Département de Médecine Interne, Université de Paris, Assistance Publique Hôpitaux de Paris, Paris, France.
Plateforme d'Immunomonitoring Vaccinal, Laboratoire d'Immunologie, Groupe hospitalier Cochin-Broca-Hotel Dieu, Assistance Publique Hôpitaux de Paris, Paris, France.
Vaccine. 2020 Oct 14;38(44):6859-6863. doi: 10.1016/j.vaccine.2020.08.065. Epub 2020 Sep 4.
Systemic lupus erythematosus (SLE) patients are at risk for pneumococcal infection. Twenty-one consecutive SLE patients (40[25-75] years) received the sequential PCV13/PPSV23 vaccine and factors associated with long-term protection were analyzed. Immune protection, defined by an antigen-specific IgG concentration ≥1.3 µg/mL for at least 70% of 7 pneumococcal serotypes was assessed at baseline, 2, 6, 12 and 36 months defining long-term protection. Only 10 patients showed pneumococcal immune protection 36 months after vaccination. Eleven (52.4%) patients had no long-term protection with a seroconversion that never or only transiently occurred. SLE disease features, treatment received and immunological characteristics did not differ between protected and unprotected patients except for the pre-vaccination IgG2 serum levels. Serum IgG2 level >2.125 µg/ml showed a sensitivity of 100% and a specificity of 90.9% for long-term protection. Sequential pneumococcal vaccination conferred poor immune protection in SLE. Baseline IgG2 serum level identified patients able to benefit from pneumococcal vaccination.
系统性红斑狼疮 (SLE) 患者存在患肺炎球菌感染的风险。21 例连续的 SLE 患者（40[25-75] 岁）接受了序贯 PCV13/PPSV23 疫苗接种，并分析了与长期保护相关的因素。免疫保护定义为至少 70%的 7 种肺炎球菌血清型的抗原特异性 IgG 浓度≥1.3µg/mL，在基线、2、6、12 和 36 个月时进行评估，以定义长期保护。仅 10 例患者在接种疫苗后 36 个月出现肺炎球菌免疫保护。11 例（52.4%）患者无长期保护，血清转化率从未发生或仅短暂发生。除了接种前 IgG2 血清水平外，保护性和非保护性患者的 SLE 疾病特征、接受的治疗和免疫特征没有差异。接种前 IgG2 血清水平 >2.125µg/ml 对长期保护的敏感性为 100%，特异性为 90.9%。序贯肺炎球菌疫苗接种在 SLE 中提供的免疫保护作用不佳。基线 IgG2 血清水平可识别出能从肺炎球菌疫苗接种中获益的患者。
