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Patterns of immune response among survivors of group B streptococcal meningitis
M S Edwards1, M A Hall, M A Rench
1Myers Black Section of Infectious Diseases, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030.
Insights
Infants surviving group B streptococcal (GBS) meningitis show a temporary antibody response and improved opsonophagocytosis. This immune function wanes within months, indicating a need for further research into persistent immunity.
Area of Science:
- Immunology
- Neonatal Infectious Diseases
- Microbiology
Background:
- Group B streptococcal (GBS) meningitis is a serious neonatal infection.
- Understanding the immune response in survivors is crucial for managing and preventing GBS disease.
Purpose of the Study:
- To investigate antibody responses and functional immunity in infants after GBS meningitis.
- To correlate antibody levels with opsonophagocytic activity against type III GBS.
Main Methods:
- Longitudinal serum sampling from 10 infants surviving GBS meningitis.
- Measurement of type-specific antibodies to GBS capsular polysaccharide.
- Assessment of in vitro opsonophagocytosis of type III GBS.
Main Results:
- Five infants developed a transient, IgM-predominant antibody response peaking at 4-8 weeks post-diagnosis.
- Opsonophagocytosis increased significantly with peak antibody levels but declined later.
- Three infants showed delayed responses, while two had no detectable antibody or functional immunity.
Conclusions:
- Survivors of GBS meningitis exhibit a transient specific antibody response and opsonophagocytosis.
- Functional immune competence does not persist long-term despite complement maturation.
- Further strategies may be needed to ensure sustained protection against GBS.
Abstract:
Serum samples from 10 infants surviving type III, group B streptococcal (GBS) meningitis were collected acutely and longitudinally for 6 months to determine patterns of antibody response to the capsular polysaccharide and their in vitro functional correlates. Five infants who failed to develop specific antibody at a mean of 3.8 weeks after diagnosis had an increase of greater than or equal to 1.0 microgram/ml after another 4-8 weeks. This IgM-predominant type-specific antibody declined to baseline 2-4 months later. Opsonophagocytosis of type III GBS increased from 0 to 88% in parallel with peak antibody response. Three infants developed increased antibody and opsonophagocytosis at 15-31 weeks after diagnosis, while two had no detectable response. Despite increasing complement levels, opsonophagocytosis of type III GBS was poor with low specific antibody levels These results suggest that survivors of GBS meningitis transiently develop specific antibody and associated efficient opsonophagocytosis, but functional competence does not persist despite maturation to adult levels of complement proteins.