Webster A D, Latif A A, Brenner M K, Bird D
Br Med J (Clin Res Ed). 1984 Jun 23;288(6434):1864-6. doi: 10.1136/bmj.288.6434.1864.
Antibody responses after immunisation with pneumococcal polysaccharide did not correlate with the severity and frequency of infections in 22 patients with severe hypogammaglobulinaemia, when these were measured by a Farr radioimmunoassay. Five "healthy" patients with severe hypogammaglobulinaemia not only failed to make antipneumococcal polysaccharide antibody, when measured by radioimmunoassay, but also had very low or unrecordable antibody responses to Escherichia coli and failed to produce antibody when immunised with tetanus toxoid. Some of these subjects, however, did make small amounts of IgM antipneumococcal polysaccharide antibody when this was measured by an enzyme linked immunosorbent assay, while others retained some ability to produce IgM or IgA or both in their saliva. These findings show that the measurement of serum antibody responses after immunisation, with the possible exception of IgM antibodies to polysaccharides, is unlikely to be helpful in assessing the requirement for gammaglobulin replacement therapy in patients with hypogammaglobulinaemia.
采用Farr放射免疫分析法检测时，22例严重低丙种球蛋白血症患者接种肺炎球菌多糖后的抗体反应与感染的严重程度和频率不相关。5例严重低丙种球蛋白血症的 “健康” 患者，采用放射免疫分析法检测时，不仅未能产生抗肺炎球菌多糖抗体，而且对大肠杆菌的抗体反应极低或无法记录，接种破伤风类毒素后也未能产生抗体。然而，其中一些受试者采用酶联免疫吸附测定法检测时确实产生了少量IgM抗肺炎球菌多糖抗体，而其他一些受试者在唾液中仍保留了产生IgM或IgA或两者的能力。这些发现表明，接种疫苗后血清抗体反应的检测，可能多糖的IgM抗体除外，不太可能有助于评估低丙种球蛋白血症患者对丙种球蛋白替代疗法的需求。
