Giorgia Bucciol1,2, Heidi Schaballie1,2,3, Rik Schrijvers4, Barbara Bosch2, Marijke Proesmans2, Kris De Boeck2, Mieke Boon2, François Vermeulen2, Natalie Lorent5, Doreen Dillaerts6, Bjørn Kantsø7, Charlotte Svaerke Jørgensen7, Marie-Paule Emonds8, Xavier Bossuyt6,9, Leen Moens1, Isabelle Meyts10,11. 1. Inborn errors of immunity, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium. 2. Department of Pediatrics, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium. 3. Department of Pediatric Pulmonology, Infectious Diseases and Primary Immunodeficiencies, Ghent University Hospital, Ghent, Belgium. 4. Department of Microbiology, Immunology and Transplantation, Research group Allergy and Clinical Immunology, KU Leuven, Leuven, Belgium. 5. Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium. 6. Clinical and Diagnostic Immunology, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium. 7. Virus and Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark. 8. Histocompatibility and Immunogenetic Laboratory, Red Cross Flanders, Mechelen, Belgium. 9. Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium. 10. Inborn errors of immunity, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium. isabelle.meyts@uzleuven.be. 11. Department of Pediatrics, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium. isabelle.meyts@uzleuven.be.
Abstract
BACKGROUND: The correlation between different methods for the detection of pneumococcal polysaccharide vaccine (PPV) responses to diagnose specific polysaccharide antibody deficiency (SAD) is poor and the criteria for defining a normal response lack consensus. We previously proposed fifth percentile (p5) values of PPV responses as a new cutoff for SAD. OBJECTIVE: To analyze the association of SAD (determined by either World Health Organization (WHO)-standardized ELISA or multiplex bead-based assay) with abnormal response to Salmonella (S.) typhi Vi vaccination in a cohort of patients with recurrent infections. METHODS: Ninety-four patients with a clinical history suggestive of antibody deficiency received PPV and S. typhi Vi vaccines. Polysaccharide responses to either 3 or 18 pneumococcal serotypes were measured by either the WHO ELISA or a multiplex in-house bead-based assay. Anti-S. typhi Vi IgG were measured by a commercial ELISA kit. Allohemagglutinins (AHA) were measured by agglutination method. RESULTS: Based on the American Academy of Allergy, Asthma and Immunology (AAAAI) criteria for WHO ELISA, 18/94 patients were diagnosed with SAD and 22/93 based on serotype-specific p5 cutoffs for bead-based assay. The association between the two methods was significant, with 10 subjects showing abnormal response according to both techniques. Abnormal response to S. typhi Vi vaccination was found in 7 patients, 6 of which had SAD. No correlation was found between polysaccharide response and AHA, age, or clinical phenotype. CONCLUSION: The lack of evidence-based gold standards for the diagnosis of SAD represents a challenge in clinical practice. In our cohort, we confirmed the insufficient correlation between different methods of specific PPV response measurement, and showed that the S. typhi Vi response was not contributive. Caution in the interpretation of results is warranted until more reliable diagnostic methods can be validated.
BACKGROUND: The correlation between different methods for the detection of pneumococcal polysaccharide vaccine (PPV) responses to diagnose specific polysaccharide antibody deficiency (SAD) is poor and the criteria for defining a normal response lack consensus. We previously proposed fifth percentile (p5) values of PPV responses as a new cutoff for SAD. OBJECTIVE: To analyze the association of SAD (determined by either World Health Organization (WHO)-standardized ELISA or multiplex bead-based assay) with abnormal response to Salmonella (S.) typhi Vi vaccination in a cohort of patients with recurrent infections. METHODS: Ninety-four patients with a clinical history suggestive of antibody deficiency received PPV and S. typhi Vi vaccines. Polysaccharide responses to either 3 or 18 pneumococcal serotypes were measured by either the WHO ELISA or a multiplex in-house bead-based assay. Anti-S. typhi Vi IgG were measured by a commercial ELISA kit. Allohemagglutinins (AHA) were measured by agglutination method. RESULTS: Based on the American Academy of Allergy, Asthma and Immunology (AAAAI) criteria for WHO ELISA, 18/94 patients were diagnosed with SAD and 22/93 based on serotype-specific p5 cutoffs for bead-based assay. The association between the two methods was significant, with 10 subjects showing abnormal response according to both techniques. Abnormal response to S. typhi Vi vaccination was found in 7 patients, 6 of which had SAD. No correlation was found between polysaccharide response and AHA, age, or clinical phenotype. CONCLUSION: The lack of evidence-based gold standards for the diagnosis of SAD represents a challenge in clinical practice. In our cohort, we confirmed the insufficient correlation between different methods of specific PPV response measurement, and showed that the S. typhi Vi response was not contributive. Caution in the interpretation of results is warranted until more reliable diagnostic methods can be validated.
Authors: Axel Jeurissen; Leen Moens; Marc Raes; Greet Wuyts; Luc Willebrords; Kate Sauer; Marijke Proesmans; Jan L Ceuppens; Kris De Boeck; Xavier Bossuyt Journal: Clin Chem Date: 2007-01-26 Impact factor: 8.327
Authors: Sharif Uddin; Ray Borrow; Mansel R Haeney; Andrew Moran; Rosalind Warrington; Paul Balmer; Peter D Arkwright Journal: Vaccine Date: 2006-04-18 Impact factor: 3.641
Authors: H Schaballie; G Wuyts; D Dillaerts; G Frans; L Moens; M Proesmans; F Vermeulen; K De Boeck; I Meyts; X Bossuyt Journal: Clin Exp Immunol Date: 2016-05-20 Impact factor: 4.330
Authors: L A Sanders; G T Rijkers; W Kuis; A J Tenbergen-Meekes; B R de Graeff-Meeder; I Hiemstra; B J Zegers Journal: J Allergy Clin Immunol Date: 1993-01 Impact factor: 10.793
Authors: J Ochoa-Grullón; C Orte; A Rodríguez de la Peña; K Guevara-Hoyer; G Cordero Torres; M Fernández-Arquero; I Serrano-García; M J Recio; R Pérez de Diego; S Sánchez-Ramón Journal: MethodsX Date: 2020-05-29