title: Development of immunologic memory against tetanus toxoid and pertactin antigens from the diphtheria-tetanus-pertussis 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-gamma, appears transient but can result in a long-lasting imbalance within T helper cell (T(H)) 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 T(H) 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 T(H)1 and T(H)2 cytokines to HDM allergen and PHA. Vaccine antibody titers were normal in the atopic subjects; vaccine-specific T(H)2 responses were rarely detectable, yet T(H)1 (IFN-gamma) 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 atopy-associated deficiency in T(H)1 function in childhood can be successfully overcome by appropriate vaccination and boosting regimens.
authors.affiliation: Departments of Microbiology and Paediatrics, University of Western Australia.
authors.forename: P G
authors.initials: PG
authors.lastname: Holt
authors.forename: A
authors.initials: A
authors.lastname: Rudin
authors.forename: C
authors.initials: C
authors.lastname: Macaubas
authors.forename: B J
authors.initials: BJ
authors.lastname: Holt
authors.forename: J
authors.initials: J
authors.lastname: Rowe
authors.forename: R
authors.initials: R
authors.lastname: Loh
authors.forename: P D
authors.initials: PD
authors.lastname: Sly
mesh_terms: D000917:Antibody Formation; D000941:Antigens / Q000276:immunology; D001425:Bacterial Outer Membrane Proteins / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000096:biosynthesis; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000737:chemistry / Q000276:immunology; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000276:immunology* / Q000378:metabolism; D007156:Immunologic Memory; D007371:Interferon-gamma / Q000096:biosynthesis; D015847:Interleukin-4 / Q000235:genetics; D016906:Interleukin-9 / Q000235:genetics; D012333:RNA, Messenger / Q000378:metabolism; D013745:Tetanus Toxoid / Q000276:immunology*; D010566:Virulence Factors, Bordetella
chemical_list: D000941:Antigens; D001425:Bacterial Outer Membrane Proteins; D016207:Cytokines; D015721:Diphtheria-Tetanus-Pertussis Vaccine; D016906:Interleukin-9; D012333:RNA, Messenger; D013745:Tetanus Toxoid; D010566:Virulence Factors, Bordetella; D015847:Interleukin-4; C068929:pertactin; D007371:Interferon-gamma