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ORIGINAL RESEARCH COMMUNICATION |
1 From the Medical Research Council International Nutrition Group, London School of Hygiene and Tropical Medicine (SEM and AMP); the Department of Social and Preventive Paediatrics, King Edward Medical College and Mayo Hospital, Lahore, Pakistan (FJ and RA); the National Institutes of Health, Bethesda, MD (SCS); and the Department of Clinical Immunology, University of Göteborg, Göteborg, Sweden (LAH)
Background: Substantial evidence exists linking small size at birth to later-life susceptibility to chronic disease. Evidence is also emerging that some components of immune function may be programmed in early life. However, this evidence is limited and requires confirmation.
Objective: We investigated the association between size at birth and response to vaccination in a cohort of 257 adults (mean age: 29.4 y; 146 men) born in an urban slum in Lahore, Pakistan, during 1964-1978.
Design: A single dose of Vi polysaccharide vaccine for Salmonella typhi and 2 doses of rabies vaccine were given to each subject. Antibody titers were measured in prevaccination serum samples (Vi) and in postvaccination samples (Vi and rabies).
Results: The mean birth weight of the subjects was 3.24 kg; 14% of the subjects had low birth weights (<2.5 kg). Vaccine responses were not consistently associated with contemporary variables (month of study, sex, current age, or indicators of wealth). Response to typhoid vaccination was positively related to birth weight (anti-Vi immunoglobulin G: r = 0.138, P = 0.031; anti-Vi immunoglobulin M: r = 0.197, P = 0.034). Response to the rabies vaccine was not significantly associated with birth weight.
Conclusions: These findings add to a growing body of evidence suggesting that components of the immune system may be permanently programmed by events in early life. The contrasting effects on typhoid and rabies responses suggest that antibody generation to polysaccharide antigens, which have greater B cell involvement, is compromised by fetal growth retardation.
Key Words: Birth weight • fetal origins • vaccine response • rabies • typhoid • Pakistan
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