Specific IgE and lgG4 Immune Responses to Tetanus and Diphtheria Toxoid in Atopic and Nonatopic Children during the First Two Years of Life

Abstract

Background: In order to investigate, whether atopic and nonatopic children show differences in their specific IgE and IgG4 immune responses to tetanus (T) and diphtheria (D) antigens, we studied 538 children who had been followed from birth on and from whom records had been kept of all immunizations. Methods: The prevalence of eczema and asthma was registered at regular intervals and the cumulative incidence of symptoms was determined at 24 months of age. Total serum IgE and specific IgE to a panel of nine allergens as well as T-and D-specifíc IgE and IgG4 were determined from the 24-month blood samples. Results: Our results show that both atopic and nonatopic children are capable of mounting high levels of toxoid-specific IgE antibody responses. Children with cord blood IgE > 0.9 kU/l, serum IgE 10–100 kU/l and > 100 kU/l and at least one sensitization to an allergen at 24 months of age have significantly higher IgE responses to T and D (p < 0.001). In contrast, specific IgG4 antibody concentrations to T and D were not significantly different in children with elevated total IgE levels at 24 months. No differences in subgroups of children with or without early symptoms of atopy were observed. Conclusions: Our data indicate that IgE responses to toxoids such as T and D are not limited to infants with clinical manifestations of atopy in the first 2 years of life but are related to immunological parameters of atopy.

Transient Suppression of Atopy in Early Childhood Is Associated With High Vaccination Coverage

“…Diphtheria/ tetanus vaccination elicits an IgE response directed against the vaccinated toxoids as part of the regular immune response, but this is exaggerated in individuals predisposed to atopy. 11 Pertussis vaccination elicits an IgE response to pertussis toxin, more pronounced after vaccination with acellular than whole cell vaccines. 12 To date, however, there is no evidence of a promoting effect extending to unrelated allergens or atopic disease.…”

Environmental Epidemiology of Pediatric Asthma and Allergy

“…Two other cross-sectional surveys, one conducted in London and one using US Third National Health and Nutrition Examination Survey data, also reported an association (163,164). In addition, some laboratory results have supported increased levels of IgE in subjects exposed to diphtheria, pertussis, and tetanus antigens (101,165,166). The Avon Longitudinal Study of Parents and Children (ALSPAC) cohort found no increased risk associated with pertussis vaccination for wheezing illnesses in young English children (84).…”

Down-Regulation of IgE and IgG4 Antibodies to Tetanus Toxoid and Diphtheria Toxoid by Covaccination with Cellular Bordetella pertussis Vaccine

“…We have shown previously that in German children of a prospectively followed birth cohort (MAS-90), considerable IgE responses are constituents of the regular immune response toward diphtheria (D) 3 and tetanus (T) immunization, however exaggerated in atopics (5,6). Pertussis (P) toxin and the chemically derived toxoid have a long tradition as an adjuvant for IgE formation against simultaneously administered Ags in animal models (7,8).…”