Introduction The humoral response to vaccinations varies widely between individuals. There is no data available on the correlation between responses to different vaccines. In this study, we investigated the correlation of antibody responses between routine vaccine antigens in infants. Methods One and seven months after the 6-month vaccinations and one month after the 12-month vaccinations, antibody concentrations to diphtheria, tetanus, pertussis, polio (serotypes 1-3), Haemophilus influenzae type b (Hib), pneumococcus (13 serotypes), meningococcus C, measles, mumps and rubella were measured using fluorescent bead-based multiplex immune-assays. For the correlation of antibody responses, Spearman’s rank correlation coefficients (ρ) with 95% confidence intervals (CI) were calculated between responses to each vaccine antigen. Results The correlation between concentrations of antibodies to the vaccinations ending at 6 months of age was higher one month compared to seven months after vaccination. The strongest correlations at both time points were observed between antibody responses to different polio serotypes, certain pneumococcal serotypes and between responses to diphtheria and pneumococcal (conjugated to a diphtheria toxoid) vaccine antigens. Correlation between responses to tetanus, Hib, pertussis, polio and other vaccine antigens were weak. The correlation between antibody responses to the 12-month vaccine antigens was weaker than to the 6-month vaccine antigens and there was a negative correlation between responses to measles, mumps, rubella vaccine and non-live vaccine antigens (meningococcus C, tetanus and Hib). There was only weak correlation between antibody responses to vaccines of the same type (e.g. conjugated polysaccharide or toxoid vaccines). Conclusion Correlation between antibody responses to similar antigens in the same vaccine (such as different serotypes of a bacteria or virus), as well as responses to antigens conjugated to similar carrier proteins, are strong. In contrast, correlation between responses to other vaccines are weak. Measuring antibody responses to one or a few vaccine antigens therefore does not offer a reliable surrogate marker of responses to unrelated vaccines.
ED1TOR,-MY editorial on retinopathy of pre- maturity mentioned antioxidants in general, both regarding aetiology and prevention.Several anti- oxidant mechanisms have certainly been described previously,' but owing to restriction of space vitamin E was the only antioxidant specifically mentioned in the editorial.I agree that trans- ferrin also is very interesting.Further research concerning the relation of iron and transferrin concentrations in extremely premature children and development of retinopathy of prematurity, as well as the possible preventive effects of transferrin on retinopathy ofprematurity, will be welcomed.
Abstract Background While the relationship between pollen and respiratory allergies is well‐documented, the role of short‐term pollen exposure in food allergy and eczema flares has not previously been explored. We aimed to investigate these associations in a population‐based sample of children. Methods We investigated 1‐ ( n = 1108) and 6‐year‐old ( n = 675) children in the grass pollen season from the HealthNuts cohort. Grass pollen concentrations were considered on the day of testing (lag 0), up to three days before (lag 1‐lag 3) and cumulatively (lag 0–3). Associations between grass pollen and food skin‐prick test reactivity (SPT ≥ 2 mm at age 1 year and ≥ 3 mm at age 6 years), eczema flares, challenge‐confirmed food allergy, reaction threshold to oral food challenges (OFC), and serum food‐specific IgE levels were analyzed using either logistic or quantile regression models. Atopy and family history of allergic disease were considered as potent effect modifiers. Results Grass pollen at lag 0–3 (every 20 grains/m 3 increase) was associated with an up to 1.2‐fold increased odds of food SPT reactivity and eczema flares in 6‐year‐olds. In 1‐year‐olds, the associations were only observed for peanut in those with a family history of food allergy. Increasing grass pollen concentrations were associated with a lower reaction threshold to OFC and higher serum IgE levels in peanut‐allergic 1‐year‐olds only. Conclusion Increasing grass pollen concentration was associated with increased risk of food SPT reactivity and eczema flares in children. The associations in peanut‐allergic infants may be related to immune activation and/or peanut and grass pollen cross‐reactivity leading to a lower reaction threshold.
Method: 132 South Australian infants aged <6 months enrolled in the RCT and completed a food frequency questionnaire (FFQ) at 12 months of age.Prior to randomisation, parents were sent the ASCIA infant feeding advice.The intervention group (n = 66) received monthly text messages with infant feeding advice.The control group (n = 66) only received the ASCIA feeding advice.An independent comparator group (n = 111) also completed the 12-month FFQ.Results: Over half of the families enrolled in this study were atopic (maternal/paternal atopy: 60%/58% intervention: 52%/57% control).13% of infants enrolled in the intervention group and 9% in the control group had eczema.1 At one year of age, over 90% of the children surveyed had consumed egg and peanut.No significant differences were noted between the intervention, control or comparator groups. 2 A small number of children had never consumed egg or peanut due to lifestyle dietary choices (vegan) or the presence of allergies in the household.3 When intake during the previous week was assessed, around 45% children in each group had consumed egg 2-4 times and 30% had consumed peanut 2-4 times.One third of all the children surveyed had not consumed any peanut and 14% had not consumed any egg. Conclusion:Outcomes from this study indicates that parents are aware of the advice to introduce egg and peanut into babies' diets before one year of age.However, many families surveyed were not including these allergens regularly in their baby's dietpotentially risking loss of tolerance.
Patients at increased risk of vaccine preventable diseases require additional vaccines that are not licensed for Nurse Immunisers to administer without a prescription. An Immunisation Nurse Practitioner (NP) at the Royal Children's Hospital (RCH) Melbourne was introduced to address deficiencies in the current management of these patients. NP endorsement requires successful completion of a Masters level study program, plus the equivalent of three years (5,000) hours full-time experience in advanced clinical nursing. The Immunisation NP was endorsed in May 2017 and since then, the Immunisation service at RCH has recorded a 140% increase in uptake of Meningococcal B vaccine as well as improved delivery of immunisations to special-risk patients. In addition, there was improved access to specialist immunisation advice as well as improved opportunistic immunisation of inpatients. New initiatives were implemented including immunisation of needle phobic patients using nitrous oxide sedation. This paper describes the outcomes of employing an Immunisation NP at the RCH, Melbourne. What is currently known about the topic? Nurse Practitioners provide excellent, patient-centred care whilst also contributing to research, education, leadership and management. There is much literature on describing Nurse Practitioner specialty roles however, none in the area of Immunisation. What this paper adds: A Nurse Practitioner (NP) role in the specialty field of immunisation can contribute to improving hospital inpatient rates of immunisation, facilitate uptake of non-scheduled vaccines and decrease pressure on wait times for a specialist clinic appointment. The Immunisation NP reflects the full diversity of nursing practice and addresses the many service gaps in the previous delivery model, that can be emulated by paediatric nurses in other specialist areas.
Randomized clinical trials showed that earlier peanut introduction can prevent peanut allergy in select high-risk populations. This led to changes in infant feeding guidelines in 2016 to recommend early peanut introduction for all infants to reduce the risk of peanut allergy.
Childhood is a critical period of immune development. During this time, naïve CD4 (nCD4) T cells undergo programmed cell differentiation, mediated by epigenetic changes, in response to external stimuli leading to a baseline homeostatic state that may determine lifelong disease risk. However, the ontogeny of epigenetic signatures associated with CD4 T cell activation during key developmental periods are yet to be described. We investigated genome-wide DNA methylation (DNAm) changes associated with nCD4 T activation following 72 h culture in media+anti-CD3/CD28 beads in healthy infants (aged 12 months, n = 18) and adolescents (aged 10-15 years, n = 15). We integrated these data with transcriptomic and cytokine profiling from the same samples. nCD4 T cells from both age groups show similar extensive epigenetic reprogramming following activation, with the majority of genes involved in the T cell receptor signaling pathway associated with differential methylation. Additionally, we identified differentially methylated probes showing age-specific responses, that is, responses in only infants or adolescents, including within a cluster of T cell receptor (TCR) genes. These encoded several TCR alpha joining (TRAJ), and TCR alpha variable (TRAV) genes. Cytokine data analysis following stimulation revealed enhanced release of IFN-γ, IL-2 and IL-10, in nCD4 T cells from adolescents compared with infants. Overlapping differential methylation and cytokine responses identified four probes potentially underpinning these age-specific responses. We show that DNAm in nCD4T cells in response to activation is dynamic in infancy and adolescence, with additional evidence for age-specific effects potentially driving variation in cytokine responses between these ages.
Background
• Chronic suppurative lung diseases (CSLD) in children are important causes of morbidity and recurrent acute exacerbations are associated with long term lung function decline.
• Non-‐typeable H. influenzae (NTHi) and S. pneumoniae are commonly isolated from the lower airways of both children and adults with CSLD.
• The potential clinical impact of a non-‐typeable Haemophilus influenzae (NTHi) vaccine in children with CSLD has not been investigated.
• We aimed to determine the clinical efficacy of the 10-‐valent pneumococcal-‐Protein D conjugate vaccine (10vPHiD-‐CV) in children aged 18-‐months to <18-‐years with CSLD (Immunogenicity data are presented in Poster xxx). Primary clinical objective.
• Determine the efficacy of 10vPHiD-‐CV in reducing the incidence of acute exacerbations in the 12-‐months following the 2nd dose of study vaccine. Secondary clinical objectives.
• Determine the efficacy of 10vPHiD-‐CV in reducing the incidence of any parent/carer-‐reported respiratory symptoms in the 12 months following the second dose of study vaccine.
• Determine the efficacy of 10vPHiD-‐CV in reducing antibiotic use in the 12 months following the second dose of study vaccine.
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