Factors affecting immunogenicity of BCG in infants, a study in Malawi, The Gambia and the UK

影响婴儿 BCG 免疫原性的因素,马拉维、冈比亚和英国的一项研究

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作者:Yun-Gyoung Hur, Patricia Gorak-Stolinska, Maeve K Lalor, Hazzie Mvula, Sian Floyd, John Raynes, Anne Ben-Smith, Joseph R Fitchett, Katie L Flanagan, Sarah Burl, Martin O Ota, Amelia C Crampin, Steven G Smith, Hazel M Dockrell

Background

BCG immunogenicity in infants differs between populations and these differences have been attributed to various factors. In this study, the influence of geographical location, season of birth, timing of vaccination, micronutrient status (zinc) and inflammatory status (C-reactive protein, CRP) were assessed.

Conclusions

The cytokine/chemokine signatures observed in response to M. tuberculosis PPD in infants at 3 months post BCG vaccination were affected by geographical location, season of birth, and timing of vaccination but not associated with the concentration of plasma zinc or inflammatory status. These factors should be considered in future trials of new TB vaccines.

Methods

Immunogenicity was assessed by cytokine signature in culture supernatants from diluted whole blood samples stimulated with M. tuberculosis PPD, using a multiplex bead assay.

Results

In Malawi, infants vaccinated within the first week after birth showed lower production of most cytokines measured than those vaccinated later. The number of cytokines showing significant differences between Malawian and Gambian infants decreased after adjusting for season of birth. In Malawi, a proportion of infants had zinc deficiency and elevated plasma CRP (>10 mg/L), but neither zinc deficiency nor high CRP was associated with production of any of the cytokines measured. Conclusions: The cytokine/chemokine signatures observed in response to M. tuberculosis PPD in infants at 3 months post BCG vaccination were affected by geographical location, season of birth, and timing of vaccination but not associated with the concentration of plasma zinc or inflammatory status. These factors should be considered in future trials of new TB vaccines.

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