Antibody levels and response to pneumococcal vaccine in steroid-dependent asthma

Immunization with pneumococcal vaccine is recommended for patients with chronic respiratory diseases, and is also used to evaluate antibody responses to polysaccharide antigens. We determined the effect of chronic prednisone treatment on immunoglobulin levels, pneumococcal antibody levels, and on the serologic response to pneumococcal vaccination. We studied 14 adult steroid-dependent asthmatics receiving daily or alternate day prednisone, 10 to 35 mg, and 14 age-matched, nonsteroid dependent asthmatic patients. Immunoglobulin levels were within the normal range in all patients. There was no difference in the pre-immunization antipneumococcal polysaccharide antibody levels against serotypes 3, 7F, 9N, and 14 between steroid-dependent and nonsteroid-dependent asthmatic patients. All patients had increases in antipneumococcal antibody levels 4 weeks after pneumococcal immunization. Mean post-immunization pneumococcal antibody titers were similar in steroid-dependent and nonsteroid-dependent asthmatic patients. All patients either had or developed levels > or = 300 ng Ab N/mL against one or more pneumococcal serotypes. We conclude that chronic prednisone treatment in steroid-dependent asthmatic adults does not significantly affect immunoglobulin levels, pneumococcal antibody levels, or specific antibody responses to pneumococcal immunization.