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Guevara-Hoyer K, Vasconcelos J, Marques L, Fernandes AA, Ochoa-Grullón J, Marinho A, Sequeira T, Gil C, Rodríguez de la Peña A, Serrano García I, Recio MJ, Fernández-Arquero M, Pérez de Diego R, Ramos JT, Neves E, Sánchez-Ramón S. Variable immunodeficiency study: Evaluation of two European cohorts within a variety of clinical phenotypes. Immunol Lett 2020; 223:78-88. [PMID: 32344018 DOI: 10.1016/j.imlet.2020.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 02/02/2020] [Accepted: 03/16/2020] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Given the wide heterogeneity of common variable immunodeficiency (CVID), several groups have proposed clinical and immunological classifications to better define follow-up and prognostic algorithms. The present study aims to validate recent clinical and laboratory algorithms, based on different combinations of CVID biomarkers, to provide more personalized treatment and follow-up strategies. METHODS We analysed clinical and immunological features of 80 patients with suspected or diagnosed CVID, in two reference centres of Portugal and Spain. Clinical manifestations were categorized into clinical phenotyping proposed by Chapel et al. [1] that included cytopenia; polyclonal lymphocytic infiltration; unexplained enteropathy; and no disease-related complications. RESULTS 76% of patients in our cohort entered one of the four categories of clinical phenotyping, without overlap (cytopenia; polyclonal lymphocytic infiltration; unexplained enteropathy; and no disease-related complications). The most prominent phenotype was "cytopenia" (40%) followed by "polyclonal lymphocytic infiltration" (19%). The remaining 24% patients of our cohort had overlap of 2 clinical phenotypes (cytopenia and unexplained enteropathy mainly). A delay of CVID diagnosis in more than 6 years presented 3.7-fold higher risk of developing lymphoproliferation and/or malignancy (p < 0.05), and was associated with increased CD8+CD45RO + T-lymphocytes (p < 0.05). An association between decreased switched-memory B cells with lymphoproliferation and malignancy was observed (p < 0.03 and p < 0.05, respectively). CD4 + T-lymphocytopenia correlated with autoimmune phenotype, with 30% prevalence (p < 0.05). HLA-DR7 expression was related to CVID onset in early life in our patients (13 vs 25 years), and DQ2.5 or DQ2.2 with unexplained enteropathy (p < 0.05). CONCLUSIONS The phenotypic and genetic study is crucial for an adequate clinical orientation of CVID patients. In these two independent cohorts of patients, classification based in clinical and laboratory algorithms, provides more personalized treatment and follow-up strategies.
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Affiliation(s)
- Kissy Guevara-Hoyer
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain; Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University, Madrid, Spain; Immunodeficiency Interdepartmental Group (GIID), Madrid, Spain
| | - Julia Vasconcelos
- Department of Immunology, Centro Hospitalar e Universitário Do Porto, Porto, Portugal
| | - Laura Marques
- Department of Pediatrics, Centro Hospitalar e Universitário Do Porto, Porto, Portugal
| | | | - Juliana Ochoa-Grullón
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain; Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University, Madrid, Spain; Immunodeficiency Interdepartmental Group (GIID), Madrid, Spain
| | - Antonio Marinho
- Clinical Immunology Unit, Centro Hospitalar e Universitário Do Porto, Porto, Portugal
| | - Teresa Sequeira
- Clinical Immunology Unit, Centro Hospitalar e Universitário Do Porto, Porto, Portugal
| | - Celia Gil
- Department of Pediatrics, Hospital Clínico San Carlos, Madrid, Spain
| | | | - Irene Serrano García
- Department of Epidemiology and Preventive Medicine, Hospital Clínico San Carlos, Madrid, Spain
| | - M José Recio
- Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University, Madrid, Spain; Immunodeficiency Interdepartmental Group (GIID), Madrid, Spain
| | - Miguel Fernández-Arquero
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain; Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University, Madrid, Spain; Immunodeficiency Interdepartmental Group (GIID), Madrid, Spain
| | - Rebeca Pérez de Diego
- Immunodeficiency Interdepartmental Group (GIID), Madrid, Spain; Laboratory of Immunogenetics of Human Diseases, IdiPAZ Institute for Health Research, Madrid, Spain
| | - José Tomas Ramos
- Department of Pediatrics, Hospital Clínico San Carlos, Madrid, Spain
| | - Esmeralda Neves
- Department of Immunology, Centro Hospitalar e Universitário Do Porto, Porto, Portugal
| | - Silvia Sánchez-Ramón
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain; Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University, Madrid, Spain; Immunodeficiency Interdepartmental Group (GIID), Madrid, Spain.
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Ochoa-Grullón J, Orte C, Rodríguez de la Peña A, Guevara-Hoyer K, Cordero Torres G, Fernández-Arquero M, Serrano-García I, Recio M, Pérez de Diego R, Sánchez-Ramón S. Typhim vi immunization assists to discriminate primary antibody responses in hematological malignancies. MethodsX 2020; 7:100936. [PMID: 32551240 PMCID: PMC7289764 DOI: 10.1016/j.mex.2020.100936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 05/20/2020] [Indexed: 11/25/2022] Open
Abstract
Typhim Vi response have been proposed as a new strategy for the assessment of specific polysaccharide antibody response in SID due to HM. Different biostatistical methodologies may stablish the best cut-off value to discriminate Typhim Vi response. Typhim Vi IgG responses may better discriminate primary Ab responses showing relevant clinical correlate.
Assessment of specific antibody (Ab) production to polysaccharide antigens is clinically relevant, identifying patients at risk for infection by encapsulated bacteria and thus enabling a more rigorous selection of patients that can benefit of immunoglobulin replacement therapy. Classically, the gold-standard test is the measurement of antibody production to pure polysaccharide pneumococcal (PPV) immunization. Several factors, including introduction of conjugate vaccination schedule, serotyping analysis, high baseline Ab levels, have hindered the evaluation of polysaccharide antigens. This is even more difficult in secondary immunodeficiencies (SID), where patients can show secondary responses despite lack of primary antibody responses and present with recurrent or severe infections. Assessment of specific Ab production to pure Salmonella typhi Vi polysaccharide (TV) immunization has been proposed as a complementary test to PPV, given its low seroprevalence. To set the optimal cut-off value for PPV and TV response in SID, we tested different biostatistical methodologies, including ROC analysis, Youden index, Union index and Closest-topleft in a cohort of 42 SID patients and 24 healthy controls. The statistically chosen cut-offs value pre-post TV Ab ratio was ≥5, (sensitivity of 90%, specificity of 100%) and a postvaccination TV concentration of 28.5 U/mL (sensitivity of 90%, specificity of 95%), showing relevant clinical correlate.
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Affiliation(s)
- J. Ochoa-Grullón
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain
- Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University School of Medicine, Madrid, Spain
- Immunodeficiency Interdepartmental Group (GIID), Madrid, Spain
| | - C. Orte
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain
| | | | - K. Guevara-Hoyer
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain
- Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University School of Medicine, Madrid, Spain
- Immunodeficiency Interdepartmental Group (GIID), Madrid, Spain
| | - G. Cordero Torres
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain
| | - M. Fernández-Arquero
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain
| | - I. Serrano-García
- Department of Epidemiology and Preventive Medicine, Hospital Clínico San Carlos, Madrid, Spain
| | - M.J. Recio
- Immunodeficiency Interdepartmental Group (GIID), Madrid, Spain
- Laboratory of Immunogenetics of Human Diseases, IdiPAZ Institute for Health Research, Madrid, Spain
| | - R. Pérez de Diego
- Immunodeficiency Interdepartmental Group (GIID), Madrid, Spain
- Laboratory of Immunogenetics of Human Diseases, IdiPAZ Institute for Health Research, Madrid, Spain
| | - S. Sánchez-Ramón
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain
- Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University School of Medicine, Madrid, Spain
- Immunodeficiency Interdepartmental Group (GIID), Madrid, Spain
- Corresponding author
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Measurement of Typhim Vi® IgG antibodies in healthy donors as a tool for the diagnostic of patients with antibody deficiencies. Clin Immunol 2020; 215:108416. [DOI: 10.1016/j.clim.2020.108416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 03/05/2020] [Accepted: 04/07/2020] [Indexed: 10/24/2022]
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Ochoa-Grullón J, Benavente Cuesta C, Pérez López C, Peña Cortijo A, Rodríguez de la Peña A, Álvarez Carmona A, Mateo Morales M, Llano-Hernández K, Williams LJ, Rodríguez de Frías E, Guevara-Hoyer K, Cordero Torres G, Orte C, Fernández-Arquero M, Fernández-Paredes L, Serrano-García I, Recio MJ, Pérez de Diego R, Martínez R, Sánchez-Ramón S. Evaluation of Polysaccharide Typhim Vi Antibody Response as a predictor of Humoral Immunodeficiency in Haematological Malignancies. Clin Immunol 2019; 210:108307. [PMID: 31760095 DOI: 10.1016/j.clim.2019.108307] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 10/28/2019] [Accepted: 11/09/2019] [Indexed: 02/07/2023]
Abstract
An increasing healthcare challenge in the management of haematological malignancy (HM) is secondary immunodeficiency. From January 2019, the EMA included the evaluation of specific antibody (Ab) responses to better select patients for immunoglobulin replacement therapy (IgRT). We evaluated Ab responses to pneumococcal and Salmonella typhi pure polysaccharide immunization in a cohort of 42 HM patients and 24 healthy-controls. Pre-post specific Ab concentrations were measured by ELISA at 4 weeks. Globally, significantly lower Typhim Vi (TV) seroprevalence (9%) compared to 23-valent pneumococcal polysaccharide vaccine (PPV) (76%) (p <0.001) was observed. TV non responders (88%) were higher than PPV non responders (62%) (p <0.0001) and correlated better to infectious history. By ROC analysis, pre-post 5-fold TV increase was the best cut-off to discriminate HM with recurrent infections and controls (sensitivity 91%, specificity 100%). Despite the small sample cohort, our results suggest that specific anti-S typhi Ab response is a useful complementary assay in the diagnosis and management decision of SID to HM.
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Affiliation(s)
- J Ochoa-Grullón
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain; Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University School of Medicine, Madrid, Spain; Immunodeficiency Interdepartmental Group, (GIID), Madrid, Spain
| | | | - C Pérez López
- Department of Haematology, Hospital Clínico San Carlos, Madrid, Spain
| | - A Peña Cortijo
- Department of Haematology, Hospital Clínico San Carlos, Madrid, Spain
| | | | - A Álvarez Carmona
- Department of Haematology, Hospital Clínico San Carlos, Madrid, Spain
| | - M Mateo Morales
- Department of Haematology, Hospital Clínico San Carlos, Madrid, Spain
| | - K Llano-Hernández
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain
| | | | - E Rodríguez de Frías
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain; Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University School of Medicine, Madrid, Spain
| | - K Guevara-Hoyer
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain; Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University School of Medicine, Madrid, Spain; Immunodeficiency Interdepartmental Group, (GIID), Madrid, Spain
| | - G Cordero Torres
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain
| | - C Orte
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain
| | - M Fernández-Arquero
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain; Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University School of Medicine, Madrid, Spain
| | - L Fernández-Paredes
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain
| | - I Serrano-García
- Department of Epidemiology and Preventive Medicine, Hospital Clínico San Carlos, Madrid, Spain
| | - M J Recio
- Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University School of Medicine, Madrid, Spain; Immunodeficiency Interdepartmental Group, (GIID), Madrid, Spain
| | - R Pérez de Diego
- Immunodeficiency Interdepartmental Group, (GIID), Madrid, Spain; Laboratory of Immunogenetics of Human Diseases, IdiPAZ Institute for Health Research, Madrid, Spain
| | - R Martínez
- Immunodeficiency Interdepartmental Group, (GIID), Madrid, Spain
| | - S Sánchez-Ramón
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain; Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University School of Medicine, Madrid, Spain; Immunodeficiency Interdepartmental Group, (GIID), Madrid, Spain.
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Guevara-Hoyer K, Gil C, Parker AR, Williams LJ, Orte C, Rodriguez de la Peña A, Ochoa-Grullón J, Rodriguez De Frias E, García IS, García-Gómez S, Recio MJ, Fernández-Arquero M, Pérez de Diego R, Ramos JT, Sánchez-Ramón S. Measurement of Typhim Vi IgG as a Diagnostic Tool to Determine Anti-polysaccharide Antibody Production Deficiency in Children. Front Immunol 2019; 10:654. [PMID: 31001267 PMCID: PMC6455213 DOI: 10.3389/fimmu.2019.00654] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 03/11/2019] [Indexed: 11/13/2022] Open
Abstract
Background: The assessment of specific polysaccharide antibody production plays a pivotal role in the diagnosis of humoral primary immunodeficiencies (PID). The response to 23-valent pneumococcal vaccine (PPV) remains the gold standard for the diagnosis of polysaccharide antibodies. However, in Spain, the interpretation of pure polysaccharide 23-valent immunization is hampered by the high endemicity of pneumococcal disease and the generalization of the 13-valent adjuvant pneumococcal vaccination. Specific Typhim Vi vaccination (TV) immunoglobulin G IgG response to immunization is useful in adult PID, but there is no data regarding children. Objectives: To evaluate the clinical utility of TV IgG production as a diagnostic tool to determine anti-polysaccharide antibody production deficiency in children, when the response to PPV is unclear and isolated determination of serotypes is unfeasible. Methods: We conducted a single-institution prospective observational study on 61 children with recurrent infections. Baseline specific antibodies against PPV and TV were evaluated. In 28 children (46%), the response to the production of antibodies confirmed a clinical suspicion of humoral PID, and they were therefore immunized with 23-valent pneumococcal vaccine and Typhim Vi. Both specific antibody responses were measured by ELISA (The Binding Site Group Ltd, Birmingham, UK) using previously published cut-offs. Results: Seventy percent of the 61 children displayed baseline PPV IgG > 27 mg/L, whereas only 8% showed TV IgG > 28 U/mL (p < 0.0001). Twenty-one of 28 children (75%) achieved a 3-fold increase in post-vaccination TV IgG levels, whereas only 3% achieved a 4-fold increase in PPV IgG post vaccination, mainly due to high baseline PPV IgG titers. When we classified children according to their response to TV as responders or non-responders and compared this with the well-known clinical warning signs of the Jeffrey Modell Foundation. The proportions of children with history of pneumonia and the need for intravenous antibiotics were significantly higher in TV IgG non-responders than in TV IgG responders (p = 0.02 and p = 0.01, respectively). Conclusion: Response to TV can be considered an ancillary diagnostic tool to determine polysaccharide antibodies in children, particularly when isolated determination of pneumococcal serotypes is not feasible. TV provides a useful asset for clinicians in the era of conjugate PPV vaccination, with clinical relevance. Further research is warranted for validation.
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Affiliation(s)
- Kissy Guevara-Hoyer
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain.,Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University, Madrid, Spain.,Immunodeficiency Interdepartmental Group (GIID), Madrid, Spain
| | - Celia Gil
- Department of Pediatrics, Hospital Clínico San Carlos, Madrid, Spain
| | | | | | - Carmen Orte
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain
| | | | - Juliana Ochoa-Grullón
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain.,Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University, Madrid, Spain.,Immunodeficiency Interdepartmental Group (GIID), Madrid, Spain
| | | | - Irene Serrano García
- Department of Epidemiology and Preventive Medicine, Hospital Clínico San Carlos, Madrid, Spain
| | - Sonia García-Gómez
- Immunodeficiency Interdepartmental Group (GIID), Madrid, Spain.,Laboratory of Immunogenetics of Human Diseases, IdiPAZ Institute for Health Research, Madrid, Spain
| | - M José Recio
- Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University, Madrid, Spain.,Immunodeficiency Interdepartmental Group (GIID), Madrid, Spain
| | - Miguel Fernández-Arquero
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain.,Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University, Madrid, Spain.,Immunodeficiency Interdepartmental Group (GIID), Madrid, Spain
| | - Rebeca Pérez de Diego
- Immunodeficiency Interdepartmental Group (GIID), Madrid, Spain.,Laboratory of Immunogenetics of Human Diseases, IdiPAZ Institute for Health Research, Madrid, Spain
| | - Jose Tomas Ramos
- Department of Pediatrics, Hospital Clínico San Carlos, Madrid, Spain
| | - Silvia Sánchez-Ramón
- Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain.,Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University, Madrid, Spain.,Immunodeficiency Interdepartmental Group (GIID), Madrid, Spain
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6
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Parker AR, Bradley C, Harding S, Sánchez-Ramón S, Jolles S, Kiani-Alikhan S. Measurement and interpretation of Salmonella typhi Vi IgG antibodies for the assessment of adaptive immunity. J Immunol Methods 2018; 459:1-10. [PMID: 29800575 DOI: 10.1016/j.jim.2018.05.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 04/26/2018] [Accepted: 05/21/2018] [Indexed: 01/15/2023]
Abstract
Response to polysaccharide vaccination can be an invaluable tool for assessing functionality of the adaptive immune system. Measurement of antibodies raised in response to Pneumovax®23 is the current gold standard test, but there are significant challenges and constraints in both the measurement and interpretation of the response. An alternative polysaccharide vaccine approach (Salmonella typhi Vi capsule (ViCPS)) has been suggested. In the present article, we review current evidence for the measurement of ViCPS antibodies in the diagnosis of primary and secondary antibody deficiencies. In particular, we review emerging data suggesting their interpretation in combination with the response to Pneumovax®23 and comment upon the utility of these vaccines to assess humoral immune responses while receiving immunoglobulin replacement therapy (IGRT).
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Affiliation(s)
| | | | | | - Silvia Sánchez-Ramón
- Department of Clinical Immunology Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Stephen Jolles
- Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, UK
| | - Sorena Kiani-Alikhan
- Department of Immunology, Barts and The London National Health Service Trust, London, UK
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Evans C, Bateman E, Steven R, Ponsford M, Cullinane A, Shenton C, Duthie G, Conlon C, Jolles S, Huissoon AP, Longhurst HJ, Rahman T, Scott C, Wallis G, Harding S, Parker AR, Ferry BL. Measurement of Typhi Vi antibodies can be used to assess adaptive immunity in patients with immunodeficiency. Clin Exp Immunol 2018; 192:292-301. [PMID: 29377063 PMCID: PMC5980364 DOI: 10.1111/cei.13105] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2017] [Indexed: 02/06/2023] Open
Abstract
Vaccine‐specific antibody responses are essential in the diagnosis of antibody deficiencies. Responses to Pneumovax II are used to assess the response to polysaccharide antigens, but interpretation may be complicated. Typhim Vi®, a polysaccharide vaccine for Salmonella typhoid fever, may be an additional option for assessing humoral responses in patients suspected of having an immunodeficiency. Here we report a UK multi‐centre study describing the analytical and clinical performance of a Typhi Vi immunoglobulin (Ig)G enzyme‐linked immunosorbent assay (ELISA) calibrated to an affinity‐purified Typhi Vi IgG preparation. Intra‐ and interassay imprecision was low and the assay was linear, between 7·4 and 574 U/ml (slope = 0·99–1·00; R2 > 0·99); 71% of blood donors had undetectable Typhi Vi IgG antibody concentrations. Of those with antibody concentrations > 7·4 U/ml, the concentration range was 7·7–167 U/ml. In antibody‐deficient patients receiving antibody replacement therapy the median Typhi Vi IgG antibody concentrations were < 25 U/ml. In vaccinated normal healthy volunteers, the median concentration post‐vaccination was 107 U/ml (range 31–542 U/ml). Eight of eight patients (100%) had post‐vaccination concentration increases of at least threefold and six of eight (75%) of at least 10‐fold. In an antibody‐deficient population (n = 23), only 30% had post‐vaccination concentration increases of at least threefold and 10% of at least 10‐fold. The antibody responses to Pneumovax II and Typhim Vi® correlated. We conclude that IgG responses to Typhim Vi® vaccination can be measured using the VaccZyme Salmonella typhi Vi IgG ELISA, and that measurement of these antibodies maybe a useful additional test to accompany Pneumovax II responses for the assessment of antibody deficiencies.
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Affiliation(s)
- C Evans
- Clinical Immunology Laboratory, Oxford University Hospitals Foundation Trust, Oxford, UK
| | - E Bateman
- Clinical Immunology Laboratory, Oxford University Hospitals Foundation Trust, Oxford, UK
| | - R Steven
- Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, UK
| | - M Ponsford
- Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, UK
| | - A Cullinane
- Clinical Immunology Laboratory, Oxford University Hospitals Foundation Trust, Oxford, UK
| | - C Shenton
- Clinical Immunology Laboratory, Oxford University Hospitals Foundation Trust, Oxford, UK
| | - G Duthie
- Infectious Disease Department, Oxford University Hospitals Foundation Trust, Oxford, UK
| | - C Conlon
- Infectious Disease Department, Oxford University Hospitals Foundation Trust, Oxford, UK
| | - S Jolles
- Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, UK
| | - A P Huissoon
- West Midlands Primary Immunodeficiency Centre, Birmingham Heartlands Hospital, Birmingham, UK
| | - H J Longhurst
- Department of Immunology, Barts Health NHS Trust, London, UK
| | - T Rahman
- Department of Immunology, Barts Health NHS Trust, London, UK
| | - C Scott
- Department of Immunology, Barts Health NHS Trust, London, UK
| | - G Wallis
- Binding Site Group Limited, Birmingham, UK
| | - S Harding
- Binding Site Group Limited, Birmingham, UK
| | - A R Parker
- Binding Site Group Limited, Birmingham, UK
| | - B L Ferry
- Clinical Immunology Laboratory, Oxford University Hospitals Foundation Trust, Oxford, UK
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