Healthy elderly people lack neutrophil-mediated functional activity to type V group B Streptococcus

To determine the function of capsular polysaccharide (CPS)-specific immunoglobulin-G (IgG) and neutrophils from older adults in increasing ingestion and killing of type V group B Streptococcus (GBS).

Cross-sectional study.

Outpatient clinic at Baylor College of Medicine.

The subjects were 40 healthy, community-dwelling adults aged 65 and older from Houston, Texas.

The serum level of type V GBS CPS-specific IgG was measured using an enzyme-linked immunosorbent assay. Functional activity was evaluated using an opsonophagocytosis assay.

Sera from four subjects promoted efficient neutrophil-mediated phagocytosis and killing of type V GBS (mean log10 reduction+/-standard deviation in colony-forming units (cfu)=1.51+/-0.39). Each had serum CPS-specific IgG concentrations exceeding 1 microg/mL. Sera from 36 subjects did not promote neutrophil-mediated functional activity (mean log10 reduction in cfu=-0.09+/-0.06; P=.025). Only one of these 36 had a CPS-specific IgG concentration exceeding 1 microg/mL. When pooled sera from young adults given type V GBS conjugate vaccine was added at CPS-specific IgG concentrations of 4 microg/mL or 0.4 microg/mL, sera from all subjects promoted neutrophil-mediated killing of type V GBS. No impairment was evident in the neutrophil function of elderly subjects when it was compared with that of young adults.

CPS-specific IgG and neutrophils from healthy older adults function to ingest and kill type V GBS, but these antibodies are not present in sufficient amounts in most individuals. Further studies should determine whether a type V GBS vaccine induces functionally active antibodies in older people.