Lancet Infect Dis:阿奇霉素对口服脊髓灰质炎疫苗的免疫原性有什么影响?

2016-09-08 Mechront 译 MedSci原创

口服脊髓灰质炎疫苗的免疫原性和有效性在低收入国家较低,可能归因于肠道致病菌和相关的环境性肠病发生率高。这项双盲、随机、安慰剂对照试验研究,旨在评估阿奇霉素能否改善血清3型单价口服脊髓灰质炎疫苗的免疫原性。 研究纳入了印度韦洛尔14个街区生活的健康婴儿,年龄6-11个月,按1:1随机分为口服阿奇霉素10mg/kg或安慰剂(一天一次,共三天),第14天接受血清3型单价口服脊髓灰质炎疫苗。主要终点

口服脊髓灰质炎疫苗的免疫原性和有效性在低收入国家较低,可能归因于肠道致病菌和相关的环境性肠病发生率高。这项双盲、随机、安慰剂对照试验研究,旨在评估阿奇霉素能否改善血清3型单价口服脊髓灰质炎疫苗的免疫原性。

研究纳入了印度韦洛尔14个街区生活的健康婴儿,年龄6-11个月,按1:1随机分为口服阿奇霉素10mg/kg或安慰剂(一天一次,共三天),第14天接受血清3型单价口服脊髓灰质炎疫苗。主要终点为第35天稀释后(至少稀释八分之一)血清3型脊髓灰质炎病毒的血清中和抗体的检测情况。

共纳入754名婴儿,阿奇霉素组和安慰剂组分别有376名和378名;分别有348名(93%)和357名(94%)完成了研究;学情转化发生率分别有175名(50%)和192名(54%)(RR 0.94;95% CI,0.81~1.08;P=0.366)。阿奇霉素降低环境性肠病粪便中的生物标志物(钙卫蛋白、髓过氧化物酶、α1-抗胰蛋白)和细菌性患病率(非病毒或真核病原体)。病毒病原体与低血清转化率相关。

研究期间发生了3例严重不良事件(阿奇霉素2例,安慰剂1例),但均与研究干预无关。

结果表明,阿奇霉素虽然可以降低环境性肠病的生物标志物和致病性肠道细菌的流行率,但不能提高口服脊髓灰质炎疫苗的免疫原性。病毒干扰和天然抗病毒免疫机制可能是活病毒口服疫苗免疫原性的重要决定因素。

原始出处:

Nicholas C Grassly.et al.The effect of azithromycin on the immunogenicity of oral poliovirus vaccine: a double-blind randomised placebo-controlled trial in seronegative Indian infants.Lancet Infect Dis.Volume 16, No. 8, p905–914, August 2016

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    2017-05-22 howi
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    2016-10-11 1e10c84am36(暂无匿称)

    好文章,受益

    0

  4. 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encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Fri Oct 14 03:30:00 CST 2016, time=2016-10-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1393788, encodeId=d25c1393e885f, content=<a href='/topic/show?id=718528982e3' target=_blank style='color:#2F92EE;'>#免疫原性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28982, encryptionId=718528982e3, topicName=免疫原性)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/78FA0899509C358B01B975E8EAC1F88A/100, createdBy=7d822500145, createdName=ms5353107019656438, createdTime=Sat Sep 10 06:30:00 CST 2016, time=2016-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483116, encodeId=0dff148311672, content=<a href='/topic/show?id=19398461920' 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  5. 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  6. 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GetPortalCommentsPageByObjectIdResponse(id=114275, encodeId=36171142e55c, content=阿奇霉素虽然可以降低环境性肠病的生物标志物和致病性肠道细菌的流行率,但不能提高口服脊髓灰质炎疫苗的免疫原性。, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Thu Sep 08 17:39:00 CST 2016, time=2016-09-08, status=1, ipAttribution=)]
  7. 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createdBy=3f0227, createdName=howi, createdTime=Mon May 22 18:30:00 CST 2017, time=2017-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=144449, encodeId=12bf1444490f, content=好文章,受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Oct 11 15:12:27 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2012124, encodeId=88662012124a2, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Fri Oct 14 03:30:00 CST 2016, time=2016-10-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1393788, encodeId=d25c1393e885f, content=<a href='/topic/show?id=718528982e3' target=_blank style='color:#2F92EE;'>#免疫原性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28982, encryptionId=718528982e3, topicName=免疫原性)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/78FA0899509C358B01B975E8EAC1F88A/100, createdBy=7d822500145, createdName=ms5353107019656438, createdTime=Sat Sep 10 06:30:00 CST 2016, time=2016-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483116, encodeId=0dff148311672, content=<a href='/topic/show?id=19398461920' target=_blank style='color:#2F92EE;'>#脊髓灰质炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84619, encryptionId=19398461920, topicName=脊髓灰质炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b9117881304, createdName=12498c32m70暂无昵称, createdTime=Sat Sep 10 06:30:00 CST 2016, time=2016-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=115052, encodeId=f8f0115052fc, content=阿奇霉素虽然可以降低环境性肠病的生物标志物和致病性肠道细菌的流行率,但不能提高口服脊髓灰质炎疫苗的免疫原性。, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 09 11:18:00 CST 2016, time=2016-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=115053, encodeId=79da115053e4, content=谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 09 11:18:00 CST 2016, time=2016-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=115054, encodeId=e071115054aa, content=继续关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 09 11:18:00 CST 2016, time=2016-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=114275, encodeId=36171142e55c, content=阿奇霉素虽然可以降低环境性肠病的生物标志物和致病性肠道细菌的流行率,但不能提高口服脊髓灰质炎疫苗的免疫原性。, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Thu Sep 08 17:39:00 CST 2016, time=2016-09-08, status=1, ipAttribution=)]
    2016-09-09 知难而进

    阿奇霉素虽然可以降低环境性肠病的生物标志物和致病性肠道细菌的流行率,但不能提高口服脊髓灰质炎疫苗的免疫原性。

    0

  8. 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createdBy=3f0227, createdName=howi, createdTime=Mon May 22 18:30:00 CST 2017, time=2017-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=144449, encodeId=12bf1444490f, content=好文章,受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Oct 11 15:12:27 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2012124, encodeId=88662012124a2, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Fri Oct 14 03:30:00 CST 2016, time=2016-10-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1393788, encodeId=d25c1393e885f, content=<a href='/topic/show?id=718528982e3' target=_blank style='color:#2F92EE;'>#免疫原性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28982, encryptionId=718528982e3, topicName=免疫原性)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/78FA0899509C358B01B975E8EAC1F88A/100, createdBy=7d822500145, createdName=ms5353107019656438, createdTime=Sat Sep 10 06:30:00 CST 2016, time=2016-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483116, encodeId=0dff148311672, content=<a href='/topic/show?id=19398461920' target=_blank style='color:#2F92EE;'>#脊髓灰质炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84619, encryptionId=19398461920, topicName=脊髓灰质炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b9117881304, createdName=12498c32m70暂无昵称, createdTime=Sat Sep 10 06:30:00 CST 2016, time=2016-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=115052, encodeId=f8f0115052fc, content=阿奇霉素虽然可以降低环境性肠病的生物标志物和致病性肠道细菌的流行率,但不能提高口服脊髓灰质炎疫苗的免疫原性。, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 09 11:18:00 CST 2016, time=2016-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=115053, encodeId=79da115053e4, content=谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 09 11:18:00 CST 2016, time=2016-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=115054, encodeId=e071115054aa, content=继续关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 09 11:18:00 CST 2016, time=2016-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=114275, encodeId=36171142e55c, content=阿奇霉素虽然可以降低环境性肠病的生物标志物和致病性肠道细菌的流行率,但不能提高口服脊髓灰质炎疫苗的免疫原性。, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Thu Sep 08 17:39:00 CST 2016, time=2016-09-08, status=1, ipAttribution=)]
    2016-09-09 知难而进

    谢谢分享!

    0

  9. 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createdBy=3f0227, createdName=howi, createdTime=Mon May 22 18:30:00 CST 2017, time=2017-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=144449, encodeId=12bf1444490f, content=好文章,受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Oct 11 15:12:27 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2012124, encodeId=88662012124a2, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Fri Oct 14 03:30:00 CST 2016, time=2016-10-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1393788, encodeId=d25c1393e885f, content=<a href='/topic/show?id=718528982e3' target=_blank style='color:#2F92EE;'>#免疫原性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28982, encryptionId=718528982e3, topicName=免疫原性)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/78FA0899509C358B01B975E8EAC1F88A/100, createdBy=7d822500145, createdName=ms5353107019656438, createdTime=Sat Sep 10 06:30:00 CST 2016, time=2016-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483116, encodeId=0dff148311672, content=<a href='/topic/show?id=19398461920' target=_blank style='color:#2F92EE;'>#脊髓灰质炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84619, encryptionId=19398461920, topicName=脊髓灰质炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b9117881304, createdName=12498c32m70暂无昵称, createdTime=Sat Sep 10 06:30:00 CST 2016, time=2016-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=115052, encodeId=f8f0115052fc, content=阿奇霉素虽然可以降低环境性肠病的生物标志物和致病性肠道细菌的流行率,但不能提高口服脊髓灰质炎疫苗的免疫原性。, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 09 11:18:00 CST 2016, time=2016-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=115053, encodeId=79da115053e4, content=谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 09 11:18:00 CST 2016, time=2016-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=115054, encodeId=e071115054aa, content=继续关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 09 11:18:00 CST 2016, time=2016-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=114275, encodeId=36171142e55c, content=阿奇霉素虽然可以降低环境性肠病的生物标志物和致病性肠道细菌的流行率,但不能提高口服脊髓灰质炎疫苗的免疫原性。, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Thu Sep 08 17:39:00 CST 2016, time=2016-09-08, status=1, ipAttribution=)]
    2016-09-09 知难而进

    继续关注!

    0

  10. 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    2016-09-08 医路开来

    阿奇霉素虽然可以降低环境性肠病的生物标志物和致病性肠道细菌的流行率,但不能提高口服脊髓灰质炎疫苗的免疫原性。

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