Kinetics of antibody-secreting cell and fecal IgA responses after oral cholera vaccination in different age groups in a cholera endemic country

Akhtar, Marjahan; Qadri, Firdausi; Bhuiyan, Taufiqur Rahman; Akter, Sarmin; Rafique, Tanzeem Ahmed; Khan, Arifuzzaman; Islam, Laila N.; Saha, Amit; Svennerholm, Ann‐Mari; Lundgren, Anna

doi:10.1016/j.vaccine.2016.11.055

Cited by 20 publications

(25 citation statements)

References 33 publications

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“…66,67 A recent study in Bangladesh found that robust circulating IgA responses were induced by a single dose of oral cholera vaccine in adults and toddlers but not in infants. 68 In contrast, the responses to a second dose of cholera vaccine in infants were similar to older children and adults. Plasma IgA peaked on day 5 after vaccination and fecal sIgA responses were detected at day 7, suggesting that plasma IgA decreases as memory B cells migrate to the mucosa.…”

Section: B Cell Derangementsmentioning

confidence: 93%

“…Plasma IgA peaked on day 5 after vaccination and fecal sIgA responses were detected at day 7, suggesting that plasma IgA decreases as memory B cells migrate to the mucosa. 68 One possible explanation for the lack of a response in infants is that natural exposure in older individuals primes an enhanced response to the first dose of oral vaccine. We are not aware of studies of total IgA or sIgA in EED nor have studies yet explored a possible effect of vitamin A deficiency on vaccine efficacy through effects on the polymeric Ig receptor as has been demonstrated in vitro.…”

Section: B Cell Derangementsmentioning

confidence: 99%

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Pathophysiology of environmental enteric dysfunction and its impact on oral vaccine efficacy

et al. 2018

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Environmental enteric dysfunction (EED) refers to a subclinical disorder of intestinal function common in tropical countries and in settings of poverty and economic disadvantage. The enteropathy that underlies this syndrome is characterized by mucosal inflammation and villus blunting mediated by T cell activation. Epithelial cell disruption and microbial translocation drive systemic inflammation. EED in young children is associated geographically with growth failure, malnutrition, and greatly impaired responses to oral vaccines, notably rotavirus and poliovirus vaccines. In this review, we describe the pathophysiology of EED and examine the evidence linking EED and oral vaccine failure. This evidence is far from conclusive. Although our understanding of EED is still sketchy, there is limited evidence of disturbed innate immunity, B cell disturbances including aggregation into lymphoid follicles, and autoantibody generation. Pathways of T cell activation and the possibility of dendritic cell anergy, which could help explain oral vaccine failure, require further work.

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Section: B Cell Derangementsmentioning

confidence: 93%

Section: B Cell Derangementsmentioning

confidence: 99%

Pathophysiology of environmental enteric dysfunction and its impact on oral vaccine efficacy

et al. 2018

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“…Further elevation of response is therefore not seen. However, it may also be that we were not able to obtain the specimen very soon after the second dose, that is within 5-6 days of vaccination and may have missed the peak of the response as has been shown earlier in other enteric vaccines [23].…”

Section: Discussionmentioning

confidence: 90%

Immunogenicity of a killed bivalent whole cell oral cholera vaccine in forcibly displaced Myanmar nationals in Cox's Bazar, Bangladesh

et al. 2020

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After the large influx of Rohingya nationals (termed Forcibly Displaced Myanmar National; FDMN) from Rakhine State of Myanmar to Cox's Bazar in Bangladesh, it was apparent that outbreaks of cholera was very likely in this setting where people were living under adverse water and sanitation conditions. Large campaigns of oral cholera vaccine (OCV) were carried out as a preemptive measure to control cholera epidemics. The aim of the study was to evaluate the immune responses of healthy adults and children after administration of two doses of OCV at 14 days interval in FDMN population and compare with the response observed in Bangladeshi's vaccinated earlier. A cross-sectional immunogenicity study was conducted among FDMNs of three age cohort; in adults (18+years; n = 83), in older children (6-17 years; n = 63) and in younger children (1-5 years; n = 80). Capillary blood was collected at three time points to measure vibriocidal antibodies using either plasma or dried blood spot (DBS) specimens. There was a significant increase of responder frequency of vibriocidal antibody titer at day 14 in all groups for Vibrio cholerae O1 (Ogawa/Inaba: adults-64%/64%, older children-70%/89% and younger children-51%/75%). There was no overall difference of vibriocidal antibody titer between FDMN and Bangladeshi population at baseline (p = 0.07-0.08) and at day 14, day 28 in all age groups for both serotypes. The seroconversion rate and geometric mean titer (GMT) of either serotype were comparable using both plasma and DBS specimens. These results showed that OCV is capable of inducing robust immune responses in adults and children among the FDMN population which is comparable to that seen in Bangladeshi participants in different age groups or that reported from other cholera endemic countries. Our results also suggest that the displaced population were exposed to V. cholerae prior to seeking shelter in Bangladesh.

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“…We have identified these timepoints to be optimal for assessing circulating antibody-secreting cell or ALS responses after oral vaccination, with only minor differences in plasma IgA and IgG responses between day 5 and later timepoints after the second dose. 16,21,22 Immune responses were assessed by measuring vaccine-specific (ie, CFA/I, CS3, CS5, CS6, and LTB) IgA antibodies in ALS specimens 16,18,23 and IgA antibody levels against the five vaccine antigens and IgG antibody concentrations against LTB in plasma. 16,23,24 See Online for appendix Peripheral blood mononuclear cells (PBMCs) and plasma were separated from the blood by density-gradient centrifugation on Ficoll-Isopaque.…”

Section: Methodsmentioning

confidence: 99%

Safety and immunogenicity of the oral, inactivated, enterotoxigenic Escherichia coli vaccine ETVAX in Bangladeshi children and infants: a double-blind, randomised, placebo-controlled phase 1/2 trial

Qadri

Akhtar

Bhuiyan

et al. 2020

The Lancet Infectious Diseases

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Background Enterotoxigenic Escherichia coli causes diarrhoea, leading to substantial mortality and morbidity in children, but no specific vaccine exists. This trial tested an oral, inactivated, enterotoxigenic E coli vaccine (ETVAX), which has been previously shown to be safe and highly immuongenic in Swedish and Bangladeshi adults. We tested the safety and immunogenicity of ETVAX, consisting of four E coli strains overexpressing the most prevalent colonisation factors (CFA/I, CS3, CS5, and CS6) and a toxoid (LCTBA) administered with or without a double-mutant heat-labile enterotoxin (dmLT) as an adjuvant, in Bangladeshi children. Methods We did a randomised, double-blind, placebo-controlled, dose-escalation, age-descending, phase 1/2 trial in Dhaka, Bangladesh. Healthy children in one of three age groups (24-59 months, 12-23 months, and 6-11 months) were eligible. Children were randomly assigned with block randomisation to receive either ETVAX, with or without dmLT, or placebo. ETVAX (half [5•5 × 10¹⁰ cells], quarter [2•5 × 10¹⁰ cells], or eighth [1•25 × 10¹⁰ cells] adult dose), with or without dmLT adjuvant (2•5 µg, 5•0 µg, or 10•0 µg), or placebo were administered orally in two doses 2 weeks apart. Investigators and participants were masked to treatment allocation. The primary endpoint was safety and tolerability, assessed in all children who received at least one dose of vaccine. Antibody responses to vaccine antigens, defined as at least a two-times increase in antibody levels between baseline and post-immunisation, were assessed as secondary endpoints. This trial is registered with ClinicalTrials.gov, NCT02531802.

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Kinetics of antibody-secreting cell and fecal IgA responses after oral cholera vaccination in different age groups in a cholera endemic country

Cited by 20 publications

References 33 publications

Pathophysiology of environmental enteric dysfunction and its impact on oral vaccine efficacy

Pathophysiology of environmental enteric dysfunction and its impact on oral vaccine efficacy

Immunogenicity of a killed bivalent whole cell oral cholera vaccine in forcibly displaced Myanmar nationals in Cox's Bazar, Bangladesh

Safety and immunogenicity of the oral, inactivated, enterotoxigenic Escherichia coli vaccine ETVAX in Bangladeshi children and infants: a double-blind, randomised, placebo-controlled phase 1/2 trial

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