Robbins Ailsa, Bahuaud Mathilde, Hentzien Maxime, Maestraggi Quentin, Barbe Coralie, Giusti Delphine, Le Naour Richard, Batteux Frederic, Servettaz Amélie
Internal Medicine, Clinical Immunology and Infectious Diseases Department, University Hospital Centre, Reims, France.
Laboratory of Immunology, EA7509 IRMAIC, University of Reims Champagne-Ardenne (URCA), Reims, France.
Front Immunol. 2021 Jul 5;12:697128. doi: 10.3389/fimmu.2021.697128. eCollection 2021.
Patients with primary humoral immunodeficiency are more prone to invasive as well as recurrent pneumococcal infections. Therefore, anti-pneumococcal vaccination including the 13-valent conjugate vaccine is recommended. Nevertheless, to date, no data is available on immunogenicity of this vaccine in this population.
To assess the immunogenicity and the persistence of protection up to one year after a 13-valent pneumococcal conjugate vaccine in patients with primary humoral immunodeficiency.
Twenty-nine patients with common variable immunodeficiency or IgG subclass deficiency were vaccinated. Immune response and immune protection at baseline as well as at one, six and twelve months after vaccination were evaluated by measuring specific IgG serum concentrations (ELISA), and opsonophagocytic activities directed against selected pneumococcal (MOPA).
By ELISA, half of the patients had protective IgG concentrations before vaccination, 35.7% showed an immune response one month after vaccination, 71.4%, 66.7% and 56.0% of the patients were protected at one, six and twelve months respectively. Conversely, by MOPA, 3.4% of the patients were protected at baseline, 10.7% showed an immune response and 28.6%, 48.2% and 33.3% were protected at one, six and twelve months respectively. IgG subclass deficiency, Ig replacement therapy and higher IgG2 concentrations at diagnosis were associated with long-term protection.
Pneumococcal conjugate vaccine improves immune protection and antibodies' functionality in a subset of patients with primary immunodeficiency. Prime-boost vaccine strategy needs to be better and individually adapted.
原发性体液免疫缺陷患者更容易发生侵袭性及复发性肺炎球菌感染。因此，推荐接种包括13价结合疫苗在内的抗肺炎球菌疫苗。然而，迄今为止，尚无关于该疫苗在这一人群中免疫原性的数据。
评估13价肺炎球菌结合疫苗在原发性体液免疫缺陷患者中的免疫原性及长达一年的保护持续性。
对29例常见变异型免疫缺陷或IgG亚类缺陷患者进行疫苗接种。通过检测特异性IgG血清浓度（酶联免疫吸附测定）以及针对选定肺炎球菌的调理吞噬活性（MOPA），评估基线时以及接种疫苗后1个月、6个月和12个月时的免疫反应和免疫保护情况。
通过酶联免疫吸附测定，一半的患者在接种疫苗前具有保护性IgG浓度，35.7%的患者在接种疫苗后1个月出现免疫反应，分别有71.4%、66.7%和56.0%的患者在1个月、6个月和12个月时受到保护。相反，通过MOPA检测，3.4%的患者在基线时受到保护，10.7%的患者出现免疫反应，分别有28.6%、48.2%和33.3%的患者在1个月、6个月和12个月时受到保护。IgG亚类缺陷、Ig替代疗法以及诊断时较高的IgG2浓度与长期保护相关。
肺炎球菌结合疫苗可改善一部分原发性免疫缺陷患者的免疫保护及抗体功能。初免 - 加强疫苗策略需要更好地进行个体化调整。
