Development of immunologic memory against tetanus toxoid and pertactin antigens from the diphtheria-tetanuspertussis vaccine in atopic versus nonatopic children

Abstract

Background: Recent findings suggest that a hallmark of the atopic phenotype is reduced capacity to respond to vaccine antigens, as well as to environmental allergens, during infancy. This deficiency, which is most marked for the cytokine IFN-γ, appears transient but can result in a long-lasting imbalance within T helper cell (TH) memory responses to allergens. Indirect evidence suggests that parallel effects may occur within immunologic memory responses against vaccine antigens in atopic children. Objective: Our purpose was to compare vaccine antigen-specific TU memory responses in atopic and nonatopic children. Methods: We analyzed specific serum IgG and cytokine responses to pertactin and tetanus antigens as well as to mitogen (PHA) and house dust mite (HDM) allergen in 25 HDM-sensitized atopic and 25 nonatopic 6-year-old children who were vaccinated and boosted with diphtheria-tetanus-pertussis (DTP) vaccine. Results: PBMCs from the atopic subjects produced higher levels of TH1 and TH2 cytokines to HDM allergen and PHA. Vaccine antibody titers were normal in the atopic subjects; vaccine-specific TH2 responses were rarely detectable, yet TH1 (IFN-γ) responses, in particular against tetanus, were frequent and higher in the atopic subjects (121.5 [SE 64.3] vs 8.0 [3.5] pg/mL culture fluid, P = .04). Corresponding pertactin responses were comparable in both groups. Conclusions: At the completion of the full primer-booster DTP vaccination regimen, levels of vaccine-specific immunity in atopic 6-year-old children are at least equivalent to their nonatopic counterparts, indicating that the transient atopyassociated deficiency in TH1 function in childhood can be successfully overcome by appropriate vaccination and boosting regimens. Copyright © 2000 by Mosby, Inc.