「Correlates of Protection」の版間の差分

提供: Vaccipedia | Resources for Vaccines, Tropical medicine and Travel medicine
ナビゲーションに移動 検索に移動
 
(同じ利用者による、間の20版が非表示)
1行目: 1行目:
 +
{{Floating_Menu}}
 +
 
==Correlates of Protection==
 
==Correlates of Protection==
 
{|class="wikitable
 
{|class="wikitable
26行目: 28行目:
  
 
===Be careful===
 
===Be careful===
*'''"Immune reseponses"''' contain various kinds of immunological functions
+
*'''"Immune reseponses"''' contain various kinds of immunological functions, thus a single immune biomarker cannot necessarily be CoP
 
**Serum antibodies with multiple isotypes and multiple functions
 
**Serum antibodies with multiple isotypes and multiple functions
 
**Mucosal antibodies with multiple isotypes and multiple functions
 
**Mucosal antibodies with multiple isotypes and multiple functions
32行目: 34行目:
 
**Killer T cells
 
**Killer T cells
 
**Regulatory T cells
 
**Regulatory T cells
 +
**Natural killer cells
 +
**Phagocytes and antigen-presenting cells
 
**etc.
 
**etc.
 
*'''Protection against infection''' is generally different from '''protection against disease'''
 
*'''Protection against infection''' is generally different from '''protection against disease'''
48行目: 52行目:
 
|}
 
|}
  
====An example of measles====
+
<div class="toccolours mw-collapsible mw-collapsed" style="margin-left:40px; max-width:650px; overflow:auto;">
<div style="margin-left:40px">
+
'''An example of measles'''
 +
<div class="mw-collapsible-content" style="">
 
{{Quote|content=
 
{{Quote|content=
 
<div class="csl-entry">Chen, R. T., Markowitz, L. E., Albrecht, P., Stewart, J. A., Mofenson, L. M., Preblud, S. R., &#38; Orenstein, W. A. (1990). Measles Antibody: Reevaluation of Protective Titers. In <i>The Journal of Infectious Diseases</i> (Vol. 162). https://doi.org/10.1093/infdis/162.5.1036</div>}}
 
<div class="csl-entry">Chen, R. T., Markowitz, L. E., Albrecht, P., Stewart, J. A., Mofenson, L. M., Preblud, S. R., &#38; Orenstein, W. A. (1990). Measles Antibody: Reevaluation of Protective Titers. In <i>The Journal of Infectious Diseases</i> (Vol. 162). https://doi.org/10.1093/infdis/162.5.1036</div>}}
</div>
+
 
 
{|class="wikitable" style="margin-left:40px; text-align:center"
 
{|class="wikitable" style="margin-left:40px; text-align:center"
 +
|+Comparison between Cases and Non-cases; serologically confirmed
 
|-
 
|-
!
+
!style="width:150px"|
!Pre-exposure PRN &le;120<br>(GMT)
+
!style="width:200px"|Pre-exposure PRN &le;120<br>(GMT)
!Post-exposure PRN >120<br>(GMT)
+
!style="width:200px"|Pre-exposure PRN >120<br>(GMT)
 
|-
 
|-
 
!Cases
 
!Cases
64行目: 70行目:
 
|-
 
|-
 
!Non-cases
 
!Non-cases
|1 non-case
+
|1 non-case<br>(56)
 
|71 non-cases<br>(1157)
 
|71 non-cases<br>(1157)
 
|}
 
|}
*PRN = Plaque Reduction Neutralization
+
::<nowiki>*</nowiki>PRN = Plaque Reduction Neutralization
 +
::''t'' test ''p''<0.001
 +
 
 +
{|class="wikitable" style="margin-left:40px; text-align:center"
 +
|+Comparison among serologically discarded Non-cases
 +
|-
 +
!style="width:150px"|
 +
!style="width:200px"|Pre-exposure PRN<br>216-874
 +
!style="width:200px"|Pre-exposure PRN<br>&ge;1052
 +
|-
 +
!Post-exposure PRN<br>boosted&dagger;
 +
|7 non-cases
 +
|0 non-case
 +
|-
 +
!Post-exposure PRN<br>unchanged
 +
|4 non-cases
 +
|7 non-cases
 +
|}
 +
::&dagger;suggestive of subclinical infection
 +
::Fisher's exact test ''p''<0.001
 +
 
 +
{|class="wikitable" style="margin-left:40px; text-align:center"
 +
|+Comparison among serologically discarded Non-cases
 +
|-
 +
!style="width:150px"|
 +
!style="width:200px"|Pre-exposure PRN<br><1052
 +
!style="width:200px"|Pre-exposure PRN<br>&ge;1052
 +
|-
 +
!Non-cases with<br>&ge;1 symptom&Dagger;
 +
|26 non-cases
 +
|11 non-cases
 +
|-
 +
!Non-cases with<br>no symptom
 +
|11 non-cases
 +
|24 non-cases
 +
|}
 +
::&Dagger;suggestive of subclinical infection
 +
::&chi;<sup>2</sup> test ''p''<0.002
 +
 
 +
{|class="wikitable" style="margin-left:40px; text-align:center"
 +
|+Comparison between Cases and Non-cases; serologically confirmed
 +
|-
 +
!style="width:150px"|
 +
!style="width:133px"|Pre-exposure PRN<br>&le;120
 +
!style="width:133px"|Pre-exposure PRN<br>121-1051
 +
!style="width:133px"|Pre-exposure PRN<br>&ge;1052
 +
|-
 +
!Cases with<br>no vaccine
 +
|1 unvaccinated case
 +
|
 +
|
 +
|-
 +
!Cases with<br>1 vaccine
 +
|7 unvaccinated case
 +
|
 +
|
 +
|-
 +
!Non-cases with<br>no vaccine
 +
|
 +
|0 unvaccinated non-case
 +
|0 unvaccinated non-case
 +
|-
 +
!Non-cases with<br>1 vaccine
 +
|
 +
|36 vaccinated non-cases
 +
|35 vaccinated non-cases
 +
|}
 +
</div>
 +
</div>
 +
 
 +
*'''Single definitive cut-off of CoP is not commonly available''' and '''CoP is generally relative'''
 +
**Generally speaking, the higher a CoP biomarker is, the more highly the subject is protected from infection or disease
 +
**In other words, a certain proportion of subjects with a certain level of CoP biomarker can be protected from infection/disease
 +
***The proportion of protected subjects increases as the level of CoP biomarker rises

2023年9月12日 (火) 10:22時点における最新版

Navigation Menu Vac logo.png
General issues of Vaccine
Cold chain
Correlates of Protection
Vaccines for Asplenia
Vaccines for Pregnant women
Vaccines for Immunocompromised hosts
Vaccine hesitancy
Additional materials of vaccine
General issues of Tropical med.
Definition of Tropical Medicine
Matrices of tropical infection
General issues of Helminths
Neglected Tropical Diseases
Sexually-transmitted infections
Non-Communicable Diseases
Maternal health and contraception
Child health
Malnutrition and Micronutrient
Eosinophilia
Fever in the tropics
Diarrhea in the tropics
Anemia in the tropics
Dermatology in the tropics
Ophthalmology in the tropics
Neurology in the tropics
Mental health in the tropics
Surgery in the tropics
Humanitarian emergency
Epidemiology in outbreak
Antimicrobial resistance
Pathology of infectious diseases
General issues of Travel med.
Epidemiology of Travel health
Last minute traveler
Time zone issue
High altitude medicine
Diving medicine
Pregnancy and travel
Children and travel
Elderly and travel
Immunology
Principle of human immune system
Innate immunity
Cellular immunity
Humoral immunity
Neutralizing antibody and its assay
Antigenic Cartography
Additional materials of immunology
Epi & Stats
Basics & Definition
Epidemiology
Odds in statistics and Odds in a horse race
Collider bias
Data distribution
Statistical test
Regression model
Multivariate analysis
Marginal effects
Prediction and decision
Table-related commands in STATA
Missing data and imputation
Virus
HIV
HIV-TB co-infection
HIV-STI interaction
Viral Hemorrhagic Fever
Ebola
Crimean-Congo hemorrhagic fever
SFTS
Rabies
Polio
Dengue
Yellow fever
Chikungunya
Zika
Japanese encephalitis
Tick-borne encephalitis
Viral hepatitis
Measles
Smallpox and Monkeypox
Respiratory Syncytial virus
COVID-19
Bivalent BA.1/BA.4-5 mRNA vaccines
Monovalent XBB-1.5 mRNA vaccine
Private archives of the initial phase of the pandemic
Private archives of lecture materials of COVID vaccine as of March 2021
厚生労働省が発出する保健行政関連の文書の読み解き方
Bacteria
Bacteriological tests
Tuberculosis
Tuberculosis in Children
HIV-TB co-infection
Leprosy
Dermatological mycobacterium infecions
Syphilis and Yaws
Plague
Pneumococcus
Meningococcus
Typhoid
Salmonellosis
Melioidosis
Leptospirosis
Brucellosis
Bartonellosis
Lyme disease and Relapsing fever
Tularaemia
Tetanus
Diphtheria
Anthrax
Coxiellosis
Rickettsia
Rickettsiosis
Scrub typhus
Spotted fevers
Epidemic typhus
Murine typhus
Protozoa
Overview of protozoa
Overview of medicine for protozoa
Malaria
Chagas disease
African trypanosomiasis
Leishmaniasis
Trichomoniasis
Toxoplasmosis
Amoebiasis
Giardiasis
Cryptosporidiosis
Cyclosporiasis
Isosporiasis
Pentatrichomoniasis
Microsporidiasis
Babesiosis
Fungi
General issues of fungi
Coccidioidomycosis
Paracoccidioidomycosis
Histoplasmosis
Talaromycosis
Blastomycosis
Sporotrichosis
Nematode (roundworm)
Nematode principles
Lympatic filariasis
Onchocerciasis
Loiasis
Microscopic differentiation of microfilariae
Strongyloidiasis
Ascariasis
Ancylostomiasis (hookworm)
Trichuriasis (whipworm)
Enterobiasis (pinworm)
Angiostrongyliasis (rat lungworm)
Dracunculiasis (Guinea worm)
Anisakiasis
Trichinellosis (Trichinosis)
Gnathostomiasis
Spirurinasis
Soil-transmitted helminths
Trematode (fluke, distoma)
General issues of Helminths
Trematode principles
Schistosomiasis
Clonorchiasis
Fascioliasis
Paragonimiasis
Metagonimiasis
Cestode (tapeworm)
General issues of Helminths
Cestode principles
Diphyllobothriasis
Sparganosis
Taeniasis
Echinococcosis
Medical Zoology
Zoonosis
Insectology
Mosquitology
Acarology
Batology
Snake toxicology
Scorpion and spider toxicology
Marine toxicology

Chevron-up-blue.png

Correlates of Protection

Definitions of terms
Correlates of Protection (CoP) An immune response statistically correlated with protection
Mechanistic CoP (mCoP) An immune response responsible for protection
Non-mechanistic CoP (nCoP) An immune response surrogating mCoP and easily measured

Identifying method of CoP (mCoP)

  • Theoretically
    • To measure immune responses at the time of exposure to the infection and compare them between those who get infection and not
      • might be feasible by detecting immune responses of bloods donated just before an outbreak
  • Practically
    • To measure immune responses after the vaccination and compare them between those who get infection and not
      • usually done in vaccine clinical trial phase 3
    • To measure immune responses at the time of challenging exposure of vaccinated volunteers
      • would be ethically approved only for milder and/or treatable infections such as seasonal influenza, cholera, dengue or cytomegalovirus
    • To extrapolate vaccinated animal challenge model
    • To extrapolate protective level of dosing of passive immunization (antibody treatment)

Be careful

  • "Immune reseponses" contain various kinds of immunological functions, thus a single immune biomarker cannot necessarily be CoP
    • Serum antibodies with multiple isotypes and multiple functions
    • Mucosal antibodies with multiple isotypes and multiple functions
    • Helper T cells
    • Killer T cells
    • Regulatory T cells
    • Natural killer cells
    • Phagocytes and antigen-presenting cells
    • etc.
  • Protection against infection is generally different from protection against disease
    • You should focus on which type of protection you expect
Protection against infection Protection against disease
Polio Infection is prevented by mucosal antibodies at nasopharynx and intestine (IgA + diffused IgG) Disease (paralysis) is prevented by serum antibodies before entering CNS via blood
Pneumococcus Infection (bacteremia) is prevented by 0.20-0.35 µg/mL (ELISA) of serum antibodies Disease (pneumonia, otitis media, nasopharynx carriage) is prevented by >10 times higher serum antibodies

An example of measles

Chen, R. T., Markowitz, L. E., Albrecht, P., Stewart, J. A., Mofenson, L. M., Preblud, S. R., & Orenstein, W. A. (1990). Measles Antibody: Reevaluation of Protective Titers. In The Journal of Infectious Diseases (Vol. 162). https://doi.org/10.1093/infdis/162.5.1036
Comparison between Cases and Non-cases; serologically confirmed
Pre-exposure PRN ≤120
(GMT)
Pre-exposure PRN >120
(GMT)
Cases 8 cases
(63)
0 case
Non-cases 1 non-case
(56)
71 non-cases
(1157)
*PRN = Plaque Reduction Neutralization
t test p<0.001
Comparison among serologically discarded Non-cases
Pre-exposure PRN
216-874
Pre-exposure PRN
≥1052
Post-exposure PRN
boosted†
7 non-cases 0 non-case
Post-exposure PRN
unchanged
4 non-cases 7 non-cases
†suggestive of subclinical infection
Fisher's exact test p<0.001
Comparison among serologically discarded Non-cases
Pre-exposure PRN
<1052
Pre-exposure PRN
≥1052
Non-cases with
≥1 symptom‡
26 non-cases 11 non-cases
Non-cases with
no symptom
11 non-cases 24 non-cases
‡suggestive of subclinical infection
χ2 test p<0.002
Comparison between Cases and Non-cases; serologically confirmed
Pre-exposure PRN
≤120
Pre-exposure PRN
121-1051
Pre-exposure PRN
≥1052
Cases with
no vaccine
1 unvaccinated case
Cases with
1 vaccine
7 unvaccinated case
Non-cases with
no vaccine
0 unvaccinated non-case 0 unvaccinated non-case
Non-cases with
1 vaccine
36 vaccinated non-cases 35 vaccinated non-cases
  • Single definitive cut-off of CoP is not commonly available and CoP is generally relative
    • Generally speaking, the higher a CoP biomarker is, the more highly the subject is protected from infection or disease
    • In other words, a certain proportion of subjects with a certain level of CoP biomarker can be protected from infection/disease
      • The proportion of protected subjects increases as the level of CoP biomarker rises