Department of Internal Medicine, St Antonius Hospital Nieuwegein, PO Box 2500, 3430 EM, Nieuwegein, The Netherlands.
Eur J Clin Microbiol Infect Dis. 2011 May;30(5):611-8. doi: 10.1007/s10096-010-1129-2. Epub 2010 Dec 24.
The purpose of this study was to determine the quantity and quality of antibodies against the meningococcal serogroup C (MenC) conjugated vaccine in asplenic patients. In 116 asplenic patients, antibody concentrations (IgG) were measured against meningococcal serogroup C before and after immunisation. Of MenC-specific IgG, both antibody avidity and subclasses of IgG1 and IgG2 were determined. The mean MenC IgG concentration rose from 0.16 μg/mL prior to vaccination to 3.69 μg/mL 3 weeks post-vaccination, with 67% of patients reaching the threshold of ≥ 2.0 μg/mL. The mean IgG concentration at 35 weeks post-vaccination was 3.10 μg/mL. IgG2 concentrations increased more than IgG1. Marginal avidity maturation was seen. Hypo-responders to the first MenC vaccine (IgG anti-MenC ≤ 2.0 μg/mL) were offered a booster dose. After revaccination, 59% reached the chosen IgG threshold. The IgG concentration rose from 0.29 to 1.12 μg/mL, with an increase in the IgG1/IgG2 ratio. Avidity indices remained below 33%. In asplenic patients, the quantity and quality of antibodies produced after one dose of conjugated MenC vaccination is lower than that observed in previous studies in healthy adults. Booster vaccination does, indeed, lead to a rise in IgG geometric mean concentrations (GMCs), but does not lead to higher avidity of antibodies.
本研究旨在确定脾切除患者针对脑膜炎奈瑟菌 C 群（MenC）结合疫苗的抗体数量和质量。在 116 例脾切除患者中，在免疫接种前后测量了针对脑膜炎奈瑟菌 C 群的抗体浓度（IgG）。测定了 MenC 特异性 IgG 的抗体亲和力以及 IgG1 和 IgG2 的亚类。MenC 特异性 IgG 浓度从接种前的 0.16μg/mL 上升至接种后 3 周的 3.69μg/mL，其中 67%的患者达到≥2.0μg/mL 的阈值。接种后 35 周时的平均 IgG 浓度为 3.10μg/mL。IgG2 浓度的增加高于 IgG1。可见边缘亲和力成熟。对首次 MenC 疫苗（IgG 抗-MenC≤2.0μg/mL）无反应的患者给予加强剂量。加强免疫后，59%的患者达到选择的 IgG 阈值。IgG 浓度从 0.29μg/mL 上升至 1.12μg/mL，同时 IgG1/IgG2 比值增加。亲和力指数仍低于 33%。在脾切除患者中，一剂结合型 MenC 疫苗接种后产生的抗体数量和质量低于既往健康成年人研究中的观察结果。加强免疫确实会导致 IgG 几何平均浓度（GMC）升高，但不会导致抗体亲和力升高。
