title: Cell-mediated and antibody responses to Bordetella pertussis antigens in children vaccinated with acellular or whole-cell pertussis vaccines. The Progetto Pertosse-CMI Working Group.
abstract: OBJECTIVE
  To examine induction and persistence of cell-mediated immunity (CMI) and antibody responses to Bordetella pertussis antigens in infants receiving antipertussis vaccines.
  
  
  METHODS
  A randomized, blinded study of 142 children receiving acellular pertussis vaccines combined with diphtheria-tetanus toxoids (DTaP) (DTaP manufactured by SmithKline Beecham [DTaP-SB], Rixensart, Belgium, and DTaP manufactured by Chiron Biocin [DTaP-CB], Siena, Italy), or a whole-cell pertussis vaccine (DTwP) (Connaught Laboratories Inc, Swiftwater, Pa), or a diphtheria-tetanus (DT) (Chiron Biocine) only vaccine. Three doses of each vaccine were given at 2, 4, and 6 months of age, and CMI and antibody responses were evaluated before and at 1 and 14 months after vaccination.
  
  
  METHODS
  Cell-mediated immunity was assessed by proliferation of peripheral blood mononuclear cells stimulated in vitro by B pertussis antigens (pertussis toxin, filamentous hemagglutinin, and pertactin). Antibody titers against pertussis toxin, filamentous hemagglutinin, and pertactin were determined by a standardized enzyme-linked immunosorbent assay.
  
  
  RESULTS
  A CMI-positive response to at least 1 B pertussis antigen at 1 or both postvaccination assays was detected in 46%, 55%, and 83% of DTwP, DTaP-SB, and DTaP-CB vaccine recipients, respectively. Frequency of CMI response to individual antigens ranged from less than 4.9% against pertussis toxin in DTwP recipients to 52% against pertactin in DTaP-CB recipients. The postvaccination responses measured at 14 months equalled, or had increased frequency or intensity, that of the 1-month postvaccination responses. Elevated antibody titers against the 3 antigens were present in all DTaP recipients 1 month after vaccination and were higher in CMI-positive children than in CMI-negative children. They fell, however, to low, if not negligible, levels 14 months after vaccination.
  
  
  CONCLUSIONS
  Acellular pertussis vaccines were better inducers of CMI response than the whole-cell vaccine, particularly against pertussis toxin. Once acquired, CMI persisted, in contrast with the rapid antibody decline. Thus, CMI responses could be a useful adjunct to serology in the evaluation of pertussis vaccine immunogenicity and a better correlate of long-term immunity to B pertussis than antibody titers.
authors.affiliation: Department of Bacteriology and Medical Mycology, Rome, Italy, Instituto Superiore di Sanitá, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Cassone
authors.forename: C M
authors.initials: CM
authors.lastname: Ausiello
authors.forename: F
authors.initials: F
authors.lastname: Urbani
authors.forename: R
authors.initials: R
authors.lastname: Lande
authors.forename: M
authors.initials: M
authors.lastname: Giuliano
authors.forename: A
authors.initials: A
authors.lastname: La Sala
authors.forename: A
authors.initials: A
authors.lastname: Piscitelli
authors.forename: S
authors.initials: S
authors.lastname: Salmaso
mesh_terms: D001886:Bordetella pertussis / Q000276:immunology*; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000627:therapeutic use*; D004311:Double-Blind Method; D006801:Humans; D007111:Immunity, Cellular; D007115:Immunization Schedule; D007223:Infant; D010919:Placebos; D014917:Whooping Cough / Q000517:prevention & control*
chemical_list: D015721:Diphtheria-Tetanus-Pertussis Vaccine; D010919:Placebos