The total IgM, IgA and IgG antibody responses to pneumococcal polysaccharide vaccination (Pneumovax®23) in a healthy adult population and patients diagnosed with primary immunodeficiencies.
Adult
Age Factors
Aged
Antibodies, Bacterial
/ blood
Female
Healthy Volunteers
Humans
Immunoglobulin A
/ blood
Immunoglobulin G
/ blood
Immunoglobulin M
/ blood
Male
Middle Aged
Pneumococcal Vaccines
/ administration & dosage
Primary Immunodeficiency Diseases
/ immunology
Streptococcus pneumoniae
Time Factors
Young Adult
IgA
IgG
IgM
Normal
PPV
Pneumococcal
Pneumovax
Journal
Vaccine
ISSN: 1873-2518
Titre abrégé: Vaccine
Pays: Netherlands
ID NLM: 8406899
Informations de publication
Date de publication:
28 02 2019
28 02 2019
Historique:
received:
16
02
2018
revised:
05
10
2018
accepted:
08
01
2019
pubmed:
10
2
2019
medline:
8
7
2020
entrez:
10
2
2019
Statut:
ppublish
Résumé
Interpretation of the responses to the pneumococcal polysaccharide vaccine (Pneumovax®23, PPV) has proven challenging. In addition, there are few studies documenting the longevity of these responses. The age-specific PPV IgM, IgA, IgG and IgG2 concentrations were determined pre, 4-6 weeks and 6 years post-vaccination in the serum of Prevnar®-naïve adults using VaccZyme™ pneumococcal capsular polysaccharide ELISAs. The median pre-vaccination concentrations were; PPV IgM 53 U/mL (5-95% CI: 16-169 U/mL), IgA 23 U/mL (6-103 U/mL), IgG 41 mg/L (10-184 U/mL) and IgG2 18 mg/L (3-95 U/mL). 4-6 weeks post-vaccination there was a median 6-fold (5-95% CI: 2-24) increase in PPV IgM (median 315 U/mL (5-95% CI: 60-1133 U/mL), 18-fold (4-74) increase in IgA (369 U/mL (78-1802 U/mL)), 9-fold (2-19) increase in IgG (375 mg/L (77-1238 mg/L)) and 8-fold (1-20) increase in IgG2 (141 mg/L (25-573 mg/L)). This was significant for all isotypes in all age ranges (p < 0.0001). Six years post-vaccination median PPV concentrations were; IgM 54 U/mL (17-128), IgA 85 U/mL (19-279), IgG 148 mg/L (30-997) and IgG2 57 mg/L (9-437). The median concentrations for all ages 6 years post-vaccination were significantly elevated compared to the pre-vaccination titres for PPV IgA, IgG and IgG2 isotypes only. The PPV IgM and IgA responses were influenced by age. At 6 years post vaccination, in individuals with normal PPV IgG, 34 individuals had PPV IgM and/or IgA concentrations below the lower limit of the healthy adult ranges. We also used the healthy adult reference ranges developed in this study to assess a cohort of primary immunodeficiency (PID) patients. These ranges will help to provide a framework for assessment and definition of normal response to PPV, which will facilitate clinical interpretation of a deficient polysaccharide response in those suspected of antibody deficiency.
Sections du résumé
BACKGROUND
Interpretation of the responses to the pneumococcal polysaccharide vaccine (Pneumovax®23, PPV) has proven challenging. In addition, there are few studies documenting the longevity of these responses.
METHODS
The age-specific PPV IgM, IgA, IgG and IgG2 concentrations were determined pre, 4-6 weeks and 6 years post-vaccination in the serum of Prevnar®-naïve adults using VaccZyme™ pneumococcal capsular polysaccharide ELISAs.
RESULTS
The median pre-vaccination concentrations were; PPV IgM 53 U/mL (5-95% CI: 16-169 U/mL), IgA 23 U/mL (6-103 U/mL), IgG 41 mg/L (10-184 U/mL) and IgG2 18 mg/L (3-95 U/mL). 4-6 weeks post-vaccination there was a median 6-fold (5-95% CI: 2-24) increase in PPV IgM (median 315 U/mL (5-95% CI: 60-1133 U/mL), 18-fold (4-74) increase in IgA (369 U/mL (78-1802 U/mL)), 9-fold (2-19) increase in IgG (375 mg/L (77-1238 mg/L)) and 8-fold (1-20) increase in IgG2 (141 mg/L (25-573 mg/L)). This was significant for all isotypes in all age ranges (p < 0.0001). Six years post-vaccination median PPV concentrations were; IgM 54 U/mL (17-128), IgA 85 U/mL (19-279), IgG 148 mg/L (30-997) and IgG2 57 mg/L (9-437). The median concentrations for all ages 6 years post-vaccination were significantly elevated compared to the pre-vaccination titres for PPV IgA, IgG and IgG2 isotypes only. The PPV IgM and IgA responses were influenced by age. At 6 years post vaccination, in individuals with normal PPV IgG, 34 individuals had PPV IgM and/or IgA concentrations below the lower limit of the healthy adult ranges. We also used the healthy adult reference ranges developed in this study to assess a cohort of primary immunodeficiency (PID) patients.
CONCLUSION
These ranges will help to provide a framework for assessment and definition of normal response to PPV, which will facilitate clinical interpretation of a deficient polysaccharide response in those suspected of antibody deficiency.
Identifiants
pubmed: 30737041
pii: S0264-410X(19)30098-2
doi: 10.1016/j.vaccine.2019.01.035
pii:
doi:
Substances chimiques
Antibodies, Bacterial
0
Immunoglobulin A
0
Immunoglobulin G
0
Immunoglobulin M
0
Pneumococcal Vaccines
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1350-1355Informations de copyright
Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.