Institute for Transfusion Medicine, University Hospital Essen, Essen, Germany.
Transplantation. 2012 Jul 15;94(1):50-6. doi: 10.1097/TP.0b013e318250fc8c.
We have recently shown that kidney transplant recipients with clinically stable condition can produce almost normal antibody concentrations at month 1 after vaccination against Streptococcus pneumoniae. It was the aim of the present study to define the long-term efficacy of this vaccination in a similar cohort.
Using Pneumovax 23, we immunized 49 kidney transplant recipients (21 women and 28 men, aged 29-74 years). Antibodies against 14 pneumococcal serotypes were determined before vaccination and at months 1 and 15 after vaccination by Luminex assay.
The total antibody concentration (median [range]) increased from 18.2 mg/L (2.9-55.5 mg/L) before vaccination to 53.6 mg/L (4.5-132.4 mg/L) at month 1 and 41.3 mg/L (4.9-105.0 mg/L) at month 15 (P<0.0001 as compared with before vaccination). The antibody concentration at month 15 was 77% of the response at month 1. The number of pneumococcal serotypes recognized was 8 (0-13) before vaccination, 13 (0-14) at month 1, and 11 (0-14) at month 15. At month 15, the total antibody concentration and the number of serotypes with protective antibodies already displayed a significant decrease (P<0.0001 each) as compared with month 1. It could be shown that the decrease in antibody concentrations (months 1-15) was minor in younger patients, in women, in patients receiving cyclosporine A versus tacrolimus, and in patients with better kidney function.
Our results demonstrate that, at month 15 after vaccination versus before vaccination, kidney transplant recipients with clinically stable condition still display higher antibody concentrations against pneumococci. Therefore, they should be partly protected against pneumococcal infection until month 15.
我们最近发现，在接种肺炎球菌疫苗后 1 个月，临床状况稳定的肾移植受者可以产生几乎正常的抗体浓度。本研究的目的是在类似队列中定义这种疫苗接种的长期疗效。
使用沛儿 23，我们对 49 名肾移植受者（21 名女性和 28 名男性，年龄 29-74 岁）进行免疫接种。在接种前和接种后 1 个月和 15 个月，通过 Luminex 测定法测定针对 14 种肺炎球菌血清型的抗体。
总抗体浓度（中位数[范围]）从接种前的 18.2 毫克/升（2.9-55.5 毫克/升）增加到接种后 1 个月的 53.6 毫克/升（4.5-132.4 毫克/升）和 15 个月的 41.3 毫克/升（4.9-105.0 毫克/升）（与接种前相比，P<0.0001）。接种后 15 个月的抗体浓度为接种后 1 个月的 77%。接种前可识别的肺炎球菌血清型数量为 8（0-13），接种后 1 个月为 13（0-14），接种后 15 个月为 11（0-14）。接种后 15 个月，与接种后 1 个月相比，总抗体浓度和具有保护性抗体的血清型数量均显著下降（均 P<0.0001）。结果表明，与接种后 1 个月相比，年轻患者、女性患者、接受环孢素 A 与他克莫司的患者以及肾功能较好的患者的抗体浓度下降幅度较小。
我们的结果表明，与接种前相比，临床状况稳定的肾移植受者在接种后 15 个月仍可产生针对肺炎球菌的更高抗体浓度。因此，他们应该在接种后 15 个月内部分免受肺炎球菌感染的保护。
