Does segmental immunization of the lower alimentary tract with poliovaccine elicit local and systemic antibody responses in patients with double-barrel surgical colostomy?
Segmental immunization of the distal colon with live poliovaccine induces local secretory IgA responses but does not confer nasopharyngeal immunity.
Summary Poliovirus antibody response in serum, nasopharynx and segments of the lower alimentary tract has been studied following immunization of the distal segment of the colon in twelve patients with double-barrel surgical eolostomy. The response was characterized by the appearance of secretory γA antibody in the immunized segment of colon. The antibody appeared 14 days after immunization and gradually increased in titer. Low levels of γA antibody appeared in the segments of colon that were in close proximity to the immunized segment. However, antibody activity in the nasopharynx was conspicuously absent. Subsequent oral administration of live poliovaccine after the closure of the colostomy in three patients, who had previously received immunization of the distal colon with live vaccine, elicited an appreciable antibody response in the nasopharynx. Pre-existing levels of antibody in rectal washings did not influence nasopharyngeal susceptibility to infection. However, virus excretion in rectal washings was significantly limited.
Ogra et al. (Sun,) studied this question.