GELATIN-SPECIFIC HUMORAL AND CELLULAR IMMUNE-RESPONSES IN CHILDREN WITH IMMEDIATE-TYPE AND NONIMMEDIATE-TYPE REACTIONS TO LIVE MEASLES, MUMPS, RUBELLA, AND VARICELLA VACCINES

Background: This study was designed to investigate the development of both cellular and humoral immune responses to gelatin in patients with vaccine-related immediate and nonimmediate reactions. Our purpose was to define the nature of the responses in the different clinical state s. Methods: Six patients with immediate reactions and 21 patients with nonimmediate reactions after inoculation of various live vaccines wer e studied. Measurement of gelatin-specific IgE was performed in all su bjects. Gelatin-specific T-cell responses detected by an in vitro lymp hocyte proliferation assay and by an assay for IL-2 responsiveness wer e investigated to compare the immune response in patients with the two types of reaction. Results: till six patients with immediate reaction s had IgE responses to gelatin, whereas none of the 21 patients with n onimmediate reactions had any anti-gelatin IgE. All of the six patient s with immediate reactions and 17 of the 21 patients with nonimmediate reactions exhibited positive T-lymphocyte responses specific to gelat in. Conclusions: Immediate and nonimmediate reactions are caused by di fferent types of allergy to gelatin, and cell-mediated immunity to gel atin mag play an important role in the pathogenesis of nonimmediate re actions.