title: Local reactions and IgE antibodies to pertussis toxin after acellular diphtheria-tetanus-pertussis immunization.
abstract: Local reactions and pertussis toxin specific immunoglobulin E antibodies (PT-IgE) were investigated in healthy children following primary and booster immunization with a combined diphtheria tetanus acellular pertussis vaccine (DTPa) including pertussis toxin, filamentous haemagglutinin and pertactin. A primary series of DTPa was administered to 150 infants, and 104 of them received a booster dose of DTPa combined with inactivated polio vaccine at 2 years of age. PT-IgE was measured in serum samples from 72 children using a modified nitrocellulose RAST. Primary immunization was associated with low incidence of local reactions (1%-5%). After the booster dose 21% of children had a local reaction >/=20 mm. Local reactions after the booster dose tended to be more common in children who had experienced reaction at primary immunization. PT-IgE was detected in 18% and 86% of children following primary and booster vaccinations, respectively. Allergic and non-allergic children did not differ in PT-IgE responses. After primary immunization, elevated PT-IgE levels were found more often in children with a family history of allergy than in those without known allergy in the family. Children with local reactions had significantly higher pre- and post-booster PT-IgE levels and median post-booster pertactin IgG and diphtheria-IgG levels than children without local reactions. Conclusion Acellular pertussis immunization induces IgE antibodies to pertussis toxin, especially after booster vaccination. The higher median pre- and post-booster levels of pertussis toxin specific immunoglobulin E and post-booster levels of IgG to pertactin and diphtheria in children with local side-effects reflect a multifactorial immunological mechanism of such reactions.
authors.affiliation: Department of Paediatrics, Turku University Hospital, FIN-20520, Turku, Finland.
authors.forename: K
authors.initials: K
authors.lastname: Edelman
authors.forename: K
authors.initials: K
authors.lastname: Malmström
authors.forename: Q
authors.initials: Q
authors.lastname: He
authors.forename: J
authors.initials: J
authors.lastname: Savolainen
authors.forename: E O
authors.initials: EO
authors.lastname: Terho
authors.forename: J
authors.initials: J
authors.lastname: Mertsola
mesh_terms: D002675:Child, Preschool; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000009:adverse effects / Q000276:immunology*; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000276:immunology; D007117:Immunization, Secondary; D007073:Immunoglobulin E / Q000097:blood*; D007074:Immunoglobulin G / Q000097:blood; D007223:Infant; D008297:Male; D037342:Pertussis Toxin; D010566:Virulence Factors, Bordetella / Q000276:immunology*
chemical_list: D015721:Diphtheria-Tetanus-Pertussis Vaccine; D007074:Immunoglobulin G; D010566:Virulence Factors, Bordetella; D007073:Immunoglobulin E; D037342:Pertussis Toxin