012, Klein et al., 2013, Liko et al., 2013, Witt et al., 2013). "
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    ABSTRACT: Current acellular pertussis vaccines have various shortcomings, which may contribute to their sub-optimal efficacy and waning immunity in vaccinated populations. This calls for the development of new pertussis vaccines capable of inducing long-lived protective immunity. Immunization with whole cell pertussis vaccines and natural infection with Bordetella pertussis induce distinct and more protective immune responses when compared with immunization with acellular pertussis vaccines. Therefore, the immune responses induced with whole cell vaccine or after infection can be used as a benchmark for the development of third generation vaccines against pertussis. Here, we review the literature on the immunology of B. pertussis infection and vaccination and discuss the lessons learned that will help in the design of improved pertussis vaccines.
    Pathogens and Disease 09/2015; DOI:10.1093/femspd/ftv067 · 2.40 Impact Factor
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    • "This is in contrast to wP vaccines, which provide protection well into the teenaged years (Klein et al. 2012). As a result of these shortcomings, in countries that switched to the aP vaccine in the 1990s we now have a generation of children not only less well-protected against pertussis but who may also be less responsive to boosters, since the vaccine with which a child is primed may determine their immune response to later booster vaccination (Podda et al. 1995; Mascart et al. 2007; Sheridan et al. 2012; Liko, Robison and Cieslak 2013; Smits et al. 2013). "
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    ABSTRACT: Pertussis (whooping cough) is a respiratory disease caused by the bacterium Bordetella pertussis. Despite the implementation of immunization programs and high vaccine coverage in most jurisdictions, pertussis is still one of the most common vaccine-preventable diseases, suggesting that the current vaccines and immunization schedules have not been sufficiently effective. Several factors are thought to contribute to this. The acellular pertussis vaccine that has been used in many jurisdictions since the 1990s is less effective than the previously used whole-cell vaccine, with immunity waning over time. Both whole-cell and acellular pertussis vaccines are effective at reducing disease severity but not transmission, resulting in outbreaks in vaccinated cohorts. In this review we discuss the various limitations of the current approaches to protection from pertussis and outline various options for reducing the burden of pertussis on a population-level. © Her Majesty the Queen in Right of Canada 2015. Reproduced with the permission of the Minister of Health.
    Pathogens and Disease 08/2015; 73(8). DOI:10.1093/femspd/ftv057 · 2.40 Impact Factor
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    • "In the last years there has been a resurgence of pertussis cases and infant deaths in countries with high vaccination coverage [29] [30] [31], emphasizing the need for a different vaccine approach to provide protection for the most susceptible infants. Studies have shown that a primary dose of a Pw-vaccine reduces the risk of pertussis compared to a primary dose of a Pa-vaccine [30–32], and the live attenuated BPZE1 vaccine may be a promising priming candidate in that context. "
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    ABSTRACT: Despite high vaccination coverage, pertussis is still a global concern in infant morbidity and mortality, and improved pertussis vaccines are needed. A live attenuated Bordetella pertussis strain, named BPZE1, was designed as an intranasal vaccine candidate and has recently been tested in man in a phase I clinical trial. Here, we report the evaluation of the B-cell responses after vaccination with BPZE1. Forty-eight healthy males with no previous pertussis-vaccination were randomized into one of three dose-escalating groups or into a placebo group. Plasma blast- and memory B-cell responses were evaluated by ELISpot against three different pertussis antigens: pertussis toxin, filamentous haemagglutinin and pertactin. Seven out of the 36 subjects who had received the vaccine were colonized by BPZE1, and significant increases in the memory B-cell response were detected against all three tested antigens in the culture-positive subjects between days 0 and 28 post-vaccination. The culture-positive subjects also mounted a significant increase in the filamentous haemagglutinin-specific plasma blast response between days 7 and 14 post-vaccination. No response could be detected in the culture-negatives or in the placebo group post-vaccination. These data show that BPZE1 is immunogenic in humans and is therefore a promising candidate for a novel pertussis vaccine. This trial is registered at (NCT01188512).
    Vaccine 04/2014; 32(27). DOI:10.1016/j.vaccine.2014.04.048 · 3.62 Impact Factor
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