{"id":56681,"date":"2024-06-30T00:34:43","date_gmt":"2024-06-29T22:34:43","guid":{"rendered":"https:\/\/www.infokuryr.cz\/n\/?p=56681"},"modified":"2024-06-29T17:59:38","modified_gmt":"2024-06-29T15:59:38","slug":"bezpecnost-ockovani-proti-cernemu-kasli-je-velmi-sporna","status":"publish","type":"post","link":"https:\/\/www.infokuryr.cz\/n\/2024\/06\/30\/bezpecnost-ockovani-proti-cernemu-kasli-je-velmi-sporna\/","title":{"rendered":"Bezpe\u010dnost o\u010dkov\u00e1n\u00ed proti \u010dern\u00e9mu ka\u0161li je velmi sporn\u00e1"},"content":{"rendered":"
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\u010cern\u00fd ka\u0161el v sou\u010dasnosti koluje po cel\u00e9m sv\u011bt\u011b, proto\u017ee ochrann\u00fd \u00fa\u010dinek vakc\u00edny rychle miz\u00ed. Studie tak\u00e9 nazna\u010duj\u00ed, \u017ee o\u010dkov\u00e1n\u00ed ve skute\u010dnosti prodlu\u017euje dobu, po kterou infikovan\u00ed lid\u00e9 z\u016fst\u00e1vaj\u00ed infek\u010dn\u00ed. Pro\u010d? Proto\u017ee se imunitn\u00ed syst\u00e9m p\u0159episuje. To je zvl\u00e1\u0161t\u011b nebezpe\u010dn\u00e9 pro novorozence.<\/span><\/strong><\/p>\n

\u010cern\u00fd ka\u0161el (pertussis) je v sou\u010dasnosti v novin\u00e1ch. V sou\u010dasn\u00e9 dob\u011b existuj\u00ed velk\u00e1 ohniska po cel\u00e9m sv\u011bt\u011b, i kdy\u017e je proo\u010dkovanost vysok\u00e1. Ale v\u00fdsledky studi\u00ed ze studi\u00ed na pavi\u00e1nech (u nich\u017e jsou infekce \u010dern\u00e9ho ka\u0161le podobn\u00e9 t\u011bm u lid\u00ed) a humanizovan\u00fdch my\u0161\u00edch nazna\u010duj\u00ed, \u017ee o\u010dkov\u00e1n\u00ed v\u011bci zhor\u0161ilo.<\/span><\/p>\n

Britsk\u00fd rodinn\u00fd l\u00e9ka\u0159 v d\u016fchodu Douglas Jenkinson, kter\u00fd se touto nemoc\u00ed zab\u00fdv\u00e1 des\u00edtky let a provozuje tak\u00e9\u00a0<\/span>vlastn\u00ed webovou str\u00e1nku<\/span><\/a>\u00a0, se sna\u017e\u00ed o osv\u011btu ve\u0159ejnosti. Mimo jin\u00e9 tak\u00e9 s ohledem na ochrann\u00fd \u00fa\u010dinek o\u010dkov\u00e1n\u00ed proti pertusi. Ukazuje to i srovn\u00e1n\u00ed r\u016fzn\u00fdch o\u010dkov\u00e1n\u00ed (i kdy\u017e\u00a0<\/span>u spalni\u010dek<\/span><\/a>\u00a0je d\u00e9lka ochrany zjevn\u011b p\u0159ehnan\u00e1) v odborn\u00e9m \u010dasopise\u00a0<\/span>Science<\/span><\/a>\u00a0(\u201eWaning Immunity\u201c). Americk\u00e1\u00a0<\/span>studie<\/span><\/a>\u00a0\u201eWaning Tdap Effectiveness in Adolescents\u201c tak\u00e9 uk\u00e1zala, \u017ee nap\u0159\u00edklad d\u011bti ji\u017e po pouh\u00fdch \u010dty\u0159ech letech po p\u0159eo\u010dkov\u00e1n\u00ed nemaj\u00ed \u017e\u00e1dnou ochranu p\u0159ed o\u010dkov\u00e1n\u00edm.<\/span><\/p>\n

Ale to nen\u00ed v\u0161echno. Nejen, \u017ee (relativn\u00ed) ochrann\u00fd \u00fa\u010dinek rychle odezn\u00ed, ale tak\u00e9 se zd\u00e1, \u017ee p\u0159eprogramuje imunitn\u00ed syst\u00e9m a v\u00fdrazn\u011b prodlou\u017e\u00ed dobu infekce.\u00a0<\/span>Studie<\/span><\/a>\u00a0\u201eAcelul\u00e1rn\u00ed vakc\u00edny proti \u010dern\u00e9mu ka\u0161li chr\u00e1n\u00ed p\u0159ed nemocemi, ale nedok\u00e1\u017eou zabr\u00e1nit infekci a p\u0159enosu na modelu prim\u00e1t\u016f krom\u011b \u010dlov\u011bka\u201c , kter\u00e1 byla provedena na pavi\u00e1nech, ukazuje\u00a0, \u017ee zv\u00ed\u0159ata ji\u017e po o\u010dkov\u00e1n\u00ed v\u00e1\u017en\u011b neonemocn\u011bla \u010dern\u00fdm ka\u0161lem, ale byla naka\u017eliv\u00e1 t\u00fddny \u2013 v\u00fdrazn\u011b d\u00e9le ne\u017e jejich neo\u010dkovan\u00e9 prot\u011bj\u0161ky. N\u011bco podobn\u00e9ho bylo\u00a0<\/span>nalezeno<\/span><\/a>\u00a0tak\u00e9 u humanizovan\u00fdch my\u0161\u00ed\u00a0.<\/span><\/p>\n

\u00dadaje ze studie jsou podpo\u0159eny v\u00fdzkumem publikovan\u00fdm v\u00a0<\/span>Journal of Infectious Diseases,<\/span><\/a>\u00a0\u201eK p\u0159eprogramov\u00e1n\u00ed reakc\u00ed hostitele acelul\u00e1rn\u00ed vakc\u00edny proti \u010dern\u00e9mu ka\u0161li v modelu pavi\u00e1na jsou nutn\u00e9 opakovan\u00e9 infekce Bordetella pertussis. D\u016fvodem je, \u017ee o\u010dkovan\u00ed pavi\u00e1ni postr\u00e1daj\u00ed imunitn\u00ed obranu, kter\u00e1 je d\u016fle\u017eit\u00e1 pro boj s bakteriemi \u010dern\u00e9ho ka\u0161le na sliznic\u00edch v krku a vznik\u00e1 p\u0159i p\u0159irozen\u00fdch infekc\u00edch. Data nav\u00edc ukazuj\u00ed, \u017ee o\u010dkovan\u00ed pavi\u00e1ni pot\u0159ebuj\u00ed alespo\u0148 dv\u011b dal\u0161\u00ed infekce k p\u0159eprogramov\u00e1n\u00ed vlastn\u00edho imunitn\u00edho syst\u00e9mu, aby byli schopni tuto obrannou funkci obnovit.<\/span><\/p>\n

O\u010dkov\u00e1n\u00ed vede k vy\u0161\u0161\u00edmu v\u00fdskytu infekce<\/span><\/h3>\n

Lidsk\u00e1\u00a0<\/span>studie<\/span><\/a> \u201eInterak\u010dn\u00ed, nespecifick\u00e9, imunologick\u00e9 \u00fa\u010dinky vakc\u00edn proti obrn\u011b inaktivovan\u00fdch Bacille Calmette-Gu\u00e9rin a tetanus-difterie-pertussis: Pr\u016fzkumn\u00e1, n\u00e1hodn\u00e1 studie\u201c ukazuje velmi podobn\u00e9 v\u00fdsledky. Zvl\u00e1\u0161t\u011b kritick\u00fd je Dr. Jenkinson poukazuje na to, \u017ee fale\u0161n\u00e9 zabezpe\u010den\u00ed podporuje \u0161\u00ed\u0159en\u00ed bakteri\u00ed. Ka\u017ed\u00fd, kdo nevykazuje \u017e\u00e1dn\u00e9 p\u0159\u00edznaky infekce, je ukol\u00e9b\u00e1n fale\u0161n\u00fdm pocitem bezpe\u010d\u00ed a m\u016f\u017ee nev\u011bdomky \u0161\u00ed\u0159it patogeny na miminka, kter\u00e1 (zat\u00edm) nebyla proti \u010dern\u00e9mu ka\u0161li o\u010dkov\u00e1na. \u201estrategie kokonu\u201c (tj. o\u010dkov\u00e1n\u00ed v\u0161ech \u010dlen\u016f rodiny novorozence) je zjevn\u011b ne\u00fa\u010dinn\u00e1.<\/span><\/p>\n

Pokud uv\u00e1\u017e\u00edte, \u017ee p\u0159ed zaveden\u00edm vakc\u00edny na ni zem\u0159elo jedno z 25 d\u011bt\u00ed trp\u00edc\u00edch \u010dern\u00fdm ka\u0161lem, zd\u00e1 se, \u017ee sou\u010dasn\u00e9 vakc\u00edny jist\u011b p\u0159inesly zlep\u0161en\u00ed. V\u0161echny studie v\u0161ak tak\u00e9 ukazuj\u00ed, \u017ee ukol\u00e9b\u00e1vaj\u00ed lidi ve fale\u0161n\u00e9m pocitu bezpe\u010d\u00ed a vystavuj\u00ed tak zejm\u00e9na novorozence dal\u0161\u00edmu riziku. A co v\u00edc, bakterie \u010dern\u00e9ho ka\u0161le tak\u00e9 vykazuj\u00ed adaptabilitu a podkop\u00e1vaj\u00ed ochranu o\u010dkov\u00e1n\u00edm prost\u0159ednictv\u00edm mutac\u00ed.<\/span><\/p>\n

Celkov\u011b se ukazuje, \u017ee v sou\u010dasnosti pou\u017e\u00edvan\u00e9 vakc\u00edny proti \u010dern\u00e9mu ka\u0161li situaci sp\u00ed\u0161e zhor\u0161uj\u00ed, pokud si nejste v\u011bdomi v\u0161ech t\u011bchto skute\u010dnost\u00ed. To p\u0159edstavuje zvl\u00e1\u0161tn\u00ed nebezpe\u010d\u00ed, zejm\u00e9na pro novorozence. Krom\u011b toho bychom nem\u011bli zapom\u00ednat, \u017ee trval\u00e9 p\u0159eo\u010dkov\u00e1n\u00ed tak\u00e9 zat\u011b\u017euje imunitn\u00ed syst\u00e9m, zejm\u00e9na proto, \u017ee vakc\u00edny obsahuj\u00ed\u00a0<\/span>velmi nezdrav\u00e9 slo\u017eky<\/span><\/a>\u00a0(nap\u0159. ).<\/span><\/p>\n

\"\"<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

\u010cern\u00fd ka\u0161el v sou\u010dasnosti koluje po cel\u00e9m sv\u011bt\u011b, proto\u017ee ochrann\u00fd \u00fa\u010dinek vakc\u00edny rychle miz\u00ed. Studie…<\/p>\n","protected":false},"author":2,"featured_media":56682,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[7],"tags":[7519,213,21],"_links":{"self":[{"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/posts\/56681"}],"collection":[{"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/comments?post=56681"}],"version-history":[{"count":0,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/posts\/56681\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/media\/56682"}],"wp:attachment":[{"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/media?parent=56681"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/categories?post=56681"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/tags?post=56681"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}