BACKGROUND Children with nephrotic syndrome (NS) are vulnerable to infections. Measles infection is an important cause of morbidity and mortality in immunosuppressed children. A suboptimal seroprotection against measles has been shown in immunocompromised children. There is limited published literature on measles immunity in children with difficult-to-treat nephrotic syndrome (DTNS). We compared the proportions of children with DTNS and healthy controls who were seroprotected against measles. METHODS This was a cross-sectional study. Measles-specific IgG antibodies of 108 children with DTNS (3 to 10 years of age) and an equal number of age-matched healthy controls were measured. All children had received two doses of measles-containing vaccine at 9-12 and 16-24 months of age under routine immunisation programme. Serum measles IgG antibody titres were measured by indirect ELISA. The assay results were interpreted as (1) > 11 NTU (NovaTec Units), positive/seroprotective titres; (2) 9-11, equivocal; and (3) < 9 NTU, negative. Inter- and intra-group comparisons were made to identify the disease characteristics related to seroprotection status. RESULTS The proportion of children with protective anti-measles antibodies (n = 70, 65%) was significantly lower in DTNS as compared to controls (n = 88, 81.48%) (p = 0.005). Their median [IQR] antibody titres were also significantly lower than those in controls (14.1 [14] NTU vs. 18.3 [15.2] NTU (p = 0.001). The age, gender, clinical subtype, duration of disease, and type of immunosuppressive therapy were not significantly different between seroprotected and non-seroprotected children with DTNS. CONCLUSION A significantly lower percentage of fully vaccinated children with DTNS were seroprotected against measles compared to healthy controls. A higher resolution version of the Graphical abstract is available as Supplementary information.

中文翻译：

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以前接种过疫苗的患有难治性肾病综合征的儿童对麻疹的血清保护作用。

背景技术患有肾病综合征 (NS) 的儿童易受感染。麻疹感染是免疫抑制儿童发病和死亡的重要原因。在免疫功能低下的儿童中已显示出对麻疹的次优血清保护。关于难治性肾病综合征 (DTNS) 儿童麻疹免疫的已发表文献有限。我们比较了 DTNS 患儿和健康对照组接受麻疹血清保护的比例。方法 这是一项横断面研究。测量了 108 名 DTNS 儿童（3 至 10 岁）和同等数量的年龄匹配的健康对照的麻疹特异性 IgG 抗体。在常规免疫计划下，所有儿童在 9-12 个月和 16-24 个月大时都接种了两剂麻疹疫苗。通过间接ELISA测量血清麻疹IgG抗体滴度。分析结果被解释为 (1) > 11 NTU (NovaTec Units)，阳性/血清保护滴度；(2) 9-11，模棱两可；(3) < 9 NTU，阴性。进行组间和组内比较以确定与血清保护状态相关的疾病特征。结果 与对照组相比，具有保护性抗麻疹抗体的儿童比例（n = 70, 65%）显着低于对照组（n = 88, 81.48%）（p = 0.005）。他们的中位 [IQR] 抗体滴度也显着低于对照组（14.1 [14] NTU vs. 18.3 [15.2] NTU (p = 0.001)。年龄、性别、临床亚型、疾病持续时间和免疫抑制类型血清保护和非血清保护的 DTNS 儿童的治疗没有显着差异。结论 与健康对照组相比，完全接种 DTNS 的儿童对麻疹的血清保护百分比显着降低。图形摘要的更高分辨率版本可作为补充信息。