Takahashi Yoshiko, Ishiwada Naruhiko, Hishiki Haruka, Tanaka Junko, Akeda Yukihiro, Shimojo Naoki, Oishi Kazunori, Kohno Yoichi
Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan.
Division of Control and Treatment of Infectious Diseases, Chiba University Hospital, Chiba, Japan.
J Infect Chemother. 2014 Dec;20(12):794-8. doi: 10.1016/j.jiac.2014.08.027. Epub 2014 Sep 19.
No studies showed specific antibody levels against all serotypes covered by 13-valent pneumococcal conjugate vaccine (PCV13) among polyclonal intravenous immunoglobulin (IVIG) products. Our study aimed to assess whether we could expect the efficacy of IVIG therapy for invasive pneumococcal disease (IPD) and to clarify the age group which should be recommended for IVIG therapy in case of IPD. Serotype-specific immunoglobulin G (IgG) levels against PCV13 serotypes were measured in four IVIGs which were produced from Japanese donors who were not immunized with any pneumococcal conjugate vaccines (PCVs), and in the serum of 160 non-PCV immunized Japanese subjects, by enzyme-linked immunosorbent assay. The functional opsonic activities of the IVIGs against serotypes 6B and 19A were assessed by a multiplexed opsonophagocytic killing assay. Japanese infants aged <2 years had a geometric mean IgG concentration of <0.35 μg/ml against several serotypes. Serotype-specific IgG concentrations varied among IVIGs. In general, IgG antibodies against serotypes 6A, 14 and 19A were higher in each IVIG. Although opsonization indices also varied among preparations, each IVIG had the ability to opsonize both serotypes 6B and 19A. This study suggests that routine immunization with PCV is important for prevention of IPD, especially for children <2 years old and IVIGs might be effective for IPD patients.
没有研究显示在多克隆静脉注射免疫球蛋白(IVIG)产品中存在针对13价肺炎球菌结合疫苗(PCV13)所涵盖的所有血清型的特异性抗体水平。我们的研究旨在评估是否可以预期IVIG治疗侵袭性肺炎球菌疾病(IPD)的疗效,并明确在IPD情况下应推荐接受IVIG治疗的年龄组。通过酶联免疫吸附测定法,在四种由未接种任何肺炎球菌结合疫苗(PCV)的日本捐赠者生产的IVIG以及160名未接种PCV的日本受试者的血清中,测量了针对PCV13血清型的血清型特异性免疫球蛋白G(IgG)水平。通过多重调理吞噬杀伤试验评估了IVIG对6B和19A血清型的功能性调理活性。年龄<2岁的日本婴儿针对几种血清型的几何平均IgG浓度<0.35μg/ml。血清型特异性IgG浓度在IVIG之间有所不同。一般来说,每种IVIG中针对6A、14和19A血清型的IgG抗体较高。尽管调理指数在不同制剂之间也有所不同,但每种IVIG都有调理6B和19A两种血清型的能力。这项研究表明,PCV常规免疫对于预防IPD很重要,特别是对于<2岁的儿童,并且IVIG可能对IPD患者有效。