Goonewardene Shamitha Thishakya, Tang Calyn, Tan Loh Teng-Hern, Chan Kok-Gan, Lingham Prithvy, Lee Learn-Han, Goh Bey-Hing, Pusparajah Priyia
Medical Health and Translational Research Group, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia.
Novel Bacteria and Drug Discovery Research Group, Microbiome and Bioresource Research Strength Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia.
Front Pediatr. 2019 Aug 13;7:339. doi: 10.3389/fped.2019.00339. eCollection 2019.
Nephrotic syndrome affects both children and adults. Idiopathic nephrotic syndrome is reported to be one of the most frequent renal pathologies in childhood. Nephrotic children are at high risk for severe pneumococcal infections as one of the life-threatening complications of nephrotic syndrome due to involvement of the immunosuppressive regimen and the acquired immune deficiency induced by nephrotic syndrome including decreased plasma IgG and low complement system components. Aiming to prevent pneumococcal infection is of paramount importance especially in this era of ever-increasing pneumococcal resistance to penicillins and cephalosporins. The pneumococcal vaccines currently available are inactivated vaccines-the two main forms in use are polysaccharide vaccines and conjugated vaccines. However, the data supporting the use of these vaccines and to guide the timing and dosage recommendations is still limited for nephrotic children. Thus, this review discusses the evidences of immunogenicity and safety profile of both vaccinations on nephrotic patients as well as the effect of nephrotic syndrome treatment on vaccine seroresponses.
肾病综合征影响儿童和成人。特发性肾病综合征据报道是儿童期最常见的肾脏疾病之一。肾病儿童由于免疫抑制方案的参与以及肾病综合征所致的获得性免疫缺陷（包括血浆IgG降低和补体系统成分低下），发生严重肺炎球菌感染的风险很高，这是肾病综合征危及生命的并发症之一。在肺炎球菌对青霉素和头孢菌素耐药性不断增加的这个时代，预防肺炎球菌感染至关重要。目前可用的肺炎球菌疫苗是灭活疫苗——使用的两种主要形式是多糖疫苗和结合疫苗。然而，支持肾病儿童使用这些疫苗并指导接种时间和剂量建议的数据仍然有限。因此，本综述讨论了这两种疫苗对肾病患者的免疫原性和安全性证据，以及肾病综合征治疗对疫苗血清反应的影响。
