Carrier priming or suppression: understanding carrier priming enhancement of anti-polysaccharide antibody response to conjugate vaccines

Karl Pobre; Mohamed Tashani; Iman Ridda; Harunor Rashid; Melanie Wong; Robert Booy

doi:10.1016/j.vaccine.2014.01.047

Carrier priming or suppression: understanding carrier priming enhancement of anti-polysaccharide antibody response to conjugate vaccines

Vaccine. 2014 Mar 14;32(13):1423-30. doi: 10.1016/j.vaccine.2014.01.047. Epub 2014 Jan 31.

Authors

Karl Pobre¹, Mohamed Tashani², Iman Ridda³, Harunor Rashid¹, Melanie Wong⁴, Robert Booy⁵

Affiliations

¹ National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children's Hospital at Westmead, New South Wales, Australia.
² National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children's Hospital at Westmead, New South Wales, Australia; Sydney Medical School, The University of Sydney, New South Wales, Australia. Electronic address: Mohamed.tashani@health.nsw.gov.au.
³ National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children's Hospital at Westmead, New South Wales, Australia; Sydney Medical School, The University of Sydney, New South Wales, Australia.
⁴ Department of Immunology, Children's Hospital at Westmead, Westmead, New South Wales, Australia.
⁵ National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children's Hospital at Westmead, New South Wales, Australia; Sydney Emerging Infections and Biosecurity Institute, University of Sydney, Australia.

PMID: 24492014
DOI: 10.1016/j.vaccine.2014.01.047

Abstract

Introduction: With the availability of newer conjugate vaccines, immunization schedules have become increasingly complex due to the potential for unpredictable immunologic interference such as 'carrier priming' and 'carrier induced epitopic suppression'. Carrier priming refers to an augmented antibody response to a carbohydrate portion of a glycoconjugate vaccine in an individual previously primed with the carrier protein. This review aims to provide a critical evaluation of the available data on carrier priming (and suppression) and conceptualize ways by which this phenomenon can be utilized to strengthen vaccination schedules.

Methods: We conducted this literature review by searching well-known databases to date to identify relevant studies, then extracted and synthesized the data on carrier priming of widely used conjugate polysaccharide vaccines, such as, pneumococcal conjugate vaccine (PCV), meningococcal conjugate vaccine (MenCV) and Haemophilus influenzae type b conjugate vaccines (HibV).

Results: We found evidence of carrier priming with some conjugate vaccines, particularly HibV and PCV, in both animal and human models but controversy surrounds MenCV. This has implications for the immunogenicity of conjugate polysaccharide vaccines following the administration of tetanus-toxoid or diphtheria-toxoid containing vaccine (such as DTP).

Conclusion: Available evidence supports a promising role for carrier priming in terms of maximizing the immunogenicity of conjugate vaccines and enhancing immunization schedule by making it more efficient and cost effective.

Keywords: Antibody response; Carrier priming; Conjugate vaccine; Polysaccharide vaccine.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Animals
Antibody Formation*
Bacterial Capsules / immunology
Drug Carriers / pharmacology*
Haemophilus Vaccines / immunology
Humans
Immunization Schedule*
Meningococcal Vaccines / immunology
Pneumococcal Vaccines / immunology
Polysaccharides / immunology*
Vaccines, Conjugate / immunology*

Substances

Drug Carriers
Haemophilus Vaccines
Haemophilus influenzae type b polysaccharide vaccine
Meningococcal Vaccines
Pneumococcal Vaccines
Polysaccharides
Vaccines, Conjugate