Defining Polysaccharide Antibody Deficiency: Measurement of Anti-Pneumococcal Antibodies and Anti-Salmonella typhi Antibodies in a Cohort of Patients with Recurrent Infections.
Adolescent
Adult
Antibodies, Bacterial
/ immunology
Child
Child, Preschool
Humans
Immunoglobulin G
/ immunology
Male
Middle Aged
Pneumococcal Vaccines
/ immunology
Polysaccharides, Bacterial
/ immunology
Primary Immunodeficiency Diseases
/ immunology
Prospective Studies
Salmonella typhi
/ immunology
Serogroup
Streptococcus pneumoniae
/ immunology
Typhoid-Paratyphoid Vaccines
/ immunology
Vaccination
/ methods
Young Adult
Pneumococcal polysaccharide vaccine
SAD
Salmonella typhi
allohemagglutinins
antibody deficiency
polysaccharide antibody deficiency
primary immunodeficiency
specific antibody deficiency
Journal
Journal of clinical immunology
ISSN: 1573-2592
Titre abrégé: J Clin Immunol
Pays: Netherlands
ID NLM: 8102137
Informations de publication
Date de publication:
01 2020
01 2020
Historique:
received:
02
08
2019
accepted:
11
09
2019
pubmed:
11
11
2019
medline:
12
2
2021
entrez:
10
11
2019
Statut:
ppublish
Résumé
The correlation between different methods for the detection of pneumococcal polysaccharide vaccine (PPV) responses to diagnose specific polysaccharide antibody deficiency (SAD) is poor and the criteria for defining a normal response lack consensus. We previously proposed fifth percentile (p5) values of PPV responses as a new cutoff for SAD. To analyze the association of SAD (determined by either World Health Organization (WHO)-standardized ELISA or multiplex bead-based assay) with abnormal response to Salmonella (S.) typhi Vi vaccination in a cohort of patients with recurrent infections. Ninety-four patients with a clinical history suggestive of antibody deficiency received PPV and S. typhi Vi vaccines. Polysaccharide responses to either 3 or 18 pneumococcal serotypes were measured by either the WHO ELISA or a multiplex in-house bead-based assay. Anti-S. typhi Vi IgG were measured by a commercial ELISA kit. Allohemagglutinins (AHA) were measured by agglutination method. Based on the American Academy of Allergy, Asthma and Immunology (AAAAI) criteria for WHO ELISA, 18/94 patients were diagnosed with SAD and 22/93 based on serotype-specific p5 cutoffs for bead-based assay. The association between the two methods was significant, with 10 subjects showing abnormal response according to both techniques. Abnormal response to S. typhi Vi vaccination was found in 7 patients, 6 of which had SAD. No correlation was found between polysaccharide response and AHA, age, or clinical phenotype. The lack of evidence-based gold standards for the diagnosis of SAD represents a challenge in clinical practice. In our cohort, we confirmed the insufficient correlation between different methods of specific PPV response measurement, and showed that the S. typhi Vi response was not contributive. Caution in the interpretation of results is warranted until more reliable diagnostic methods can be validated.
Sections du résumé
BACKGROUND
The correlation between different methods for the detection of pneumococcal polysaccharide vaccine (PPV) responses to diagnose specific polysaccharide antibody deficiency (SAD) is poor and the criteria for defining a normal response lack consensus. We previously proposed fifth percentile (p5) values of PPV responses as a new cutoff for SAD.
OBJECTIVE
To analyze the association of SAD (determined by either World Health Organization (WHO)-standardized ELISA or multiplex bead-based assay) with abnormal response to Salmonella (S.) typhi Vi vaccination in a cohort of patients with recurrent infections.
METHODS
Ninety-four patients with a clinical history suggestive of antibody deficiency received PPV and S. typhi Vi vaccines. Polysaccharide responses to either 3 or 18 pneumococcal serotypes were measured by either the WHO ELISA or a multiplex in-house bead-based assay. Anti-S. typhi Vi IgG were measured by a commercial ELISA kit. Allohemagglutinins (AHA) were measured by agglutination method.
RESULTS
Based on the American Academy of Allergy, Asthma and Immunology (AAAAI) criteria for WHO ELISA, 18/94 patients were diagnosed with SAD and 22/93 based on serotype-specific p5 cutoffs for bead-based assay. The association between the two methods was significant, with 10 subjects showing abnormal response according to both techniques. Abnormal response to S. typhi Vi vaccination was found in 7 patients, 6 of which had SAD. No correlation was found between polysaccharide response and AHA, age, or clinical phenotype.
CONCLUSION
The lack of evidence-based gold standards for the diagnosis of SAD represents a challenge in clinical practice. In our cohort, we confirmed the insufficient correlation between different methods of specific PPV response measurement, and showed that the S. typhi Vi response was not contributive. Caution in the interpretation of results is warranted until more reliable diagnostic methods can be validated.
Identifiants
pubmed: 31705452
doi: 10.1007/s10875-019-00691-8
pii: 10.1007/s10875-019-00691-8
doi:
Substances chimiques
Antibodies, Bacterial
0
Immunoglobulin G
0
Pneumococcal Vaccines
0
Polysaccharides, Bacterial
0
Typhoid-Paratyphoid Vaccines
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
105-113Références
Ann Allergy Asthma Immunol. 2000 Jan;84(1):25-30
pubmed: 10674561
J Clin Immunol. 2013 Feb;33(2):335-41
pubmed: 23054341
J Allergy Clin Immunol. 2011 Apr;127(4):1079-80; author reply 1080-1
pubmed: 21306761
J Immunol Methods. 2005 Jan;296(1-2):135-47
pubmed: 15680158
J Allergy Clin Immunol. 1993 Jan;91(1 Pt 1):110-9
pubmed: 8423268
Clin Exp Immunol. 2016 Aug;185(2):180-9
pubmed: 26939935
Clin Chem. 2007 Mar;53(3):505-10
pubmed: 17259230
Vaccine. 2006 Jul 7;24(27-28):5637-44
pubmed: 16730399
Front Immunol. 2017 May 22;8:586
pubmed: 28588580
J Allergy Clin Immunol Pract. 2019 Mar;7(3):801-808
pubmed: 30682575
Clin Vaccine Immunol. 2015 Feb;22(2):148-52
pubmed: 25520149
Front Immunol. 2017 May 12;8:546
pubmed: 28553290
J Clin Immunol. 2017 Jul;37(5):427-433
pubmed: 28589420
Clin Immunol. 2016 Aug;169:80-84
pubmed: 27236002
Ann Allergy Asthma Immunol. 2006 Sep;97(3):306-11
pubmed: 17042135
Clin Exp Immunol. 2004 May;136(2):297-303
pubmed: 15086394
J Clin Immunol. 2016 Feb;36(2):141-8
pubmed: 26846287
J Allergy Clin Immunol. 2012 Sep;130(3 Suppl):S1-24
pubmed: 22935624
Clin Diagn Lab Immunol. 1998 Mar;5(2):199-204
pubmed: 9521143
Clin Exp Immunol. 2006 Dec;146(3):486-92
pubmed: 17100769
Front Immunol. 2018 May 14;9:694
pubmed: 29867917
Ann Allergy Asthma Immunol. 2007 Nov;99(5):462-4
pubmed: 18051217
J Allergy Clin Immunol. 2018 Oct;142(4):1358-1360
pubmed: 29936105
Clin Diagn Lab Immunol. 1995 Sep;2(5):590-7
pubmed: 8548539
Clin Exp Immunol. 2015 May;180(2):271-9
pubmed: 25516411
Clin Exp Immunol. 2018 Jun;192(3):292-301
pubmed: 29377063