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Cockx M, Haerynck F, Hoste L, Schrijvers R, Van der Werff Ten Bosch J, Dillaerts D, Thomas D, Schaballie H, Bucciol G, Robberechts W, Patel D, Berbers G, Desombere I, Geukens N, Meyts I, Bossuyt X. Combined deficient response to polysaccharide-based and protein-based vaccines predicts a severe clinical phenotype. Clin Chem Lab Med 2024; 62:138-149. [PMID: 37731388 DOI: 10.1515/cclm-2023-0626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/31/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVES Antibody response on polysaccharide- and protein-based vaccines is useful to test B cell functionality. As only few studies have explored the value of studying immune response to both vaccines, we evaluated the clinical value of anti-polysaccharide and anti-protein Luminex-based multiplex assays in context of primary immunodeficiency (PID) diagnosis. METHODS A 10-plex Luminex-based assay detecting antibodies to ten pneumococcal polysaccharide (PnPS) serotypes [present in unconjugated Pneumovax, not in 13-valent pneumococcal conjugated vaccine (PCV)] and a 5-plex assay detecting antibodies to five protein antigens (present in DTap/Tdap) were clinically validated in healthy individuals (n=99) and in retrospective (n=399) and prospective (n=108) patient cohorts. Clinical features of individuals with impaired response to PnPS and/or proteins were compared to those with normal response. RESULTS Antigen-specific antibody thresholds were determined in healthy individuals. Individuals with impaired anti-PnPS responses and deficient immunoglobulin levels suffered more from autoimmune diseases and had lower B cell levels compared to individuals with impaired anti-PnPS response with normal immunoglobulin levels. Individuals with combined impaired response to PnPS and proteins showed more severe clinical manifestations compared to individuals with isolated impaired response to PnPS or proteins. Eight of the 11 individuals with severely impaired responses to both PnPS and proteins had common variable immunodeficiency. Evaluation of the anti-PnPS response to four serotypes not contained in 20-valent PCV was comparable to evaluation to ten serotypes not contained in 13-valent PCV. CONCLUSIONS Multiplexed assessment of anti-PnPS and anti-protein responses combined with immunoglobulin quantification provides useful clinical information to support PID diagnosis.
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Affiliation(s)
- Maaike Cockx
- Department of Microbiology, Immunology and Transplantation, University of Leuven, Leuven, Belgium
- PharmAbs, The KU Leuven Antibody Center, University of Leuven, Leuven, Belgium
| | - Filomeen Haerynck
- Department of Internal Medicine and Pediatrics, Center for Primary Immunodeficiency, PID research lab, Ghent University, Ghent, Belgium
- Department of Pediatric Pulmonology and Immunology, University Hospital Ghent, Ghent, Belgium
| | - Levi Hoste
- Department of Internal Medicine and Pediatrics, Center for Primary Immunodeficiency, PID research lab, Ghent University, Ghent, Belgium
- Department of Pediatric Pulmonology and Immunology, University Hospital Ghent, Ghent, Belgium
| | - Rik Schrijvers
- Department of Microbiology, Immunology and Transplantation, University of Leuven, Leuven, Belgium
- Department of General Internal Medicine, University Hospitals Leuven, Leuven, Belgium
| | | | - Doreen Dillaerts
- Department of Microbiology, Immunology and Transplantation, University of Leuven, Leuven, Belgium
| | - Debby Thomas
- PharmAbs, The KU Leuven Antibody Center, University of Leuven, Leuven, Belgium
- Laboratory for Therapeutic and Diagnostic Antibodies, University of Leuven, Leuven, Belgium
| | - Heidi Schaballie
- Department of Pediatrics, Division of Primary Immunodeficiencies, University Hospitals Leuven, Leuven, Belgium
| | - Giorgia Bucciol
- Department of Pediatrics, Division of Primary Immunodeficiencies, University Hospitals Leuven, Leuven, Belgium
| | - Wiert Robberechts
- Department of Pediatrics, University Hospital Brussels, Brussels, Belgium
| | - Dina Patel
- UK NEQAS Immunology, Immunochemistry & Allergy, Northern General Hospital, Sheffield, UK
| | - Guy Berbers
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, The Netherlands
| | - Isabelle Desombere
- Department of Infectious Diseases in Humans, Laboratory Immune Response, Sciensano, Brussels, Belgium
| | - Nick Geukens
- PharmAbs, The KU Leuven Antibody Center, University of Leuven, Leuven, Belgium
| | - Isabelle Meyts
- Department of Pediatrics, Division of Primary Immunodeficiencies, University Hospitals Leuven, Leuven, Belgium
- Department of Microbiology, Immunology and Transplantation, Laboratory for Inborn Errors of Immunity, University of Leuven, Leuven, Belgium
| | - Xavier Bossuyt
- Department of Microbiology, Immunology and Transplantation, University of Leuven, Leuven, Belgium
- PharmAbs, The KU Leuven Antibody Center, University of Leuven, Leuven, Belgium
- Laboratory of Clinical and Diagnostic Immunology, Leuven, Belgium
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Peterson LK. Application of vaccine response in the evaluation of patients with suspected B-cell immunodeficiency: Assessment of responses and challenges with interpretation. J Immunol Methods 2022; 510:113350. [PMID: 36067869 DOI: 10.1016/j.jim.2022.113350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 08/01/2022] [Accepted: 08/30/2022] [Indexed: 12/31/2022]
Abstract
Diagnostic vaccination is an integral component in the evaluation of patients suspected to have a B cell or humoral deficiency. Evaluation of antibody production in response to both protein- and polysaccharide-based vaccines aids in distinguishing between specific categories of humoral deficiency. Although assessment of pneumococcal polysaccharide responses is widely available and included in diagnostic guidelines, significant variability still exists in the measurement and interpretation of these responses. Interpretation can also be complicated by age, vaccination history and treatment with immunoglobulin replacement therapy. Despite the challenges and limitations of evaluating pneumococcal polysaccharide vaccine responses, it can provide valuable diagnostic and prognostic information to guide therapeutic intervention. Future efforts are needed to further standardize measurement and interpretation of pneumococcal antibody responses to vaccination and to identify and establish other methods and/or vaccines as alternatives to pneumococcal vaccination to address the challenges in certain patient populations.
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Affiliation(s)
- Lisa K Peterson
- Department of Pathology, University of Utah, 15 N Medical Dr. East Ste. 1100, Salt Lake City, UT 84112, USA; ARUP Institute for Clinical and Experimental Pathology, 500 Chipeta Way, Salt Lake City, UT 84108, USA.
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Thomas D, Dillaerts D, Cockx M, Ampofo L, She J, Desombere I, Geukens N, Bossuyt X. Development and validation of a microfluidic multiplex immunoassay for the determination of levels and avidity of serum antibodies to tetanus, diphtheria and pertussis antigens. J Immunol Methods 2022; 503:113245. [DOI: 10.1016/j.jim.2022.113245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 01/28/2022] [Accepted: 02/27/2022] [Indexed: 11/28/2022]
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Marsh RA, Orange JS. Antibody deficiency testing for primary immunodeficiency: A practical review for the clinician. Ann Allergy Asthma Immunol 2019; 123:444-453. [PMID: 31446132 DOI: 10.1016/j.anai.2019.08.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/14/2019] [Accepted: 08/18/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To review selected published studies related to the diagnostic evaluation of antibody deficiency. DATA SOURCES Published literature. STUDY SELECTIONS Studies related to the diagnostic evaluation of antibody deficiency and existing recommendations were selected. RESULTS Many primary immunodeficiency diseases include humoral deficiency. Practical tests used in the clinical evaluation of patients for possible antibody deficiency include immunoglobulin measurement, specific antibody titers, and B-cell enumeration and phenotyping. CONCLUSION Clinically available tests can be used to readily evaluate patients for antibody deficiencies.
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Affiliation(s)
- Rebecca A Marsh
- Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio; Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Jordan S Orange
- Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, New York; NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, New York
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Abstract
Immunological investigations need to be considered in any child presenting with chronic wet cough. Not infrequently, such children are subjected to a detailed, expensive battery of immune function tests, without consideration as to whether such extensive testing is necessary or indeed helpful. The main aim of this review is to discuss which immune function tests are and are not particularly helpful when investigating a child with persistent wet cough.
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Affiliation(s)
- Sam Mehr
- Department of Allergy and Immunology, Children's Hospital at Westmead, Sydney, Australia.
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Lehman HK, Hernandez-Trujillo VP, Ballow M. The use of commercially available genetic tests in immunodeficiency disorders. Ann Allergy Asthma Immunol 2008; 101:212-8. [PMID: 18727479 DOI: 10.1016/s1081-1206(10)60212-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Heather K Lehman
- Division of Allergy/Immunology, Women and Children's Hospital of Buffalo, Buffalo, New York 14222, USA.
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