Department of Clinical Immunology, Aarhus University Hospital, Denmark; Department of Molecular Medicine, Aarhus University Hospital, Denmark.
Department of Clinical Epidemiology, Aarhus University Hospital, Denmark.
Clin Immunol. 2022 Aug;241:109070. doi: 10.1016/j.clim.2022.109070. Epub 2022 Jun 30.
Functional antibody deficiency is clinically assessed from antibody responses to vaccination. However, diagnostic vaccination is complex and may fail in practice. We hypothesized that the levels of naturally occurring antibodies against galactose-α-1,3-galactose (αGal) may represent alternative markers of functional antibody capacity. We included data from 229 patients with suspected primary immunodeficiency in a retrospective study. Antibody levels against αGal and twelve pneumococcal serotypes were determined with solid-phase immunoassays. Pneumococcal vaccinations and treatment with normal human immunoglobulin were assessed from medical records. Anti-αGal antibody levels correlated positively with anti-pneumococcal antibody levels measured before and after pneumococcal vaccination. Contrary to the anti-pneumococcal antibody levels, the anti-αGal antibody level showed potential for predicting subsequent immunoglobulin treatment - a marker of disease severity. Naturally occurring antibodies may reflect the functional capacity tested by diagnostic vaccination but add more useful clinical data. The clinical utility of this easy test should be evaluated in prospective studies.
功能性抗体缺陷可通过接种疫苗后的抗体反应进行临床评估。然而，诊断性疫苗接种较为复杂，在实际操作中可能会失败。我们假设，针对半乳糖-α-1,3-半乳糖（αGal）的天然存在的抗体水平可能是功能性抗体能力的替代标志物。我们对 229 例疑似原发性免疫缺陷的患者进行了回顾性研究，其中包括数据。使用固相免疫测定法测定了针对αGal 和 12 种肺炎球菌血清型的抗体水平。从病历中评估了肺炎球菌疫苗接种和正常人类免疫球蛋白的治疗情况。抗-αGal 抗体水平与肺炎球菌疫苗接种前后测量的抗肺炎球菌抗体水平呈正相关。与抗肺炎球菌抗体水平相反，抗-αGal 抗体水平具有预测随后免疫球蛋白治疗的潜力-疾病严重程度的标志物。天然存在的抗体可能反映了诊断性疫苗接种所测试的功能能力，但增加了更多有用的临床数据。应在前瞻性研究中评估这种简便测试的临床应用价值。
