Gazi Umut, Karasartova Djursun, Sahiner Ibrahim Tayfun, Gureser Ayse Semra, Tosun Ozgur, Derici Mehmet Kursat, Dolapci Mete, Taylan Ozkan Aysegul
Department of Medical Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, Nicosia, Cyprus.
Department of Medical Microbiology, Faculty of Medicine, Hitit University, Corum, Turkey.
Int J Clin Pract. 2018 May;72(5):e13077. doi: 10.1111/ijcp.13077. Epub 2018 Mar 13.
Splenectomised patients are associated with lifelong risk of fatal overwhelming post-splenectomy infection (OPSI), which is mostly caused by Streptococcus pneumoniae. Today OPSI cases can still be reported even in patients with appropriate vaccination. In our study, the levels of vaccine-specific memory B- and T cells were compared between control and splenectomised patients to enlighten the underlying reason.
Five healthy and 14 post-traumatic splenectomised individuals were vaccinated with 13-valent pneumococcal conjugate vaccine (PCV-13) followed by 23-valent pneumococcal polysaccharide vaccine (PPV-23). The levels of memory B- and T cells were compared by ELISPOT analysis.
Splenectomised patients generated reduced levels of memory IgG B cells in response to PCV-13 vaccination, while the memory IFN-γ T-cell levels were undetectable in asplenic patients. This was despite the detection of vaccine-induced memory T-cell levels in control patients, which were analysed simultaneously following the same experimental protocol.
Our results suggest that spleen is important, but not essential, for survival and/or generation of memory IgG B cells. In contrast, it seems to be indispensable for PCV-13-specific memory T 1-cell levels. Studies enhancing the levels of vaccine-induced memory cells and further enlightening the immune responses in asplenic individuals are required to develop more effective vaccination strategies against OPSI.
脾切除患者终生面临致命的脾切除术后暴发性感染（OPSI）风险，其主要由肺炎链球菌引起。如今，即使是接种了疫苗的患者仍有OPSI病例报告。在我们的研究中，比较了对照组和脾切除患者中疫苗特异性记忆B细胞和T细胞的水平，以阐明潜在原因。
5名健康个体和14名创伤后脾切除患者接种13价肺炎球菌结合疫苗（PCV-13），随后接种23价肺炎球菌多糖疫苗（PPV-23）。通过ELISPOT分析比较记忆B细胞和T细胞的水平。
脾切除患者在接种PCV-13疫苗后产生的记忆IgG B细胞水平降低，而在无脾患者中未检测到记忆IFN-γ T细胞水平。尽管在按照相同实验方案同时分析的对照患者中检测到了疫苗诱导的记忆T细胞水平，但仍出现上述情况。
我们的结果表明，脾脏对于记忆IgG B细胞的存活和/或产生很重要，但并非必不可少。相比之下，它似乎对于PCV-13特异性记忆T细胞水平是不可或缺的。需要开展研究提高疫苗诱导的记忆细胞水平，并进一步阐明无脾个体的免疫反应，以制定更有效的预防OPSI的疫苗接种策略。
