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Published on: August 7, 2017
Low Baseline Pneumococcal Antibody Titers Predict Specific Antibody Deficiency, Increased Upper Respiratory
Charles H Song1, Dennys Estevez2, Diana Chernikova1
1Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, California.
Insights
Low pneumococcal antibody (PA) titers are linked to recurrent respiratory infections and specific antibody deficiency (SAD). Inadequate PA titers correlate with increased sinusitis and allergic conditions, highlighting the importance of immune status in respiratory health.
Area of Science:
- Immunology
- Infectious Diseases
- Allergy & Immunology
Background:
- Inadequate pneumococcal antibody (PA) titers are common in patients experiencing recurrent respiratory infections.
- The relationship between the degree of inadequate PA titers and vaccine response, sinusitis, and allergies requires further investigation.
Purpose of the Study:
- To determine how inadequate baseline PA titers affect polysaccharide vaccine response.
- To assess the impact of inadequate PA titers on the incidence of sinusitis and allergic conditions.
Main Methods:
- 313 patients with recurrent respiratory infections were classified based on baseline and post-vaccination PA titers (pPA).
- Groups included adequate baseline-pPA (A), inadequate baseline with adequate post-pPA (B, responders), and inadequate baseline with inadequate post-pPA (C, nonresponders, specific antibody deficiency [SAD]).
- Analysis included demographics, sinusitis history, allergic conditions, and serotype-specific antibody titers.
Main Results:
- Over 80% of patients exhibited inadequate baseline-pPA.
- Inadequate baseline-pPA was inversely related to SAD prevalence (OR=2.02, P=.01).
- Inadequate PA titers (Groups B and C) were associated with higher rates of chronic rhinosinusitis (P<.001), allergic sensitization, and allergic rhinitis (P<.05).
Conclusions:
- Low baseline pneumococcal antibody titers and low titers to serotype 3 are strongly associated with specific antibody deficiency (SAD).
- These low titers also correlate with an increased incidence of respiratory infections, including chronic rhinosinusitis, and allergic conditions.
Background:
Inadequate titers of pneumococcal antibody (PA) are commonly present among patients with recurrent respiratory infections.
Objective:
We sought to determine the effect of the degree of inadequacy in baseline PA titers on the subsequent polysaccharide vaccine response, the incidence of sinusitis, and allergic conditions.
Methods:
A total of 313 patients aged 6 to 70 years with symptoms of recurrent respiratory infections were classified by baseline-pPA (percentage of protective [≥1.3 µg/mL] PA serotypes/total tested serotypes) and postvaccination pPA (post-pPA): Group A (adequate baseline-pPA), Group B (inadequate baseline-pPA, adequate post-pPA, responders), and Group C (inadequate baseline-pPA, inadequate postpPA, nonresponders, specific antibody deficiency [SAD]). Immunity against Streptococcus pneumoniae was defined as adequate when the pPA was ≥70%. Each group and combined groups, Group AB (inadequate baseline-pPA), and Group BC (adequate post-pPA) were analyzed for demographics, history of sinusitis, recurrent sinusitis in the following year, allergic conditions, and association with inadequate individual serotype titers.
Results:
Over 80% of patients with respiratory symptoms had inadequate baseline-pPA. Baseline-pPA and SAD prevalence are inversely related (odds ratio = 2.02, 95% CI: 1.15-3.57, P = .01). Inadequate serotype 3 antibody titer is highly associated with SAD (odds ratio = 2.02, 96% CI: 1.61-5.45, P < .01). The groups with inadequate pPA (Group B and C, or BC) had significantly higher percentage of patients with chronic rhinosinusitis (P < .001), allergic sensitization, and allergic rhinitis (P < .05). Group A contained higher percentage of patients with recurrent upper airway infections (P < .001).
Conclusion:
Low baseline-pPA and low antibody titers to serotype 3 are highly associated with SAD, increased incidence of respiratory infections including CRS and allergic conditions.
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