Rezaei Nima, Siadat Seyed Davar, Aghamohammadi Asghar, Moin Mostafa, Pourpak Zahra, Norouzian Dariush, Mobarakeh Jalal Izadi, Aghasadeghi Mohammad Reza, Nejati Mehdi, Read Robert C
Growth and Development Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Clin Vaccine Immunol. 2010 Apr;17(4):524-8. doi: 10.1128/CVI.00389-09. Epub 2010 Jan 27.
Some patients with common variable immunodeficiency (CVID) can generate an antibody response following vaccination with Neisseria meningitidis polysaccharide, but the duration of this protection is unknown. In this study, serum bactericidal antibody (SBA) responses to serogroup C N. meningitidis of 23 patients with CVID and 23 sex- and age-matched controls were measured 1 year after vaccination with the plain A/C meningococcal polysaccharide vaccine. The fold rise in serum bactericidal antibody geometric mean titers of the control group from prevaccination to 1 year postvaccination was significantly higher than that of the patient group (5.41- versus 2.96-fold, P = 0.009). Of 23 CVID patients, 8 had a poor response to vaccine (<4-fold rise) 3 weeks after vaccination, and low titers remained when measured 1 year later. Of the 15 CVID patients who had a normal response to vaccine (>/=4-fold rise) 3 weeks after vaccination, 6 cases failed to maintain protective SBA titers, whereas the remaining 9 had protective titers 1 year after vaccination. Only one of the 23 controls, who developed protective SBA titers after 3 weeks, lost the protective titers after 1 year. Among the patients, the presence of bronchiectasis and/or splenomegaly at enrollment was associated with poor SBA response to vaccine at 3 weeks and/or failure to maintain protective levels at 1 year. The results of this study demonstrate that a number of CVID patients can produce protective antibody titers that can persist for 1 year after vaccination, which lends strong support to the inclusion of polysaccharide vaccine in the immunization program for CVID patients.
一些常见可变免疫缺陷（CVID）患者接种脑膜炎奈瑟菌多糖疫苗后可产生抗体反应，但这种保护的持续时间尚不清楚。在本研究中，对23例CVID患者和23例年龄及性别匹配的对照者接种普通A/C脑膜炎球菌多糖疫苗1年后，检测其对C群脑膜炎奈瑟菌的血清杀菌抗体（SBA）反应。对照组血清杀菌抗体几何平均滴度从接种前到接种后1年的升高倍数显著高于患者组（分别为5.41倍和2.96倍，P = 0.009）。23例CVID患者中，8例在接种疫苗3周后反应不佳（升高倍数<4倍），1年后检测时滴度仍较低。15例接种疫苗3周后反应正常（升高倍数≥4倍）的CVID患者中，6例未能维持保护性SBA滴度，而其余9例在接种疫苗1年后仍有保护性滴度。23例对照者中只有1例在3周后产生了保护性SBA滴度，但1年后失去了保护性滴度。在患者中，入组时存在支气管扩张和/或脾肿大与接种疫苗3周时SBA反应不佳和/或1年后未能维持保护水平有关。本研究结果表明，一些CVID患者接种疫苗后可产生持续1年的保护性抗体滴度，这有力支持了将多糖疫苗纳入CVID患者免疫规划。
