Antony R Parker1, Miguel A Park2, Stephen Harding3, Roshini S Abraham4. 1. The Binding Site Group Limited, Birmingham, UK. 2. Division of Allergic Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA. 3. The Binding Site Group Limited, Birmingham, UK. Electronic address: Stephen.Harding@Bindingsite.co.uk. 4. Department of Laboratory Medicine and Pathology, Mayo Clinic , Rochester, MN, USA.
Abstract
BACKGROUND: Interpretation of the responses to the pneumococcal polysaccharide vaccine (Pneumovax®23, PPV) has proven challenging. In addition, there are few studies documenting the longevity of these responses. METHODS: The age-specific PPV IgM, IgA, IgG and IgG2 concentrations were determined pre, 4-6 weeks and 6 years post-vaccination in the serum of Prevnar®-naïve adults using VaccZyme™ pneumococcal capsular polysaccharide ELISAs. RESULTS: The median pre-vaccination concentrations were; PPV IgM 53 U/mL (5-95% CI: 16-169 U/mL), IgA 23 U/mL (6-103 U/mL), IgG 41 mg/L (10-184 U/mL) and IgG2 18 mg/L (3-95 U/mL). 4-6 weeks post-vaccination there was a median 6-fold (5-95% CI: 2-24) increase in PPV IgM (median 315 U/mL (5-95% CI: 60-1133 U/mL), 18-fold (4-74) increase in IgA (369 U/mL (78-1802 U/mL)), 9-fold (2-19) increase in IgG (375 mg/L (77-1238 mg/L)) and 8-fold (1-20) increase in IgG2 (141 mg/L (25-573 mg/L)). This was significant for all isotypes in all age ranges (p < 0.0001). Six years post-vaccination median PPV concentrations were; IgM 54 U/mL (17-128), IgA 85 U/mL (19-279), IgG 148 mg/L (30-997) and IgG2 57 mg/L (9-437). The median concentrations for all ages 6 years post-vaccination were significantly elevated compared to the pre-vaccination titres for PPV IgA, IgG and IgG2 isotypes only. The PPV IgM and IgA responses were influenced by age. At 6 years post vaccination, in individuals with normal PPV IgG, 34 individuals had PPV IgM and/or IgA concentrations below the lower limit of the healthy adult ranges. We also used the healthy adult reference ranges developed in this study to assess a cohort of primary immunodeficiency (PID) patients. CONCLUSION: These ranges will help to provide a framework for assessment and definition of normal response to PPV, which will facilitate clinical interpretation of a deficient polysaccharide response in those suspected of antibody deficiency.
BACKGROUND: Interpretation of the responses to the pneumococcalpolysaccharide vaccine (Pneumovax®23, PPV) has proven challenging. In addition, there are few studies documenting the longevity of these responses. METHODS: The age-specific PPV IgM, IgA, IgG and IgG2 concentrations were determined pre, 4-6 weeks and 6 years post-vaccination in the serum of Prevnar®-naïve adults using VaccZyme™ pneumococcal capsular polysaccharide ELISAs. RESULTS: The median pre-vaccination concentrations were; PPV IgM 53 U/mL (5-95% CI: 16-169 U/mL), IgA 23 U/mL (6-103 U/mL), IgG 41 mg/L (10-184 U/mL) and IgG2 18 mg/L (3-95 U/mL). 4-6 weeks post-vaccination there was a median 6-fold (5-95% CI: 2-24) increase in PPV IgM (median 315 U/mL (5-95% CI: 60-1133 U/mL), 18-fold (4-74) increase in IgA (369 U/mL (78-1802 U/mL)), 9-fold (2-19) increase in IgG (375 mg/L (77-1238 mg/L)) and 8-fold (1-20) increase in IgG2 (141 mg/L (25-573 mg/L)). This was significant for all isotypes in all age ranges (p < 0.0001). Six years post-vaccination median PPV concentrations were; IgM 54 U/mL (17-128), IgA 85 U/mL (19-279), IgG 148 mg/L (30-997) and IgG2 57 mg/L (9-437). The median concentrations for all ages 6 years post-vaccination were significantly elevated compared to the pre-vaccination titres for PPV IgA, IgG and IgG2 isotypes only. The PPV IgM and IgA responses were influenced by age. At 6 years post vaccination, in individuals with normal PPV IgG, 34 individuals had PPV IgM and/or IgA concentrations below the lower limit of the healthy adult ranges. We also used the healthy adult reference ranges developed in this study to assess a cohort of primary immunodeficiency (PID) patients. CONCLUSION: These ranges will help to provide a framework for assessment and definition of normal response to PPV, which will facilitate clinical interpretation of a deficient polysaccharide response in those suspected of antibody deficiency.
Authors: Kevin J Kramer; Erin M Wilfong; Kelsey Voss; Sierra M Barone; Andrea R Shiakolas; Nagarajan Raju; Caroline E Roe; Naveenchandra Suryadevara; Lauren M Walker; Steven C Wall; Ariana Paulo; Samuel Schaefer; Debolanle Dahunsi; Camille S Westlake; James E Crowe; Robert H Carnahan; Jeffrey C Rathmell; Rachel H Bonami; Ivelin S Georgiev; Jonathan M Irish Journal: Nat Commun Date: 2022-06-16 Impact factor: 17.694
Authors: Lisanne M A Janssen; Michiel Heron; Jean-Luc Murk; Alexander C A P Leenders; Ger T Rijkers; Esther de Vries Journal: Clin Exp Immunol Date: 2021-06-01 Impact factor: 4.330
Authors: Antony R Parker; Markus Skold; Stephen Harding; J Clayborn Barton; Luigi F Bertoli; James C Barton Journal: BMC Immunol Date: 2019-08-20 Impact factor: 3.615
Authors: Lisanne M A Janssen; Michiel Heron; Jean-Luc Murk; Alexander C A P Leenders; Ger T Rijkers; Esther de Vries Journal: Front Immunol Date: 2019-11-05 Impact factor: 7.561