Altered reactivity to respiratory syncytial virus: Antibody response to RSV antigens and studies of the pathogensis of atypical RSV illness in recipients of inactivated vaccine

摘要

The vaccine, in contrast to natural infection, failed to produce significant serum IgA antibody. Kinetic experiments revealed no defect in the quality of IgG antibody produced by the vaccine. Arthus and precipitating antibodies were not demonstrable in post-vaccine sera. The mean percent blastoid formation and uptake of radiouridine were greater in vaccinees than in controls in vitro lymphocyte stimulation tests. A delayed dermal hypersensitivity reaction could be demonstrated in guinea pigs and African Green monkeys after multiple injections of adjuvanted RSV vaccine. Immediate wheal and flare reactions were not detected. A positive delayed skin test was still present in the monkeys 12 months after immunization. An African Green monkey previously immunized developed a temperature elevation above 106° and rales in the lungs, but no wheezing, lasting about 48 hours, beginning 9 days after intranasal challenge with live 11th MK passage RSV. The vaccine was shown to contain a disproportionate amount of soluble, CF antigens compared to surface, viral antigens. Evidence indicates that the vaccine overstimulated delayed hypersensitivity and IgE in young atopic children. Enhanced delayed hypersensitivity may account for the high fever, rash and some pulmonary infiltration, and the IgE-mediated response for the marked wheezing seen in atypical illness.