Oral polio vaccine response in breast fed infants with malnutrition and diarrhea

Haque, Rashidul; Snider, Cynthia J.; Liu, Yue; Jennie, Z.; Liu, Lei; Nayak, Uma; Mychaleckyj, Josyf C.; Korpe, Poonum; Mondal, Dinesh; Kabir, Mamun; Alam, Masud; Pallansch, Mark A.; Oberste, M. Steven; Weldon, William C.; Kirkpatrick, Beth D.; Petri, William A.

doi:10.1016/j.vaccine.2013.11.056

Cited by 62 publications

(58 citation statements)

References 22 publications

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“…In spite of these immunological deficits, a consistent link between malnutrition and oral vaccine performance has not been found [108,109]. A recent study among infants in Bangladesh documented significantly lower serotype 3 poliovirus antibody titers in conjunction with underweight (weight-for-age Z score ≤2) after at least three doses of OPV [65]. However, other studies in India, Nigeria and Pakistan have not observed an association between malnutrition and OPV immunogenicity [110][111][112].…”

Section: Malnutrition and Micronutrient Deficienciesmentioning

confidence: 99%

Section: Breastfeedingmentioning

confidence: 99%

“…[65], [98], [108], [135], [171], [196] [67], [133][134][135], [198][199][200][201] [8], [181], [182], [201], [203], [204] [28], [92], [93], [128], [131], [137], [138], [140], [130], [131], [157], [202] [ [43][44][45], [49], [61][62][63][64][65][66][67][68][69][70], [197] [ [155][156][157] [28], [98], [170][171][172]…”

Section: Conclusion and Future Perspectiveunclassified

“…Later in infancy, the picture is more ambiguous -while an increase in the duration of breastfeeding was associated with a lower seroconversion rate (significant for serotype 3) following four doses of trivalent OPV among infants in Brazil, breastfeeding status had no effect on seroconversion rates during studies in Uganda [62] and India [63]. To confuse matters further, several studies have documented an improvement in OPV immunogenicity among breastfed infants [43,64,65].Studies of oral rotavirus vaccines have similarly failed to establish a clear inhibitory or beneficial effect of breastfeeding on vaccine performance. While several trials have observed a reduction in immunogenicity among breastfed infants [66,67], the effect has typically been modest.…”

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confidence: 99%

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Causes of Impaired Oral Vaccine Efficacy in Developing Countries

et al. 2017

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Oral vaccines are less immunogenic when given to infants in low-income compared with high-income countries, limiting their potential public health impact. Here, we review factors that might contribute to this phenomenon, including transplacental antibodies, breastfeeding, histo blood group antigens, enteric pathogens, malnutrition, microbiota dysbiosis and environmental enteropathy. We highlight several clear risk factors for vaccine failure, such as the inhibitory effect of enteroviruses on oral poliovirus vaccine. We also highlight the ambiguous and at times contradictory nature of the available evidence, which undoubtedly reflects the complex and interconnected nature of the factors involved. Mechanisms responsible for diminished immunogenicity may be specific to each oral vaccine. Interventions aiming to improve vaccine performance may need to reflect the diversity of these mechanisms. Enteric pathogens are a substantial threat to public health. This threat takes many forms, from the toxin-producing bacteria (e.g., Vibrio cholerae) and flagellated protozoa (e.g., Giardia lamblia) that colonize the mucosal surface of the small intestine to the enteroviruses that are capable of spreading via the bloodstream to the CNS, causing acute flaccid paralysis (e.g., poliovirus). Each year, enteric pathogens cause hundreds of millions of cases of diarrhea and approximately 800,000 deaths, the vast majority of which occur among children in low-income countries [1]. The most common causes of childhood diarrheal morbidity include rotavirus, Cryptosporidium, enterotoxigenic Escherichia coli and Shigella [2].Vaccines against enteric pathogens are important tools for mitigating this disease burden. Oral vaccines offer several distinct benefits compared with parenteral vaccines. They can be produced in large quantities at relatively low cost, are easy to administer and have the capacity to induce local immunity in the intestinal mucosa, thereby protecting vaccinated individuals against subsequent infection and -by blocking onward transmission -enhancing herd immunity [3,4]. Currently licensed oral vaccines include live-attenuated poliovirus vaccines containing one, two or three serotypes, live-attenuated rotavirus vaccines (Rotarix R , RotaTeq R , Lanzhou lamb rotavirus vaccine [China only] and Rotavac R [India only]), live-attenuated cholera vaccine (CVD 103-HgR or Vaxchora TM ), inactivated cholera vaccines (Dukoral R and Shanchol R ) and live-attenuated typhoid vaccine (Ty21a). Other oral vaccines are in development, including those against Shigella, enterotoxigenic E. coli, Campylobacter and Clostridium difficile, as well as several novel rotavirus vaccine candidates (including the human neonatal vaccine RV3-BB [5] and an oral bovine pentavalent vaccine [6]).Yet oral vaccines have an Achilles' heel -their immunogenicity and efficacy is impaired in low-income countries that experience the greatest burden of enteric disease (Box 1). For example, Rotarix has a 1-year protective efficacy against severe rotavirus-associated gas...

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Section: Malnutrition and Micronutrient Deficienciesmentioning

confidence: 99%

Section: Breastfeedingmentioning

confidence: 99%

Section: Conclusion and Future Perspectiveunclassified

mentioning

confidence: 99%

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Causes of Impaired Oral Vaccine Efficacy in Developing Countries

et al. 2017

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“…Therefore, it is the intricate interplay between these variables that results in a particular metabolic state, and a key question is how immunity to vaccination is affected by such metabolic states. There are several studies documenting impaired immune responses associated with obesity (69,70) and undernutrition (71)(72)(73). Systems vaccinology offers a promising way to dissect the molecular mechanisms that result in impaired vaccine immunity in such abnormal conditions.…”

Section: Vaccines For Which There Are No Knownmentioning

confidence: 99%

Systems vaccinology: Probing humanity’s diverse immune systems with vaccines

Pulendran

2014

Proc. Natl. Acad. Sci. U.S.A.

175

123

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Homo sapiens are genetically diverse, but dramatic demographic and socioeconomic changes during the past century have created further diversification with respect to age, nutritional status, and the incidence of associated chronic inflammatory disorders and chronic infections. These shifting demographics pose new challenges for vaccination, as emerging evidence suggests that age, the metabolic state, and chronic infections can exert major influences on the immune system. Thus, a key public health challenge is learning how to reprogram suboptimal immune systems to induce effective vaccine immunity. Recent advances have applied systems biological analysis to define molecular signatures induced early after vaccination that correlate with and predict the later adaptive immune responses in humans. Such "systems vaccinology" approaches offer an integrated picture of the molecular networks driving vaccine immunity, and are beginning to yield novel insights about the immune system. Here we discuss the promise of systems vaccinology in probing humanity's diverse immune systems, and in delineating the impact of genes, the environment, and the microbiome on protective immunity induced by vaccination. Such insights will be critical in reengineering suboptimal immune systems in immunocompromised populations.

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ADMEProcesses in Vaccines andPK/PDApproaches for Vaccination Optimization

Gómez-Mantilla

Trocóniz

Garrido

2015

Pharmaceutical Sciences Encyclopedia

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In order to present the current knowledge on vaccine absorption, distribution, metabolism, and excretion (ADME) and vaccine modeling, this chapter briefly summarizes how vaccines are developed, what type of vaccines are available, and how much it is known about their mechanisms of action. It also summarizes the current knowledge on the impact of administration routes, dosing schedules, and formulation on vaccine ADME processes, focusing on the vaccine properties that can be altered without modifying the antigens (Ag). The chapter then describes the influence of biopharmaceutics properties on vaccine pharmacokinetic (PK) processes such as absorption and distribution. Mathematical models may be used to optimize vaccination in cancer treatment. There is an urgent need to perform studies based on PK, pharmacodynamics, and systems biology principles, to get the longitudinal information required, that once analyzed under the model‐based framework, can be linked to the biopharmaceutical characteristics of the vaccine formulation.

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Oral polio vaccine response in breast fed infants with malnutrition and diarrhea

Cited by 62 publications

References 22 publications

Causes of Impaired Oral Vaccine Efficacy in Developing Countries

Causes of Impaired Oral Vaccine Efficacy in Developing Countries

Systems vaccinology: Probing humanity’s diverse immune systems with vaccines

ADMEProcesses in Vaccines andPK/PDApproaches for Vaccination Optimization

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