Becker-Dreps S, Vilchez S, Bucardo F, Twitchell E, Choi W, Hudgens M, Perez J, Yuan L

BACKGROUND Environmental enteropathy (EE) is a common intestinal condition among children living in low and middle income countries and is associated with diminished enteric immunity to gastrointestinal pathogens, and possibly, to oral vaccine antigens. The goal of this study was to examine associations between biomarkers of EE and immunogenicity to the pentavalent rotavirus vaccine (RV5).

METHODS Infants were recruited one day before their first RV5 immunization in León, Nicaragua, from public health rosters. Infants provided a pre-immunization blood and stool sample, and a second blood sample 1 month after receipt of RV5. We measured IgA seroconversion to the first dose of RV5, and concentrations of 4 previously identified fecal biomarkers of EE (alpha-1 antitrypsin, neopterin, myeloperoxidase, and calprotectin). We then assessed associations between concentrations of these biomarkers, both individually and as combined scores, and seroconversion to the first dose of RV5.

RESULTS Of the 43 enrolled infants, 24 (56%) seroconverted following the first dose of RV5. As compared to infants who seroconverted, those who did not seroconvert had higher median concentrations of both myeloperoxidase (3.1 vs.1.1 µg/mL, p=0.002) and calprotectin (199.1 vs. 156.2 µg/mL, p=0.03). Further, those who did not seroconvert had a higher median combined score of the 4 biomarkers as compared to those who seroconverted (6.5 vs. 4.5, p=0.017).

CONCLUSIONS We found an association between biomarkers of EE and seroconversion to the first dose of RV5. It is possible that interventions that prevent or ameliorate EE may also improve oral rotavirus vaccine response.

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