Metabolic and Hematologic Effects and Immune Complex Formation Related to Pertussis Immunization

Abstract

ABSTRACT. Selected metabolic, hematologic, and immunologic functions were evaluated in 3-to 6-mo-old Finish infants who received whole-cell pertussis-component diphtheria and tetanus toxoids and pertussis vaccine, adsorbed (DTP) vaccine, and in 4-to 6-y-old Los Angeles children who received either a licensed DTP va-ccine or an acellular pertussis component DTP vaccine. One d after immunization, there was an increase in total leukocytes and neutrophils and a decrease in lymphocytes in all vaccinees. In 4-to 6-y-old children the leukocytosis and neutrophilia were greater in recipients who received the standard DTP vaccine than in vaccinees who received an acellular pertussis component DTP vaccine. In infants there was an increase in the mean plasma insulin concentration but no change in the glucose concentration 24 h after immunization; no increase in the mean plasma insulin was noted in the 4-to 6-y-old children. Three 4-to 6-y-old vaccinees had higher circulating immune complex concentrations after immunization and two of these children had high clinical reaction scores. The etiology of adverse reactions after DTP immunization is multifactorial. In contrast with findings in animals, our findings do not demonstrate a clinically significant effect due to lymphocytosispromoting factor on glucose metabolism in vaccinated children. Neutrophilia in vaccinees is probably due to endotoxin, and some reactions may be due to circulating immune complexes. (Pediatu Res 27: 353-357,1990) Abbreviations AHG Eq, aggregated human gammaglobulin equivalent APDT, acellular pertussis component DTP vaccine CI, confidence interval CIC, circulating immune complexes DTP, diphtheria and tetanus toxoids and pertussis vaccine, adsorbed FHA, filamentous hemagglutinin LPF, lymphocytosis-promoting factor LPS, lipopolysaccharide WBC, white blood cell kocytosis with a predominant lymphocytosis, and marked adjuvancy in several immunologic systems (1-4). These effects are primarily due to the Bordetella pertussis antigen LPF but LPS (endotoxin) may also contribute to the metabolic, hematologic, and immunologic findings.Many adverse clinical events occur after pertussis immunization in children, but the pathophysiology of these events is not well understood (1,2, 5). It has been suggested that some of these adverse events may be due to biologically active LPF and LPS that are present in routinely used DTP vaccines. There are, however, few data available that indicate that these antigens are in sufficient concentration in presently used DTP vaccines to produce hematologic or metabolic changes in vaccinated children.In Japan, acellular pertussis vaccines have been used for the routine immunization of children since 198 1 (6-8). These vaccines contain significantly reduced amounts of LPS and biologically active LPF, and their use has been associated with fewer vaccination side effects than occur in whole-cell pertussis vaccine recipients. Because of the paucity of information relating to hematologic and metabolic effects and immune complex formatio...

Post-immunization leucocytosis and its implications for the management of febrile infants

“…It is therefore possible that white cell count changes post-primary immunization would be at least as marked, if not more, in other populations. Previous studies conducted in white European and mixed American populations have also shown white cell count increases at one-day post-immunization [5] , [9] , though to a lesser extent than with the combination of vaccines used in this study.…”

“…However, the effect on white cell counts of the co-administration of multiple vaccine antigens, such as those received during primary immunizations, is unknown. Studies conducted in the 1980s in Finland and the USA in a small number of older infants, showed an increase in white cell counts post administration of the combined Diptheria-Tetanus-whole cell Pertussis (DTwP) vaccination [5] . However, few similar studies have been published looking at younger infants and using the enhanced combination of vaccine antigens currently in use.…”

Molecular Pathogenesis, Epidemiology, and Clinical Manifestations of Respiratory Infections Due toBordetella pertussisand OtherBordetellaSubspecies

“…Specifically, the ratio of the increment of the plasma insulin level to that of blood glucose at 30 min after the glucose challenge remained significantly greater 4, 30, and 60 days after the initial intravenous PT injection compared with the baseline glucose tolerance test response. Infants vaccinated with DTP vaccines have also been noted to have an increase in serum insulin levels (319,552). Neonates with severe pertussis are occasionally found to be markedly hypoglycemic, suggesting hyperinsulinemia (156,165,360).…”

Hematobiochemical and Immunological Profiles of Horses Used for Preparation of ‎Antitetanic hyperimmune Serum by Different Types of Adjuvants

“…In comparison to the values measured in control group, all vaccinated groups with or without addition of adjuvants in this study demonstrated a significant increase in TLC indicated by the marked neutrophilia, lymphocytosis and monocytosis with the highest increase was observed when horses were injected with a combination of toxoid and toxin and provided with CFA (Sahal et al, 2004). These effects were suggested to be due to the release of the biologically active lymphocytosis promoting factor (LPF) which was thought to be the major responsible for the large increase in leukocyte, neutrophil, and lymphocyte counts (Mink et al, 1990).Further, vaccine is known to behave as mitogens or superantigens on some lymphocyte subpopulations leading to lymphocyte proliferation and this is likely a factor in the immunological activation following vaccination (Monaco et al, 2019 andArfuso et al, 2021). Arfuso et al, (2021) added that following vaccination, several leukocyte populations, such as lymphocytes, monocytes, and neutrophils, changed which likely reflected the animals' systemic immune-biological adaptation to the vaccine, and in particular to the second dosage of injection.…”