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Antipolysaccharide antibodies in 450 children with otitis media
S A Misbah1, H Griffiths, T Mitchell
1Department of Immunology, Oxford Radcliffe Hospital, UK.
Insights
Children with otitis media show varied antibody levels to pneumococcal and Haemophilus polysaccharides. While most have adequate responses, a small group exhibits poor antibody production, requiring further study.
Area of Science:
- Immunology
- Pediatrics
- Infectious Diseases
Background:
- Otitis media is common in children, often associated with bacterial infections.
- Antibody responses to polysaccharide antigens are crucial for immunity against encapsulated bacteria like Streptococcus pneumoniae and Haemophilus influenzae.
Purpose of the Study:
- To investigate antibody levels to pneumococcal and Haemophilus polysaccharides in children with otitis media.
- To assess the response to polysaccharide immunization in a subset of these children.
Main Methods:
- Prospective study of 450 children aged 2-16 years with otitis media.
- Measurement of serum antibodies to pneumococcal and Haemophilus polysaccharides.
- Test immunization with 23-valent Pneumococcal polysaccharide and Haemophilus type b capsular polysaccharide in selected children.
Main Results:
- Significantly higher pneumococcal antibody levels in 2-6 and 7-10 year olds compared to controls.
- Significantly lower Haemophilus antibody levels in 7-10 year olds compared to controls.
- 19.6% of children had pneumococcal antibody levels below the 25th percentile; 21.6% of these showed suboptimal responses to test immunization.
Conclusions:
- Most children with otitis media have adequate specific polysaccharide antibody levels.
- A small minority exhibit poor responses to immunization, warranting further investigation for potential antibody deficiency.
- Long-term follow-up is needed to clarify the significance of poor immunization responses in this cohort.
Abstract:
We have measured antibodies to pneumococcal and Haemophilus polysaccharides in a prospective study of 450 children aged 2-16 years with otitis media requiring grommets (ear tubes). Pneumococcal antibody levels were significantly higher in the 2-6 year (P < 0.004) and 7-10 year (P < 0.04) study groups in comparison with age-matched controls. There was no difference in Haemophilus antibody levels between the study and control group children for the age groups 2-6 years and 11-16 years. Haemophilus antibody levels were significantly lower in the 7-10 year (P < 0.003) group in comparison with age-matched controls. Eighty-eight out of 450 (19.6%) children had pneumococcal antibody levels below the 25th percentile. Nineteen out of 88 (21.6%) children with pneumococcal antibody levels below the 25th centile were test immunized with 23 valent Pneumococcal polysaccharide and unconjugated Haemophilus type b capsular polysaccharide. Of these 19 children (aged 4-11 years), five mounted suboptimal responses to both polysaccharide antigens, whilst one child failed to respond to Haemophilus polysaccharide alone. There was no significant difference in the prevalence of IgG subclass deficiency between the normal responders and poor responders to immunization (P = 0.12). We found no evidence of specific polysaccharide antibody deficiency in the vast majority of the 450 children studied. However, the significance of poor antibody responses to test immunization in a small minority of children with otitis media is unclear. Long-term follow up of these children is required to determine whether poor immunization responses herald the development of frank antibody deficiency.