Maternal antibodies to pneumolysin but not to pneumococcal surface protein A delay early pneumococcal carriage in high-risk Papua New Guinean infants

Jacinta Francis, Peter Richmond, W.S. Pomat, A. Michael, H. Keno, S. Phuanukoonnon, J.B. Nelson, M.L. Whinnen, Tatjana Heinrich, Wendy-Anne Smith, Susan Prescott, Patrick Holt, P.M. Siba, Deborah Lehmann, Anita Van Den Biggelaar, J.P. Francis

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Immunization of pregnant women can be an efficient strategy to induce early protection in infants in developing countries. Pneumococcal protein-based vaccines may have the capacity to induce pneumococcal serotype-independent protection. To understand the potential of maternal pneumococcal protein-specific antibodies in infants in high-risk areas, we studied the placental transfer of naturally acquired antibodies to pneumolysin (Ply) and pneumococcal surface protein A family 1 and 2 (PspA1 and PspA2) in relation to onset of pneumococcal nasopharyngeal carriage in infants in Papua New Guinea (PNG). In this study, 76% of the infants carried Streptococcus pneumoniae in the upper respiratory tract within the first month of life, at a median age of 19 days. Maternal and cord blood antibody titers to Ply ( = 0.824, P <0.001), PspA1 ( = 0.746, P <0.001), and PspA2 ( = 0.631, P <0.001) were strongly correlated. Maternal pneumococcal carriage (hazard ratio [HR], 2.60; 95% confidence interval [CI], 1.25 to 5.39) and younger maternal age (HR, 0.74; 95% CI, 0.54 to 1.00) were independent risk factors for early carriage, while higher cord Ply-specific antibody titers predicted a significantly delayed onset (HR, 0.71; 95% CI, 0.52 to 1.00) and cord PspA1-specific antibodies a significantly younger onset of carriage in PNG infants (HR, 1.57; 95% CI, 1.03 to 2.40). Maternal vaccination with a pneumococcal protein-based vaccine should be considered as a strategy to protect high-risk infants against pneumococcal disease by reducing carriage risks in both mothers and infants.
Original languageEnglish
Pages (from-to)1633-1638
JournalClinical and Vaccine Immunology
Volume16
Issue number11
DOIs
Publication statusPublished - 2009

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