近年來，手足口病已經(jīng)成為危害兒童健康的重要傳染病,。2010年我國(guó)該病病例達(dá)1,795,336例,，重癥患者數(shù)超過2.1萬,，其中死亡病例905例,，比前一年均有顯著增加,，疾病流行形勢(shì)非常嚴(yán)峻。加快研發(fā)手足口病疫苗,，有效預(yù)防和控制疾病,，是我們的首要任務(wù)。由于人體對(duì)手足口病主要病原體EV71的免疫保護(hù)機(jī)理還不清楚,，給該病疫苗的研發(fā)帶來困難,。
近日，《病毒學(xué)期刊》（Virology Journal）發(fā)表了中科院上海巴斯德研究所冷啟彬研究組的最新研究成果,，揭示了手足口病患兒抗EV71的中和抗體反應(yīng)規(guī)律,，有助于深入理解和揭示手足口病患者針對(duì)EV71的獲得性免疫反應(yīng)，對(duì)疫苗開發(fā)和評(píng)價(jià)具有重要意義,。
該研究組與安徽省阜陽(yáng)市疾病預(yù)防控制中心合作,，對(duì)手足口病患兒、健康兒童和對(duì)該病具有免疫力的成人分別進(jìn)行了對(duì)比研究,，發(fā)現(xiàn)80%的患兒在感染后第一天的抗體水平已經(jīng)達(dá)到成人所具有的抗EV71中和抗體水平,，第二天抗體水平已與病后7天的水平相當(dāng)，表明患兒表現(xiàn)出臨床癥狀時(shí)已經(jīng)在感染后至少五天以上,，且獲得性免疫反應(yīng)已經(jīng)接近于最高水平,。總體上,，手足口病患兒產(chǎn)生的抗EV71中和抗體水平與疾病嚴(yán)重程度沒有相關(guān)性,。此外，即便是對(duì)該病完全具有免疫力的成人也有超過16%免疫沒有抗EV71中和抗體,，表明與疾病嚴(yán)重程度有關(guān)的可能是細(xì)胞免疫,，而不是中和抗體，提示在手足口病疫苗的設(shè)計(jì)和臨床保護(hù)評(píng)價(jià)方面,，應(yīng)考慮細(xì)胞免疫反應(yīng)的因素,。
此項(xiàng)研究得到了中國(guó)科學(xué)院“百人計(jì)劃”及疫苗項(xiàng)目啟動(dòng)經(jīng)費(fèi)、賽諾菲-安萬特-中科院上海生命科學(xué)研究院優(yōu)秀青年人才基金的資助,。(生物谷 Bioon.com)
doi:10.1186/1743-422X-8-306
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Neutralizing antibody response in the patients with hand, foot and mouth disease to enterovirus 71 and its clinical implications
Chunfu Yang, Chaoyang Deng, Junfeng Wan, Liye Zhu and Qibin Leng
Enterovirus 71 (EV71) has emerged as a significant pathogen causing large outbreaks in China for the past 3 years. Developing an EV71 vaccine is urgently needed to stop the spread of the disease; however, the adaptive immune response of humans to EV71 infection remains unclear. We examined the neutralizing antibody titers in HFMD patients and compared them to those of asymptomatic healthy children and young adults. We found that 80% of HFMD patients became positive for neutralizing antibodies against EV71 (GMT = 24.3) one day after the onset of illness. The antibody titers in the patients peaked two days (GMT = 79.5) after the illness appeared and were comparable to the level of adults (GMT = 45.2). Noticeably, the antibody response was not correlated with disease severity, suggesting that cellular immune response, besides neutralizing antibodies, could play critical role in controlling the outcome of EV71 infection in humans.
