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Defective antipneumococcal polysaccharide antibody response in children with recurrent respiratory tract infections

L A Sanders1, G T Rijkers, W Kuis

  • 1Department of Immunology, University Hospital for Children and Youth, Het Wilhelmina Kinderziekenhuis, Utrecht, The Netherlands.

The Journal of Allergy and Clinical Immunology
|January 1, 1993
PubMed

Insights

Patients with recurrent infections may have impaired immune responses to pneumococcal polysaccharides. Long-term follow-up is crucial to differentiate temporary delays from persistent defects, which can indicate developing humoral immunodeficiency.

Area of Science:

  • Immunology
  • Pediatrics
  • Infectious Diseases

Background:

  • Recurrent pyogenic infections are linked to impaired responses to polysaccharide antigens.
  • Investigated deficient pneumococcal polysaccharide responses in patients with recurrent infections.

Purpose of the Study:

  • To assess the immune response to pneumococcal polysaccharide vaccine in children with recurrent infections.
  • To identify potential underlying immunodeficiencies.

Main Methods:

  • 45 patients (1.7-17.1 years) received 23-valent pneumococcal polysaccharide vaccine.
  • Antibody levels to seven pneumococcal serotypes measured by ELISA pre- and post-vaccination.
  • Protein antigen booster immunization administered.

Main Results:

  • 14% (5/35) of patients with normal immunoglobulin levels had low antipneumococcal antibodies and failed to respond to vaccination.
  • 10 patients had diagnosed humoral immunodeficiency, with 7 failing to respond to pneumococcal vaccination.
  • Appropriate response to protein antigens was observed in patients with polysaccharide response defects.

Conclusions:

  • A defective immune response to polysaccharide antigens requires long-term follow-up.
  • Distinguishing transient maturational delay from persistent impaired response is essential.
  • Impaired polysaccharide response may precede humoral immunodeficiency disease.
Abstract

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