Document Detail

The protective effect of immunisation against diphtheria, pertussis and tetanus (DPT) in relation to sudden infant death syndrome.
MedLine Citation:
PMID:  10443507     Owner:  NLM     Status:  MEDLINE    
Epidemiological evidence indicates infants immunised against diphtheria, pertussis and tetanus (DPT) are at decreased risk of sudden infant death syndrome (SIDS). Asymptomatic whooping cough and pyrogenic toxins of Staphylococcus aureus have been implicated in the aetiology of SIDS. The objectives of the present study were: (1) to determine if the DPT vaccine induced antibodies cross-reactive with the staphylococcal toxins; (2) to determine if antibodies to the pertussis toxin (PT) and the staphylococcal toxins were present in the sera of women during late pregnancy; (3) to examine the effects of infant immunisation on levels of antibodies to PT and the staphylococcal toxins; (4) to assess the effects of changes in immunisation schedules in the UK on the incidence and age distribution of SIDS. Enzyme-linked immunosorbent assays (ELISA) were used to measure binding of rabbit or human IgG to the DPT vaccine, PT, toxic shock syndrome toxin-1 (TSST-1) and staphylococcal enterotoxins A (SEA), B (SEB) and C (SEC). Neutralisation activity of anti-DPT serum was assessed by a bioassay for induction of nitric oxide from human monocytes by the staphylococcal toxins. Anti-DPT serum bound to the DPT vaccine, PT and each of the staphylococcal toxins. It also reduced the ability of the four toxins to induce nitric oxide from monocytes. In pregnant women, levels of IgG to PT, SEC and TSST-1 decreased significantly in relation to increasing weeks of gestation while antibodies to SEA and SEB increased. In infants' sera there were significant correlations between levels of IgG bound to DPT and IgG bound to PT, TSST-1 and SEC but not SEA or SEB. Antibody levels to the toxins in infants declined with age; sera from infants < or = 2 months of age had higher levels of IgG bound to the toxins than those older than 2 months. This pattern was observed for infants whose immunisation schedules began at 2 months of age or 3 months of age. The decrease in IgG bound to the toxins was, however, less for those immunised at 2 months. The decrease in SIDS deaths after the change in immunisation schedules was greatest in the 4-6-month age range. While DPT immunisation might prevent some unexplained infant deaths due to asymptomatic whooping cough, these data indicate that immunisation with DPT also induces antibodies cross-reactive with pyrogenic staphylococcal toxins implicated in many cases of SIDS. Passive immunisation of infants who have low levels of these antibodies might reduce further the numbers of these infant deaths.
S D Essery; M W Raza; A Zorgani; D A MacKenzie; V S James; D M Weir; A Busuttil; N Hallam; C Blackwell
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  FEMS immunology and medical microbiology     Volume:  25     ISSN:  0928-8244     ISO Abbreviation:  FEMS Immunol. Med. Microbiol.     Publication Date:  1999 Aug 
Date Detail:
Created Date:  1999-10-14     Completed Date:  1999-10-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9315554     Medline TA:  FEMS Immunol Med Microbiol     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  183-92     Citation Subset:  IM    
Department of Medical Microbiology, University of Edinburgh, UK.
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MeSH Terms
Antibodies, Bacterial / blood*
Bacterial Toxins*
Cross Reactions
Diphtheria-Tetanus-Pertussis Vaccine / administration & dosage,  immunology*
Enterotoxins / immunology*
Enzyme-Linked Immunosorbent Assay
Immunization Schedule
Immunoglobulin G / blood
Infant, Newborn
Monocytes / metabolism
Nitric Oxide / biosynthesis
Pertussis Toxin
Staphylococcus aureus*
Sudden Infant Death / epidemiology,  prevention & control*
Virulence Factors, Bordetella / immunology
Reg. No./Substance:
0/Antibodies, Bacterial; 0/Bacterial Toxins; 0/Diphtheria-Tetanus-Pertussis Vaccine; 0/Enterotoxins; 0/Immunoglobulin G; 0/Superantigens; 0/Virulence Factors, Bordetella; 0/enterotoxin F, Staphylococcal; 10102-43-9/Nitric Oxide; EC Toxin

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