Mother-Infant Antibodies to Pneumococcal Polysaccharides and Proteins : Transfer and Persistence of Maternal Antibodies and Development of Vaccine-Induced and Naturally Acquired Antibodies in Infants

Symptomless nasopharyngeal carriage of Streptococcus pneumoniae (pneumococcus) is very common in young children. Occasionally the carriage proceeds into mild mucosal diseases, such as sinusitis or acute otitis media, or into serious life-threatening diseases, such as pneumonia, sepsis or meningitis. Each year, up to one million children less than five years of age worldwide die of invasive pneumococcal diseases (IPD). Especially in the low-income countries IPD is a leading health problem in infants; 75% of all IPD cases occur before one year of age. This stresses the need of increased protection against pneumococcus in infancy. Anti-pneumococcal antibodies form an important component in the defence against pneumococcal infection. Maternal immunisation and early infant immunisation are two possible ways by which potentially protective antibody concentrations against pneumococci could be achieved in early infancy. The aim of this thesis is to increase the knowledge of antibody mediated protection against pneumococcal disease in infants and young children. We investigated the transfer of maternal anti-pneumococcal antibodies from Filipino mothers to their infants, the persistence of the transferred antibodies in the infants, the immunogenicity of the 23-valent pneumococcal polysaccharide vaccine (PPV) in infants and the response of the children to a second dose of PPV at three years of age. We also investigated the development of antibodies to pneumococcal protein antigens in relation to culture-confirmed pneumococcal carriage in infants. Serum samples were collected from the mothers, the umbilical cords and from the infants at young age as well as at three years of age. The samples were used to determine the antibody concentrations to pneumococcal serotypes 1, 5, 6B, 14, 18C and 19F, as well as to the pneumococcal proteins PspA, PsaA, Ply, PspC, PhtD, PhtDC and LytC by the enzyme immunoassay. The findings of the present study confirm previously obtained results and add to the global knowledge of responses to PPV in young children. Immunising pregnant women with PPV provides the infants with increased concentrations of pneumococcal polysaccharide antibodies. Of the six serotypes examined, serotypes 1 and 5 were immunogenic already in infants. At three years of age, the children responded well to the second dose of PPV suggesting that maternal and early infant immunisations might not induce hyporesponsiveness to polysaccharide antigens after subsequent immunisations. The anti-protein antibody findings provide useful information for the development of pneumococcal protein vaccines. All six proteins studied were immunogenic in infancy and the development of anti-protein antibodies started early in life in relation to pneumococcal carriage.

Juoksuhaudoista yhteiskuntaan : Vuosien 1965-1975 sotilaallista maanpuolustusta ja puolustusvoimia koskevan joukkotiedotuksen diskursiivinen tarkastelu

The Finnish society developed rapidly in the 1960´s and 1970´s. This was result of international trends. Development of education, urbanization and wide organization of society increased discontent towards prevailing social structure and towards the power elite. Development of technology created possibility to present radical perspectives in mass media. This caused widely spread discussions dividing opinions. The purpose of this thesis was to complement research on national defence and the Finnish Defence Forces especially between years 1965 and 1975. The task of research was to clarify how changes in society and how the significance of this change was interpreted in public discussion about national defence and development of the Defence Forces. The most essential points for this thesis turned out to be discourses structured from public discussion. Main research material consisted of approximately 35000 news, editorials, articles and opinions presented in mass media supplemented by literature, committee reports and other archival sources. Frame of reference for this thesis is based on relativistic worldview. According to this, social reality is relative and there is no single truth. Environment has significant influence on the issue how knowledge and truth are formed. Data analysis was based on critical discourse. The key objective was to clarify the effects of broad changes in society using discursive methods. One essential goal was to form order of discourse using linguistic analysis and also connect discourses to wider sociocultural custom. On this thesis I came to the conclusion that on the review period there were five significant ensembles of discourse. They consisted of several discussions focused on different themes. The discourse of official security policy aimed to define national defence and the position of the Defence Forces as parts of foreign policy. Foreign policy is often perceived as the most significant part of security policy. Historical memory, geographical position of Finland and also the state contracts, changes in international warfare, tasks of the Defence Forces and increasing critic of national defence and the difference in thinking between generations formed the discourse of security policy. In the discourse of the liability to military service, the issue was about individual responsibility to society and national defence. Resisters and unarmed defence demands, encouraged by international examples were the themes. The discourse pointed out how mass media is used to influence and forced the Defence Forces to develop the practices in public information. The discourses of democracy and politics were closer to internal development of the Defence Forces to integrate more into society. The discourse of democracy focused in changing power relationships of the Defence Forces that were known as authoritarian. Issues like conscript and personnel union activity had lot of similarities to general social development. The discourse of politics presented how the Defence Forces were pushed towards parliamentary decision making. The personnel was granted the same rights as other population. Themes related to the discourse on the will to national defence were development of mental national defence, increasing education on national defence and creation of more open public information culture. According to discourses presented above I can state, that the position of the Defence Forces in society was changed between years 1965-1975. This change was advanced by the Defence Forces reformed attitude towards mass media and public information in general. Active participation in public information important became important instead of only answering topics. This positive development created an atmosphere, that was easier for the public to understand and create own pictures of the armed forces. Due to this, I can describe that the defenders and supporters of the armed forces were stuck in their trenches, until discussions presented in discourses and themes developed the Defence Forces to be better fitting part of society. Key words; society, national defence, Defence Forces, discourse, mass media, security policy, liability to military service, conscription, democracy