1
|
Helmer L, van de Sand L, Wojtakowski T, Otte M, Witzke O, Sondermann W, Krawczyk A, Lindemann M. Antibody responses after sequential vaccination with PCV13 and PPSV23 in patients with moderate to severe plaque psoriasis under immunosuppressive therapy. mBio 2024; 15:e0048224. [PMID: 38832785 PMCID: PMC11253621 DOI: 10.1128/mbio.00482-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 04/24/2024] [Indexed: 06/05/2024] Open
Abstract
A crucial step in lowering the risk of invasive pneumococcal illness in high-risk populations, such as individuals with plaque psoriasis, is pneumococcal vaccination. The serologic response to the sequential vaccination with Prevenar 13 (PCV13) and Pneumovax 23 (PPSV23) in psoriasis patients under immunosuppressive therapy is still poorly characterized despite national recommendations suggesting vaccination for immunocompromised patients. In this prospective study, we investigated the serological response in 57 patients under active systemic treatment for moderate to severe plaque psoriasis who underwent sequential vaccination with PCV13 followed by PPSV23. Our analysis focused on global and serotype-specific anti-pneumococcal antibody responses over a 7-month period post-vaccination. Our findings reveal a robust serological response in patients with plaque psoriasis under systemic therapy. When comparing our results with a cohort of kidney transplant recipients who completed a similar sequential vaccination protocol, psoriasis patients showed higher antibody concentrations. In psoriasis patients, the mean levels of all global antibody classes tested (IgG, IgG2, IgA, IgM) increased more than 4-fold (P < 0.0001) and serotype-specific antibodies more than 1.9-fold (P < 0.01). In addition to providing strong evidence of the safety and effectiveness of sequential pneumococcal vaccination in individuals with plaque psoriasis, our work sheds light on the complex interactions that exist between immunosuppressive treatment, vaccination schedule, and antibody responses in various risk groups. IMPORTANCE To protect against severe courses of infection with Streptococcus pneumoniae, the national guidelines recommend sequential vaccination for these patients. However, there are only studies on the efficacy of a single administration of these vaccines in this particular risk group. The immunological responses to the vaccine were correlated with clinical patient data. In summary, our study shows for the first time that sequential vaccination is immunogenic in patients with moderate to severe plaque psoriasis.
Collapse
Affiliation(s)
- Lorena Helmer
- Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Lukas van de Sand
- Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Thea Wojtakowski
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Mona Otte
- Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Oliver Witzke
- Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Wiebke Sondermann
- Department of Dermatology, Venereology and Allergology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Adalbert Krawczyk
- Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, Essen, Germany
- Institute for Virology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| |
Collapse
|
2
|
Parit S, Manchare A, Gholap AD, Mundhe P, Hatvate N, Rojekar S, Patravale V. Antibody-Drug Conjugates: A promising breakthrough in cancer therapy. Int J Pharm 2024; 659:124211. [PMID: 38750981 DOI: 10.1016/j.ijpharm.2024.124211] [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: 01/09/2024] [Revised: 04/30/2024] [Accepted: 05/06/2024] [Indexed: 06/03/2024]
Abstract
Antibody-drug conjugates (ADCs) provide effective cancer treatment through the selective delivery of cytotoxic payloads to the cancer cells. They offer unparalleled precision and specificity in directing drugs to cancer cells while minimizing off-target effects. Despite several advantages, there is a requirement for innovations in the molecular design of ADC owing to drug resistance, cancer heterogeneity along the adverse effects of treatment. The review critically analyses ADC function mechanisms, unraveling the intricate interplay between antibodies, linkers, and payloads in facilitating targeted drug delivery to cancer cells. The article also highlights notable advancements in antibody engineering, which aid in creating highly selective and potent ADCs. Additionally, the review details significant progress in clinical ADC development with an in-depth examination of pivotal trials and approved formulations. Antibody Drug Conjugates (ADCs) are a ground-breaking approach to targeted drug delivery, especially in cancer treatment. They offer unparalleled precision and specificity in directing drugs to cancer cells while minimizing off-target effects. This review provides a comprehensive examination of the current state of ADC development, covering their design, mechanisms of action, and clinical applications. The article emphasizes the need for greater precision in drug delivery and explains why ADCs are necessary.
Collapse
Affiliation(s)
- Swapnali Parit
- Institute of Chemical Technology, Marathwada Campus, Jalna 431203, Maharashtra, India
| | - Ajit Manchare
- Institute of Chemical Technology, Marathwada Campus, Jalna 431203, Maharashtra, India
| | - Amol D Gholap
- Department of Pharmaceutics, St. John Institute of Pharmacy and Research, Palghar 401404, Maharashtra, India
| | - Prashant Mundhe
- Institute of Chemical Technology, Marathwada Campus, Jalna 431203, Maharashtra, India
| | - Navnath Hatvate
- Institute of Chemical Technology, Marathwada Campus, Jalna 431203, Maharashtra, India
| | - Satish Rojekar
- Institute of Chemical Technology, Marathwada Campus, Jalna 431203, Maharashtra, India; Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| | - Vandana Patravale
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, Mumbai 400019, India.
| |
Collapse
|
3
|
Boer M, de Voogd M, Niemeijer ND, van Hoeven L. Tetanus- a case report highlighting the challenges in diagnosis and treatment. Trop Dis Travel Med Vaccines 2024; 10:10. [PMID: 38822438 PMCID: PMC11143707 DOI: 10.1186/s40794-024-00220-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 03/14/2024] [Indexed: 06/03/2024] Open
Abstract
Tetanus has become an increasingly rare infectious disease due to the development of successful vaccination programs in the mid-20th century. In resource-rich countries, mainly unvaccinated or partly vaccinated risk groups are affected, whereas tetanus still remains prevalent in resource-limited countries. The decreasing incidence in developed countries has hindered clinical trials evaluating the best treatment modalities for tetanus infections. Current guidelines are based on a small number of studies and case reports. So far, these studies have shown potential benefits of treating tetanus infections with benzodiazepines, magnesium sulfate and baclofen. Additionally, several treatments have been shown to be useful in stabilizing and supporting patients with tetanus. However, each treatment modality has limitations, from negative side effects to logistical challenges, especially in developing countries. Therefore, further knowledge is required to evaluate the best use of each treatment and to further optimize patient care. This knowledge can contribute to the reduction of the burden of disease in countries where tetanus remains prevalent and where resources are limited, though vaccination is the most effective method to achieve this. This case report describes the treatment of a Dutch patient with tetanus infection and illustrates the role of benzodiazepines as well as other key aspects of treating patients with tetanus.
Collapse
Affiliation(s)
- Menno Boer
- Department of Internal Medicine, IJsselland Hospital, Capelle aan den IJssel, The Netherlands
| | - Martijn de Voogd
- Department of Internal Medicine, IJsselland Hospital, Capelle aan den IJssel, The Netherlands
| | | | - Lonneke van Hoeven
- Department of Internal Medicine, IJsselland Hospital, Capelle aan den IJssel, The Netherlands.
| |
Collapse
|
4
|
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.
Collapse
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
| |
Collapse
|
5
|
Hilal MA, Kuemmerli C, Sijberden JP, Moekotte A, Zimmitti G, Alseidi A, Asbun HJ, Marudanayagam R, Bonds M, Kunzler F, Sutcliffe R, Eren E, Primrose JN, Williams AP. Autogenic splenic implantation versus splenectomy in patients undergoing distal pancreatectomy for benign or low-grade malignant lesions of the distal pancreas: study protocol for a multicentre, open-label, randomized controlled trial (RESTORE). Trials 2024; 25:31. [PMID: 38195501 PMCID: PMC10775497 DOI: 10.1186/s13063-023-07714-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 10/07/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND The spleen plays a significant role in the clearance of circulating microorganisms. Sequelae of splenectomy, especially immunodeficiency, can have a deleterious effect on a patient's health and even lead to death. Hence, splenectomy should be avoided and spleen preservation during elective surgery has become a treatment goal. However, this cannot be achieved in every patient due to intraoperative technical difficulties or oncological reasons. Autogenic splenic implantation (ASI) is currently the only possible way to preserve splenic function when a splenectomy is necessary. Experience largely stems from trauma patients with a splenic rupture. Splenic immune function can be measured by the body's clearing capacity of encapsulated bacteria. The aim of this study is to assess the splenic immune function after ASI was performed during minimally invasive (laparoscopic or robotic) distal pancreatectomy with splenectomy. METHODS This is the protocol for a multicentre, randomized, open-labelled trial. Thirty participants with benign or low-grade malignant lesions of the distal pancreas requiring minimally invasive distal pancreatectomy and splenectomy will be allocated to either additional intraoperative ASI (intervention) or no further intervention (control). An additional 15 patients who will undergo spleen-preserving distal pancreatectomy serve as the control group with normal splenic function. Six months postoperatively, after assumed restoration of splenic function, patients will be given a Salmonella typhi (Typhim Vi™) vaccine. The Salmonella typhi vaccine is a polysaccharide vaccine. The specific antibody titres immediately before and 4 to 6 weeks after vaccination will be measured. The ratio between pre- and post-vaccination antibody count is the primary outcome measure and secondary outcome measures include intraoperative details, length of hospital stay, 30-day mortality and morbidity. DISCUSSION This study will investigate the splenic immune function of patients who undergo ASI during minimally invasive distal pancreatectomy with splenectomy. The splenic immune function will be measured using the surrogate outcome of specific antibody titre after vaccination with a Salmonella typhi vaccine. The results will reveal details about splenic function after ASI and guide further treatment options for patients when a splenectomy cannot be avoided. It might eventually lead to a new standard of care making sometimes more demanding and time-consuming spleen-preserving procedures redundant. TRIAL REGISTRATION International Standard Randomized Controlled Trials Number (ISRCTN) ISRCTN10171587. Prospectively registered on 18 February 2019.
Collapse
Affiliation(s)
- Mohammed Abu Hilal
- Department of Surgery, Fondazione Poliambulanza Istituto Ospedaliero, Via Leonida Bissolati, 57, 25124, Brescia, Italy.
- Department of Surgery, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 2YD, UK.
| | - Christoph Kuemmerli
- Department of Surgery, Fondazione Poliambulanza Istituto Ospedaliero, Via Leonida Bissolati, 57, 25124, Brescia, Italy
- Department of Surgery, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 2YD, UK
| | - Jasper P Sijberden
- Department of Surgery, Fondazione Poliambulanza Istituto Ospedaliero, Via Leonida Bissolati, 57, 25124, Brescia, Italy
- Department of Surgery, Amsterdam UMC Location, University of Amsterdam, Amsterdam, The Netherlands
| | - Alma Moekotte
- Department of Surgery, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 2YD, UK
| | - Giuseppe Zimmitti
- Department of Surgery, Fondazione Poliambulanza Istituto Ospedaliero, Via Leonida Bissolati, 57, 25124, Brescia, Italy
| | - Adnan Alseidi
- Division of Hepatopancreatobiliary and Endocrine Surgery, Virginia Mason Medical Center, Seattle, WA, USA
- Department of Surgery, University of California - San Francisco, San Francisco, CA, USA
| | - Horacio J Asbun
- Division of Hepatobiliary and Pancreas Surgery, Miami Cancer Institute, Miami, FL, USA
| | - Ravi Marudanayagam
- Department of Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Morgan Bonds
- Division of Hepatopancreatobiliary and Endocrine Surgery, Virginia Mason Medical Center, Seattle, WA, USA
| | - Filipe Kunzler
- Division of Hepatobiliary and Pancreas Surgery, Miami Cancer Institute, Miami, FL, USA
| | - Robert Sutcliffe
- Department of Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Efrem Eren
- NIHR Southampton Clinical Research Facility, NIHR Southampton Biomedical Research Centre and Southampton NIHR CRUK Experimental Cancer Medicine Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - John N Primrose
- Department of Surgery, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 2YD, UK
| | - Anthony P Williams
- NIHR Southampton Clinical Research Facility, NIHR Southampton Biomedical Research Centre and Southampton NIHR CRUK Experimental Cancer Medicine Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| |
Collapse
|
6
|
Mülling N, van de Sand L, Völk K, Aufderhorst UW, van der Linden M, Horn PA, Kribben A, Wilde B, Krawczyk A, Witzke O, Lindemann M. Antibody responses after sequential vaccination with PCV13 and PPSV23 in kidney transplant recipients. Infection 2023; 51:1703-1716. [PMID: 37243960 PMCID: PMC10665231 DOI: 10.1007/s15010-023-02054-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/16/2023] [Indexed: 05/29/2023]
Abstract
PURPOSE Vaccination against Streptococcus pneumoniae is recommended in transplant recipients to reduce the morbidity and mortality from invasive pneumococcal disease. Previous studies indicate that transplant recipients can produce specific antibodies after vaccination with the 13-valent pneumococcal conjugate vaccine Prevenar 13 (PCV13) or the pneumococcal polysaccharide vaccine Pneumovax 23 (PPSV23). National guidelines recommend sequential vaccination with PCV13 followed by PPSV23 in kidney transplant patients. However, there are currently no data on the serological response in kidney transplant recipients, who received a sequential vaccination with PCV13 and PPSV23. METHODS In the current study, we sequentially vaccinated 46 kidney transplant recipients with PCV13 and PPSV23 and determined global and serotype-specific anti-pneumococcal antibody responses in the year following vaccination. RESULTS Serotype-specific and global anti-pneumococcal antibody concentrations were significantly higher compared to baseline. We observed that serotype-specific antibody responses varied by serotype (between 2.2- and 2.9-fold increase after 12 months). The strongest responses after 12 months were detected against the serotypes 9N (2.9-fold increase) and 14 (2.8-fold increase). Global antibody responses also varied with respect to immunoglobulin class. IgG2 revealed the highest increase (2.7-fold), IgM the lowest (1.7-fold). Sequential vaccination with both vaccines achieved higher antibody levels in comparison with a historical cohort studied at our institute, that was vaccinated with PCV13 alone. During the 12-months follow-up period, none of the patients developed pneumococcal-associated pneumonia or vaccination-related allograft rejection. CONCLUSION In conclusion, we strongly recommend sequential vaccination over single immunization in kidney transplant recipients.
Collapse
Affiliation(s)
- Nils Mülling
- Department of Nephrology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Lukas van de Sand
- Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Kim Völk
- Department of Nephrology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
- Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, Essen, Germany
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | | | - Mark van der Linden
- Department of Medical Microbiology, German National Reference Center for Streptococci, University Hospital Aachen (RWTH), Aachen, Germany
| | - Peter A Horn
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Andreas Kribben
- Department of Nephrology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Benjamin Wilde
- Department of Nephrology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Adalbert Krawczyk
- Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Oliver Witzke
- Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
| |
Collapse
|
7
|
Engelmaier A, Butterweck HA, Weber A. Stability assessment of anti-bacterial antibodies in immunoglobulin G-depleted serum with validated immunoassays. Immunotherapy 2023; 15:1459-1476. [PMID: 37753548 DOI: 10.2217/imt-2023-0127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023] Open
Abstract
Aim: To investigate the stability of the anti-pneumococcal (PCP) and anti-haemophilus type B (Hib) immunoglobulins (IgGs) in human IgG-depleted serum samples frozen at -20°C. Materials & methods: Modified commercially available immunoassays (ELISAs) were bioanalytically validated. These ELISAs were used to measure levels of the two anti-bacterial IgG in samples kept at -20°C for up to 15 months. Human IgG-depleted serum was spiked with GAMMAGARD Liquid to obtain those samples. Results: Both ELISAs passed the validation test. Anti-PCP IgG and anti-Hib IgG were shown to be stable for at least 15 months at -20°C. Conclusion: These data confirm the stability of anti-bacterial IgG in human IgG-depleted serum and support the common practice of testing frozen samples.
Collapse
Affiliation(s)
- Andrea Engelmaier
- Baxalta Innovations GmbH, part of Takeda, Pharmaceutical Science, Vienna A-1220, Austria
| | - Harald A Butterweck
- Baxalta Innovations GmbH, part of Takeda, Plasma Derived Therapies R&D, Vienna A-1220, Austria
| | - Alfred Weber
- Baxalta Innovations GmbH, part of Takeda, Plasma Derived Therapies R&D, Vienna A-1220, Austria
| |
Collapse
|
8
|
Baloh CH, Venturi GM, Fischer BM, Sadder LS, Kim-Chang JJ, Chan C, De Paris K, Yin L, Aldrovandi GM, Goodenow MM, Sleasman JW. Biomarkers detected in cord blood predict vaccine responses in young infants. Front Immunol 2023; 14:1152538. [PMID: 37251388 PMCID: PMC10213698 DOI: 10.3389/fimmu.2023.1152538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/24/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction Factors influencing vaccine immune priming in the first year of life involve both innate and adaptive immunity but there are gaps in understanding how these factors sustain vaccine antibody levels in healthy infants. The hypothesis was that bioprofiles associated with B cell survival best predict sustained vaccine IgG levels at one year. Methods Longitudinal study of plasma bioprofiles in 82 term, healthy infants, who received standard recommended immunizations in the United States, with changes in 15 plasma biomarker concentrations and B cell subsets associated with germinal center development monitored at birth, soon after completion of the initial vaccine series at 6 months, and prior to the 12-month vaccinations. Post vaccination antibody IgG levels to Bordetella pertussis, tetanus toxoid, and conjugated Haemophilus influenzae type B (HiB) were outcome measures. Results Using a least absolute shrinkage and selection operator (lasso) regression model, cord blood (CB) plasma IL-2, IL-17A, IL-31, and soluble CD14 (sCD14) were positively associated with pertussis IgG levels at 12 months, while CB plasma concentrations of APRIL and IL-33 were negatively associated. In contrast, CB concentrations of sCD14 and APRIL were positively associated with sustained tetanus IgG levels. A separate cross-sectional analysis of 18 mother/newborn pairs indicated that CB biomarkers were not due to transplacental transfer, but rather due to immune activation at the fetal/maternal interface. Elevated percentages of cord blood switched memory B cells were positively associated with 12-month HiB IgG levels. BAFF concentrations at 6 and 12 months were positively associated with pertussis and HiB IgG levels respectively. Discussion Sustained B cell immunity is highly influenced by early life immune dynamics beginning prior to birth. The findings provide important insights into how germinal center development shapes vaccine responses in healthy infants and provide a foundation for studies of conditions that impair infant immune development.
Collapse
Affiliation(s)
- Carolyn H. Baloh
- Division of Allergy and Immunology, Department of Pediatrics, Duke University School of Medicine, Durham, NC, United States
| | - Guglielmo M. Venturi
- Division of Allergy and Immunology, Department of Pediatrics, Duke University School of Medicine, Durham, NC, United States
| | - Bernard M. Fischer
- Division of Allergy and Immunology, Department of Pediatrics, Duke University School of Medicine, Durham, NC, United States
| | - Liane S. Sadder
- Division of Allergy and Immunology, Department of Pediatrics, Duke University School of Medicine, Durham, NC, United States
| | - Julie J. Kim-Chang
- Division of Allergy and Immunology, Department of Pediatrics, Duke University School of Medicine, Durham, NC, United States
| | - Cliburn Chan
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, United States
| | - Kristina De Paris
- Institute of Global Health and Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Department of Microbiology and Immunology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Li Yin
- Molecular HIV Host Interactions Section, National Institute of Allergy and Infectious Diseases, Bethesda, MD, United States
| | - Grace M. Aldrovandi
- Division of Infectious Diseases, Department of Pediatrics, University of California, Los Angeles, CA, United States
| | - Maureen M. Goodenow
- Molecular HIV Host Interactions Section, National Institute of Allergy and Infectious Diseases, Bethesda, MD, United States
| | - John W. Sleasman
- Division of Allergy and Immunology, Department of Pediatrics, Duke University School of Medicine, Durham, NC, United States
| |
Collapse
|
9
|
Aguinagalde Salazar L, den Boer MA, Castenmiller SM, Zwarthoff SA, de Haas C, Aerts PC, Beurskens FJ, Schuurman J, Heck AJR, van Kessel K, Rooijakkers SHM. Promoting Fc-Fc interactions between anti-capsular antibodies provides strong immune protection against Streptococcus pneumoniae. eLife 2023; 12:80669. [PMID: 36947116 PMCID: PMC10032657 DOI: 10.7554/elife.80669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 03/09/2023] [Indexed: 03/23/2023] Open
Abstract
Streptococcus pneumoniae is the leading cause of community-acquired pneumonia and an important cause of childhood mortality. Despite the introduction of successful vaccines, the global spread of both non-vaccine serotypes and antibiotic-resistant strains reinforces the development of alternative therapies against this pathogen. One possible route is the development of monoclonal antibodies (mAbs) that induce killing of bacteria via the immune system. Here, we investigate whether mAbs can be used to induce killing of pneumococcal serotypes for which the current vaccines show unsuccessful protection. Our study demonstrates that when human mAbs against pneumococcal capsule polysaccharides (CPS) have a poor capacity to induce complement activation, a critical process for immune protection against pneumococci, their activity can be strongly improved by hexamerization-enhancing mutations. Our data indicate that anti-capsular antibodies may have a low capacity to form higher-order oligomers (IgG hexamers) that are needed to recruit complement component C1. Indeed, specific point mutations in the IgG-Fc domain that strengthen hexamerization strongly enhance C1 recruitment and downstream complement activation on encapsulated pneumococci. Specifically, hexamerization-enhancing mutations E430G or E345K in CPS6-IgG strongly potentiate complement activation on S. pneumoniae strains that express capsular serotype 6 (CPS6), and the highly invasive serotype 19A strain. Furthermore, these mutations improve complement activation via mAbs recognizing CPS3 and CPS8 strains. Importantly, hexamer-enhancing mutations enable mAbs to induce strong opsonophagocytic killing by human neutrophils. Finally, passive immunization with CPS6-IgG1-E345K protected mice from developing severe pneumonia. Altogether, this work provides an important proof of concept for future optimization of antibody therapies against encapsulated bacteria.
Collapse
Affiliation(s)
| | - Maurits A den Boer
- Biomolecular Mass Spectrometry and Proteomics, Bijvoet Center for Biomolecular Research and Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
- Netherlands Proteomics Center, Utrecht, Netherlands
| | - Suzanne M Castenmiller
- Medical Microbiology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Seline A Zwarthoff
- Medical Microbiology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Carla de Haas
- Medical Microbiology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Piet C Aerts
- Medical Microbiology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | | | | | - Albert J R Heck
- Biomolecular Mass Spectrometry and Proteomics, Bijvoet Center for Biomolecular Research and Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
- Netherlands Proteomics Center, Utrecht, Netherlands
| | - Kok van Kessel
- Medical Microbiology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Suzan H M Rooijakkers
- Medical Microbiology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| |
Collapse
|
10
|
IgG antibody response to pneumococcal-conjugated vaccine (Prevenar®13) in children with immunodeficiency disorders. Med Microbiol Immunol 2023; 212:93-102. [PMID: 36595027 DOI: 10.1007/s00430-022-00759-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 12/01/2022] [Indexed: 01/04/2023]
Abstract
Measurement of anti-pneumococcal capsular polysaccharides (anti-PnPs) IgG titers is an important tool in the immunologic assessment of patients with suspected immunodeficiency disorders (ID) to reduce the morbi-mortality and minimize severe infections. Retrospectively, we studied the relationship among anti-PnPs IgG response to 3 doses of Prevenar®13, levels of immune system components, leukocyte populations, and clinical data in children with ID. Serum samples were collected at least 4 weeks post vaccination. Subsequently, multi-serotype enzyme-linked immunosorbent assay (ELISA) was performed. Eighty-seven children (under 12 years) were enrolled. Primary immunodeficiency disorder (PID) was the most common disorder (45) followed by possible immunodeficiency disorder (POID) (19), secondary immunodeficiency disorder (SID) (15), and mixed immunodeficiency disorder (MID) (8). The median age was 3 (1.50-5.33) years, 65% of patients were male. Deficient production of anti-PnPs IgG (titer ≤ 50 mg/L) was detected in 47 patients (54%), especially in the MID group, all of them under immunosuppressive therapy. In PCV13 responders, the mean of leukocyte population levels was higher with statistically significance differences in CD4 + /CD8 + T lymphocytes (p = 0.372, p = 0.014) and CD56 + /CD16 + NK (p = 0.016). Patients with previous bone marrow transplantation were the worst PCV13 responders. Pneumococcal IgG antibody titers (post-vaccination) along with clinical and analytical markers represented.
Collapse
|
11
|
Kosten TR, Domingo CB, Haile CN, Nielsen DA. A Clinical Trial of Entolimod a TLR-5 Adjuvant for Vaccines Using Diphtheria or Tetanus as Carrier Proteins. Vaccines (Basel) 2022; 10:vaccines10101592. [PMID: 36298456 PMCID: PMC9611255 DOI: 10.3390/vaccines10101592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/19/2022] [Accepted: 09/19/2022] [Indexed: 11/30/2022] Open
Abstract
Anti-drug vaccines previously failed clinical trials because they did not provide a sufficient titer or duration of antibodies (AB), but new adjuvants enhance both AB titers and efficacy duration. This clinical trial assessed AB titers after a single booster of commercial tetanus-diphtheria (Td) vaccine in 40 males randomized as 15 to Td alone and 25 to Td combined with the TLR5 adjuvant, Entolimod (Ent). Ent significantly increased ABs against diphtheria (DPT) (0.46 vs. 0.29 IU/mL increase; n = 40, p < 0.05), but against tetanus (TT) only if baseline TT AB was below 3 IU/mL (3.1 vs. 2.1 IU/mL; n = 20; p < 0.05). These 20 participants also showed a two-fold increase in anti-TT AB titer more often when given Ent than non-Ent (33% vs. 82%) (p < 0.03). Anti-Ent AB was low and appeared unlikely to reduce Ent efficacy after repeated Ent administration. Medical safety was excellent, and a TLR5 missense polymorphism reduced anti-DPT AB production, but Ent increased anti-DPT AB titers to levels induced in subjects with genetically “normal” TRL5 functioning. Further clinical testing of TLR5 adjuvants like Ent seems warranted for anti-drug vaccines.
Collapse
Affiliation(s)
- Thomas R. Kosten
- Department of Psychiatry and Immunology, Baylor College of Medicine, Houston, TX 77030, USA
- Correspondence: ; Tel.: +1-832-331-0052
| | - Coreen B. Domingo
- Department of Psychiatry and Immunology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Colin N. Haile
- Department of Psychology, University of Houston, Houston, TX 77004, USA
| | - David A. Nielsen
- Department of Psychiatry, Baylor College of Medicine, Houston, TX 77030, USA
| |
Collapse
|
12
|
Barton JC, Barton JC, Bertoli LF. Hydroxychloroquine Therapy and Serum Immunoglobulin Levels in Women with IgG Subclass Deficiency and Systemic Lupus Erythematosus, Sjögren Syndrome, and Rheumatoid Arthritis: A Retrospective Study. Arch Immunol Ther Exp (Warsz) 2022; 70:14. [PMID: 35403913 DOI: 10.1007/s00005-022-00652-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 03/08/2022] [Indexed: 11/30/2022]
Abstract
Hydroxychloroquine (HCQ) therapy decreased immunoglobulin (Ig) levels in patients with Sjögren syndrome (SS) and rheumatoid arthritis (RA) in previous studies. We found no report of Ig levels of women with IgG subclass deficiency (IgGSD) and systemic lupus erythematosus (SLE), SS, or RA treated with HCQ. We retrospectively evaluated IgG, IgG subclass, IgA, and IgM levels and other characteristics of women at IgGSD diagnosis who did and did not take HCQ for SLE, SS, or RA. There were 132 women (48 subnormal IgG1 only, 49 combined subnormal IgG1/IgG3, and 35 subnormal IgG3 only). Mean age was 49 ± 13 years. Twenty-two women with SLE, SS, RA, or combination thereof reported HCQ ≥ 200 mg/day ≥ 6 months. In each IgGSD subtype, median Ig levels of women who took HCQ were not significantly lower than those of women who did not take HCQ. Women with combined subnormal IgG1/IgG3 who took HCQ had greater median IgG2 than women who did not take HCQ (4.89 g/L (range 4.43, 4.94) vs. 2.57 g/L (1.21, 6.44), respectively; p = 0.0123). Regressions on IgG1, IgG2, and IgG3 revealed positive associations with HCQ therapy (p = 0.0043, 0.0037, and 0.0139, respectively). There were no significant Ig associations with age, SLE, SS, or RA as independent variables. HCQ therapy of SLE, SS, or RA in women with IgGSD was not associated with significantly lower IgG, IgG subclass, IgA, or IgM levels. IgG1, IgG2, and IgG3 were positively associated with HCQ therapy, after adjustment for other variables.
Collapse
Affiliation(s)
- James C Barton
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. .,Southern Iron Disorders Center, Birmingham, AL, USA. .,Department of Medicine, Brookwood Medical Center, Birmingham, AL, USA.
| | | | - Luigi F Bertoli
- Department of Medicine, Brookwood Medical Center, Birmingham, AL, USA
| |
Collapse
|
13
|
Lahimgarzadeh R, Vaseghi S, Nasehi M, Rouhollah F. Effect of multi-epitope derived from HIV-1 on REM sleep deprivation-induced spatial memory impairment with respect to the level of immune factors in mice. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2022; 25:164-172. [PMID: 35655593 PMCID: PMC9124535 DOI: 10.22038/ijbms.2022.61175.13536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 01/19/2022] [Indexed: 11/08/2022]
Abstract
Objectives Sleep deprivation (SD) has a negative impact on cognitive functions including learning and memory. Many studies have shown that rapid-eye-movement (REM) SD also disrupts memory performance. In this study, we aimed to investigate the effect of multi-epitope Gag-Pol-Env-Tat derived from Human immunodeficiency virus 1 (HIV-1) on REM SD-induced spatial memory impairment with respect to the levels of interleukin-4 (IL-4), interleukin-17 (IL-17), interferon-gamma (IFN-γ), immunoglobulin G1 (IgG1), immunoglobulin G2a (IgG2a), and lymphocyte proliferation in NMRI mice. We used multi-epitope Gag-Pol-Env-Tat derived from HIV-1 because Gag-Pol-Env-Tat immunogen sequence is one of the most sensitive immunogen sequences of HIV-1 that can significantly augment cellular and humoral immune systems, leading to the improvement of cognitive functions. Materials and Methods Morris water maze apparatus was used to assess spatial memory, and multi-platform apparatus was used to induce RSD for 24 hr. Multi-epitope derived from HIV-1 was subcutaneously injected at the dose of 20 µgr/ml, once and fourteen days before RSD. Results RSD impaired spatial memory and injection of multi-epitope derived from HIV-1 reversed this effect. RSD decreased IL-4, IgG1, and IgG2a levels, while multi-epitope derived from HIV-1 reversed these effects. Multi-epitope derived from HIV-1 also increased lymphocyte proliferation and decreased IL-17 levels in both control and RSD mice. Conclusion Multi-epitope derived from HIV-1 may improve memory performance via induction of anti-inflammatory immune response.
Collapse
Affiliation(s)
- Roya Lahimgarzadeh
- Department of Cellular and Molecular Biology, Faculty of Advanced Science and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Salar Vaseghi
- Medicinal Plants Research Center, Institute of Medicinal Plants, ACECR, Karaj, Iran
| | - Mohammad Nasehi
- Department of Cognitive Neuroscience, Institute for Cognitive Science Studies (ICSS), Tehran, Iran ,Cognitive and Neuroscience Research Center (CNRC), Amir-Almomenin Hospital, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Fatemeh Rouhollah
- Department of Cellular and Molecular Biology, Faculty of Advanced Science and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran ,Corresponding author: Fatemeh Rouhollah. Department of Cellular and Molecular Biology, Faculty of Advanced Science and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran. Tel: +98-21-66402569; Fax: +98-21-66402569;
| |
Collapse
|
14
|
Salzer U, Müller A, Zhou Q, Nieters A, Grundmann S, Wehr C. Susceptibility to infections and adaptive immunity in adults with heart failure. ESC Heart Fail 2022; 9:1195-1205. [PMID: 35032103 PMCID: PMC8934962 DOI: 10.1002/ehf2.13793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/25/2021] [Accepted: 12/14/2021] [Indexed: 12/11/2022] Open
Abstract
Aims Heart failure (HF) is a systemic inflammatory disorder with infections being an important cause of morbidity and mortality. We asked if HF patients have a higher susceptibility to infections compared with the general population and if a subtle secondary immunodeficiency facilitates infectious complications. Methods and results In a cohort of 92 patients with HF with reduced ejection fraction, we analysed recirculating lymphocyte subpopulations, serum immunoglobulin levels, and specific antibody titres against pneumococcal antigens. We quantified susceptibility to infections of the respiratory tract with a validated questionnaire and compared it to the general population. Susceptibility to infections of the respiratory tract was comparable in HF patients and the general population. Hypogammaglobulinaemia was present in 16% of HF patients, but anti‐pneumococcal titres showed no evidence of specific secondary antibody deficiency. Relative lymphopaenia in our HF cohort was due to B lymphocytopenia with a relative reduction in naive B‐cells and expansion of memory B‐cells while CD4+ and CD8+ T‐lymphocytes as well as NK‐cell counts were comparable between HF and healthy donors. The intake of the angiotensin receptor neprilysin (CD10) inhibitor (ARNI) sacubitril/valsartan was associated with increased B‐lymphocyte counts, possibly by an increased output of CD10+ transitional B lymphocytes from the bone marrow. Conclusion Despite a reduction of B lymphocytes in HF and mild hypogammaglobulinaemia, patients showed no evidence of secondary immunodeficiency or increased susceptibility to infections. The relevance of B‐cell lymphopenia in HF patients and modulation of B‐cell counts under ARNI treatment remains to be investigated.
Collapse
Affiliation(s)
- Ulrich Salzer
- Department of Rheumatology and Clinical Immunology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Alisa Müller
- Department of General Paediatrics, Children's Hospital, University of Bonn, Bonn, Germany.,Center for Chronic Immunodeficiency, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Qian Zhou
- University Heart Center Freiburg-Bad Krozingen, Department of Cardiology and Angiology I, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Department of Medicine, Division of Cardiology, University Hospital Basel, Basel, Switzerland
| | - Alexandra Nieters
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sebastian Grundmann
- University Heart Center Freiburg-Bad Krozingen, Department of Cardiology and Angiology I, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Claudia Wehr
- Center for Chronic Immunodeficiency, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| |
Collapse
|
15
|
Barton JC, Barton JC, Bertoli LF, Acton RT. Factors associated with IgG levels in adults with IgG subclass deficiency. BMC Immunol 2021; 22:53. [PMID: 34372773 PMCID: PMC8353875 DOI: 10.1186/s12865-021-00447-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 08/04/2021] [Indexed: 12/12/2022] Open
Abstract
Background Factors associated with IgG levels in adults with IgG subclass deficiency (IgGSD) are incompletely understood. We studied adults with IgGSD with subnormal IgG1 only, subnormal IgG1/IgG3, or subnormal IgG3 only without other subnormal IgG subclasses, IgA, or IgM. We compiled: age; sex; autoimmune condition(s) (AC); atopy; IgG, IgG subclasses, IgA, IgM; IgGsum (IgG1 + IgG2 + IgG3 + IgG4); and D (percentage difference between IgGsum and IgG). We compared attributes of patients with/without subnormal IgG (< 7.00 g/L; subnormal IgG1 subclass groups only) and analyzed IgGsum and IgG relationships. We performed backward stepwise regressions on IgG using independent variables IgG subclasses, age, and sex and on D using independent variables age and sex. Results There were 39 patients with subnormal IgG1 only (89.7% women), 53 with subnormal IgG1/IgG3 (88.7% women), and 115 with subnormal IgG3 only (91.3% women). Fifteen patients (38.5%) and 32 patients (60.4%) in the respective subnormal IgG1 subclass groups had subnormal IgG. Attributes of patients with/without IgG < 7.00 g/L were similar, except that AC prevalence was lower in patients with subnormal IgG1 only and IgG < 7.00 g/L than ≥ 7.00 g/L (p = 0.0484). Mean/median IgG1 and IgG2 were significantly lower in patients with IgG < 7.00 g/L in both subnormal IgG1 subclass groups (p < 0.0001, all comparisons). Regressions on IgG in three subclass groups revealed positive associations with IgG1 and IgG2 (p < 0.0001 each association). Regressions on D revealed no significant association. IgG1 percentages of IgGsum were lower and IgG2 percentages were higher in patients with subnormal IgG1 subclass levels than subnormal IgG3 only (p < 0.0001 all comparisons). Conclusions We conclude that both IgG1 and IgG2 are major determinants of IgG in patients with subnormal IgG1, combined subnormal IgG1/IgG3, or subnormal IgG3 and that in patients with subnormal IgG1 or combined subnormal IgG1/IgG3, median IgG2 levels are significantly lower in those with IgG < 7.00 g/L than those with IgG ≥ 7.00 g/L. Supplementary Information The online version contains supplementary material available at 10.1186/s12865-021-00447-3.
Collapse
Affiliation(s)
- James C Barton
- University of Alabama at Birmingham, Birmingham, AL, USA. .,Southern Iron Disorders Center, Birmingham, AL, USA. .,Department of Medicine, Brookwood Medical Center, Birmingham, AL, USA.
| | | | - Luigi F Bertoli
- Southern Iron Disorders Center, Birmingham, AL, USA.,Department of Medicine, Brookwood Medical Center, Birmingham, AL, USA
| | - Ronald T Acton
- Southern Iron Disorders Center, Birmingham, AL, USA.,Department of Microbiology, University of Alabama At Birmingham, Birmingham, AL, USA
| |
Collapse
|
16
|
Guevara-Hoyer K, Jiménez-Huete A, Vasconcelos J, Neves E, Sánchez-Ramón S. Variable immunodeficiency score upfront analytical link (VISUAL), a proposal for combined prognostic score at diagnosis of common variable immunodeficiency. Sci Rep 2021; 11:12211. [PMID: 34108596 PMCID: PMC8190250 DOI: 10.1038/s41598-021-91791-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 05/28/2021] [Indexed: 02/05/2023] Open
Abstract
The broad and heterogeneous clinical spectrum that characterizes common variable immunodeficiency (CVID) is associated with quite different disease course and prognosis, highlighting the need to develop tools that predict complications. We developed a multianalyte VISUAL score (variable immunodeficiency score upfront analytical link) aimed to predict severity using individual CVID patient data at baseline of a cohort of 50 CVID patients from two different centers in Portugal and Spain. We retrospectively applied VISUAL to the CVID clinical severity scores proposed by Ameratunga and Grimbacher after 15 years follow-up of our cohort. VISUAL score at CVID diagnosis showed adequate performance for predicting infectious and non-infectious severe complications (Cluster B). Compared to switched memory B lymphocyte phenotype alone, VISUAL provided a more accurate identification of clinically meaningful outcome, with significantly higher sensitivity (85% vs 55%, p = 0.01), and negative predictive value (77% vs 58%) and AUC of the ROC curves (0.72 vs 0.64), with optimal cut-off level of 10. For every increase of 1 point in the VISUAL scale, the odds of being in the higher risk category (Cluster B) increased in 1.3 (p = 0.005) for Ameratunga's severity score and 1.26 (p = 0.004) for Grimbacher's severity score. At diagnosis of CVID, VISUAL score ≥ 10 showed 8.94-fold higher odds of severe prognosis than below this threshold. Kaplan-Meier estimates for the VISUAL ≥ 10 points showed significantly earlier progression to Cluster B than those with VISUAL < 10 (p = 0.0002). This prognostic laboratory score might allow close monitoring and more aggressive treatment in patients with scores ≥ 10 on a personalized basis approach. Further studies are needed to prospectively validate VISUAL score.
Collapse
Affiliation(s)
- Kissy Guevara-Hoyer
- grid.411068.a0000 0001 0671 5785Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain ,grid.4795.f0000 0001 2157 7667Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University, Madrid, Spain ,Immunodeficiency Interdepartmental Group (GIID), Madrid, Spain
| | - Adolfo Jiménez-Huete
- grid.413297.a0000 0004 1768 8622Department of Neurology, Hospital Ruber Internacional, Madrid, Spain
| | - Julia Vasconcelos
- grid.5808.50000 0001 1503 7226Department of Immunology, Centro Hospitalar e Universitário do Porto, Porto, Portugal
| | - Esmeralda Neves
- grid.5808.50000 0001 1503 7226Department of Immunology, Centro Hospitalar e Universitário do Porto, Porto, Portugal
| | - Silvia Sánchez-Ramón
- grid.411068.a0000 0001 0671 5785Department of Immunology, IML and IdSSC, Hospital Clínico San Carlos, Madrid, Spain ,grid.4795.f0000 0001 2157 7667Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University, Madrid, Spain ,Immunodeficiency Interdepartmental Group (GIID), Madrid, Spain
| |
Collapse
|
17
|
Age-Related Dynamics in Post-Vaccine Antibody Immune Response to Diphtheria and Tetanus Toxoid in Bulgarian Subjects. ACTA MEDICA BULGARICA 2021. [DOI: 10.2478/amb-2021-0007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Abstract
In this study, we investigated the age-related dynamics in post-vaccine humoral immunity to diphtheria (DT) and tetanus (TT) toxoids in the Bulgarian population. In addition, we attempted to correlate the titers of specific antibodies with the predisposition to more common infectious pathology among our study participants. The 208 individuals tested were divided into five age groups: 0-4, 4-6, 6-12, 12-17 and 17-66 years, based on the vaccines received according to the immunization schedule in Bulgaria. Vaccine response was determined by measuring the concentrations of specific IgG antibodies using commercial ELISA kits. Sufficient protective levels of diphtheria (> 0.1 IU/mL) and tetanus (> 0.15 IU/mL) antitoxin were detected in 63.5% and 85.1% of all subjects, respectively. The highest rates of protection against both TT (94.3%) and DT (79.2%) were observed in the youngest age group (0-4 years). We also observed a relatively high rate of insufficient protection (< 0.1 IU/ml) against diphtheria (36% of individuals tested across all age groups) in comparison to tetanus (14.9% of all subjects). The rate of insufficient protection against both antigens was higher among children with frequent infections. Moreover, 77.1% of the individuals having low antibody titers against the highly immunogenic tetanus toxoid, also had low levels of diphtheria antibodies. The level of seroprotection is better for tetanus than for diphtheria toxoid at any age. In conclusion, our data provide information on the level of immunity to diphtheria and tetanus among vaccinated individuals in Bulgaria and allows for the identification of persons suspected of having an immune deficiency. Additional investigations are needed in order to provide reliable recommendations for the national vaccine program and personalized vaccinations.
Collapse
|
18
|
Garrido-Jareño M, Puchades-Carrasco L, Orti-Pérez L, Sahuquillo-Arce JM, Del Carmen Meyer-García M, Mollar-Maseres J, Lloret-Sos C, Gil-Brusola A, López-Hontangas JL, Beltrán-Garrido JM, Pemán-García J, Pineda-Lucena A. A surface plasmon resonance based approach for measuring response to pneumococcal vaccine. Sci Rep 2021; 11:6502. [PMID: 33753824 PMCID: PMC7985148 DOI: 10.1038/s41598-021-85958-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 03/08/2021] [Indexed: 02/06/2023] Open
Abstract
Incidence of pneumococcal disease has increased worldwide in recent years. Response to pneumococcal vaccine is usually measured using the multiserotype enzyme-linked immunosorbent assay (ELISA) pneumococcal test. However, this approach presents several limitations. Therefore, the introduction of new and more robust analytical approaches able to provide information on the efficacy of the pneumococcal vaccine would be very beneficial for the clinical management of patients. Surface plasmon resonance (SPR) has been shown to offer a valuable understanding of vaccines' properties over the last years. The aim of this study is to evaluate the reliability of SPR for the anti-pneumococcal capsular polysaccharides (anti-PnPs) IgGs quantification in vaccinated. Fast protein liquid chromatography (FPLC) was used for the isolation of total IgGs from serum samples of vaccinated patients. Binding-SPR assays were performed to study the interaction between anti-PnPs IgGs and PCV13. A robust correlation was found between serum levels of anti-PnPs IgGs, measured by ELISA, and the SPR signal. Moreover, it was possible to correctly classify patients into "non-responder", "responder" and "high-responder" groups according to their specific SPR PCV13 response profiles. SPR technology provides a valuable tool for reliably characterize the interaction between anti-PnPs IgGs and PCV13 in a very short experimental time.
Collapse
Affiliation(s)
- Marta Garrido-Jareño
- Drug Discovery Unit, Health Research Institute La Fe, Valencia, Spain.,Microbiology Department, University and Polytechnic Hospital La Fe, Valencia, Spain
| | | | | | | | | | - Joan Mollar-Maseres
- Preventive Medicine Department, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Carmina Lloret-Sos
- Microbiology Department, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Ana Gil-Brusola
- Microbiology Department, University and Polytechnic Hospital La Fe, Valencia, Spain.,Severe Infection Group, Health Research Institute Hospital La Fe, Valencia, Spain
| | | | | | - Javier Pemán-García
- Microbiology Department, University and Polytechnic Hospital La Fe, Valencia, Spain. .,Severe Infection Group, Health Research Institute Hospital La Fe, Valencia, Spain.
| | - Antonio Pineda-Lucena
- Drug Discovery Unit, Health Research Institute La Fe, Valencia, Spain. .,Molecular Therapeutics Program, Center for Applied Medical Research, University of Navarra, Pamplona, Spain.
| |
Collapse
|
19
|
Desikan R, Antia R, Dixit NM. Physical 'strength' of the multi-protein chain connecting immune cells: Does the weakest link limit antibody affinity maturation?: The weakest link in the multi-protein chain facilitating antigen acquisition by B cells in germinal centres limits antibody affinity maturation. Bioessays 2021; 43:e2000159. [PMID: 33448042 DOI: 10.1002/bies.202000159] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 12/13/2020] [Accepted: 12/16/2020] [Indexed: 12/19/2022]
Abstract
The affinities of antibodies (Abs) for their target antigens (Ags) gradually increase in vivo following an infection or vaccination, but reach saturation at values well below those realisable in vitro. This 'affinity ceiling' could in many cases restrict our ability to fight infections and compromise vaccines. What determines the affinity ceiling has been an unresolved question for decades. Here, we argue that it arises from the strength of the chain of protein complexes that is pulled by B cells during the process of Ag acquisition. The affinity ceiling is determined by the strength of the weakest link in the chain. We identify the weakest link and show that the resulting affinity ceiling can explain the Ab affinities realized in vivo, providing a conceptual understanding of Ab affinity maturation. We explore plausible evolutionary underpinnings of the affinity ceiling, examine supporting evidence and alternative hypotheses and discuss implications for vaccination strategies.
Collapse
Affiliation(s)
- Rajat Desikan
- Department of Chemical Engineering, Indian Institute of Science, Bengaluru, India
| | - Rustom Antia
- Department of Biology, Emory University, Atlanta, Georgia, USA
| | - Narendra M Dixit
- Department of Chemical Engineering, Indian Institute of Science, Bengaluru, India.,Centre for Biosystems Science and Engineering, Indian Institute of Science, Bengaluru, India
| |
Collapse
|
20
|
Hoepel W, Allahverdiyeva S, Harbiye H, de Taeye SW, van der Ham AJ, de Boer L, Zaat SAJ, van Weeghel M, Baeten DLP, Houtkooper RH, Everts B, Vidarsson G, den Dunnen J. IgG Subclasses Shape Cytokine Responses by Human Myeloid Immune Cells through Differential Metabolic Reprogramming. THE JOURNAL OF IMMUNOLOGY 2020; 205:3400-3407. [PMID: 33188071 DOI: 10.4049/jimmunol.2000263] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 10/08/2020] [Indexed: 12/15/2022]
Abstract
IgG Abs are crucial for various immune functions, including neutralization, phagocytosis, and Ab-dependent cellular cytotoxicity. In this study, we identified another function of IgG by showing that IgG immune complexes elicit distinct cytokine profiles by human myeloid immune cells, which are dependent on FcγR activation by the different IgG subclasses. Using monoclonal IgG subclasses with identical Ag specificity, our data demonstrate that the production of Th17-inducing cytokines, such as TNF, IL-1β, and IL-23, is particularly dependent on IgG2, whereas type I IFN responses are controlled by IgG3, and IgG1 is able to regulate both. In addition, we identified that subclass-specific cytokine production is orchestrated at the posttranscriptional level through distinct glycolytic reprogramming of human myeloid immune cells. Combined, these data identify that IgG subclasses provide pathogen- and cell type-specific immunity through differential metabolic reprogramming by FcγRs. These findings may be relevant for future design of Ab-related therapies in the context of infectious diseases, chronic inflammation, and cancer.
Collapse
Affiliation(s)
- Willianne Hoepel
- Amsterdam Rheumatology and Immunology Center, Department of Rheumatology and Clinical Immunology, Amsterdam University Medical Centers, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands.,Department of Experimental Immunology, Amsterdam Infection and Immunity Institute, Amsterdam University Medical Centers, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands
| | - Sona Allahverdiyeva
- Amsterdam Rheumatology and Immunology Center, Department of Rheumatology and Clinical Immunology, Amsterdam University Medical Centers, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands.,Department of Experimental Immunology, Amsterdam Infection and Immunity Institute, Amsterdam University Medical Centers, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands.,Department of Medical Microbiology, Amsterdam Infection and Immunity Institute, Amsterdam University Medical Centers, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands
| | - Haneen Harbiye
- Amsterdam Rheumatology and Immunology Center, Department of Rheumatology and Clinical Immunology, Amsterdam University Medical Centers, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands.,Department of Experimental Immunology, Amsterdam Infection and Immunity Institute, Amsterdam University Medical Centers, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands
| | - Steven W de Taeye
- Department of Medical Microbiology, Amsterdam Infection and Immunity Institute, Amsterdam University Medical Centers, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands.,Department of Experimental Immunohematology, Sanquin Research, 1066 CX Amsterdam, the Netherlands
| | - Alwin J van der Ham
- Department of Parasitology, Leiden University Medical Center, University of Leiden, 2333 ZA Leiden, the Netherlands
| | - Leonie de Boer
- Department of Medical Microbiology, Amsterdam Infection and Immunity Institute, Amsterdam University Medical Centers, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands
| | - Sebastiaan A J Zaat
- Department of Medical Microbiology, Amsterdam Infection and Immunity Institute, Amsterdam University Medical Centers, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands
| | - Michel van Weeghel
- Laboratory Genetic Metabolic Diseases, Amsterdam University Medical Centers, 1105 AZ Amsterdam, the Netherlands; and.,Core Facility Metabolomics, Amsterdam University Medical Centers, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands
| | - Dominique L P Baeten
- Amsterdam Rheumatology and Immunology Center, Department of Rheumatology and Clinical Immunology, Amsterdam University Medical Centers, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands.,Department of Experimental Immunology, Amsterdam Infection and Immunity Institute, Amsterdam University Medical Centers, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands
| | - Riekelt H Houtkooper
- Laboratory Genetic Metabolic Diseases, Amsterdam University Medical Centers, 1105 AZ Amsterdam, the Netherlands; and
| | - Bart Everts
- Department of Parasitology, Leiden University Medical Center, University of Leiden, 2333 ZA Leiden, the Netherlands
| | - Gestur Vidarsson
- Department of Experimental Immunohematology, Sanquin Research, 1066 CX Amsterdam, the Netherlands
| | - Jeroen den Dunnen
- Amsterdam Rheumatology and Immunology Center, Department of Rheumatology and Clinical Immunology, Amsterdam University Medical Centers, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands; .,Department of Experimental Immunology, Amsterdam Infection and Immunity Institute, Amsterdam University Medical Centers, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands
| |
Collapse
|
21
|
Characterization of adult patients with IgG subclass deficiency and subnormal IgG2. PLoS One 2020; 15:e0240522. [PMID: 33048985 PMCID: PMC7553271 DOI: 10.1371/journal.pone.0240522] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 09/29/2020] [Indexed: 12/11/2022] Open
Abstract
Background Adults with IgG subclass deficiency (IgGSD) with subnormal IgG2 are inadequately characterized. Methods We retrospectively analyzed observations in unrelated adults with IgGSD evaluated in a single hematology clinic (1991–2019) and selected those with subnormal serum IgG2 (<117 mg/dL (<1.2 g/L)) without corticosteroid therapy to describe: age; prevalence of women; upper/lower respiratory infection; autoimmune condition(s); atopy; other allergy; frequent or severe respiratory tract infection in first-degree relatives; IgG, IgG subclasses, IgA, and IgM; blood lymphocyte subpopulations; human leukocyte antigen (HLA)-A and -B types and haplotypes; and 23-valent pneumococcal polysaccharide vaccination (PPSV23) responses. We determined the prevalence of subnormal IgG2 among unrelated adults with IgGSD without corticosteroid therapy and compared general characteristics of those with and without subnormal IgG2. Results There were 18 patients (94.4% women) with subnormal IgG2. Mean age was 52 ± 11 y. Upper/lower respiratory infection occurred in 94.4%/74.8%, respectively. Autoimmune condition(s), atopy, other allergy, and frequent or severe respiratory infection in first-degree relatives occurred in 44.4%, 44.4%, 61.1%, and 22.2%, respectively. Median IgG2 was 105 mg/dL (83, 116). Subnormal IgG, IgG1, IgG3, IgG4, IgA, and IgM was observed in 66.7%, 50.0%, 100.0%, 5.6%, 33.3%, and 0%, respectively. Lymphocyte subpopulations were normal in most patients. HLA frequencies were similar in patients and controls. Three of 4 patients had no protective S. pneumoniae serotype-specific IgG levels before or after PPSV23. These 18 patients represent 7.6% of 236 adults with IgGSD. Prevalence of subnormal IgG, subnormal IgG3, and subnormal IgA was significantly greater in 18 adults with subnormal IgG2 than 218 adults without subnormal IgG2. Prevalence of subnormal IgM was significantly lower in patients with subnormal IgG2. Conclusions Characteristics of adults with IgGSD with subnormal IgG2 include female predominance, other immunologic abnormalities, subnormal IgG3 and/or IgG1, lack of HLA-A and -B association, and suboptimal PPSV23 response.
Collapse
|
22
|
Isolating polysaccharide IgG pneumococcal antibody responses by pre-adsorption of conjugate vaccine serotypes: A modified approach for the conjugate vaccine era. J Immunol Methods 2020; 486:112846. [PMID: 32882318 DOI: 10.1016/j.jim.2020.112846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 08/18/2020] [Accepted: 08/26/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Assessment of pure polysaccharide response to the 23-valent pneumococcal polysaccharide vaccine (PPV23) can be biased by previous exposure to the conjugate vaccine (PCV). We applied pre-analytical modification to the existing ELISA by pre-incubating serum with PCV. METHODS PCV-adsorbed and non-adsorbed sera were prepared before measuring the concentration of anti-pneumococcal capsular polysaccharide (PCP) IgG antibodies by the whole pneumococcal ELISA. Paired pre and post-pneumococcal vaccination sera from 73 subjects were analyzed and the baseline anti-PCP IgG for each sample was subtracted from the post-vaccination value to measure vaccine responses. Absolute change in titers and fold changes were then compared between both methods. RESULTS In the PCV-vaccinated group (n = 28), pre-adsorption with PCV significantly reduced the vaccine responses compared to non-adsorbed sera [median increase in anti-PCP titers: 27.55 mg/l and 45.98 mg/l, respectively]. In addition, the median fold change dropped significantly from 3.026 to 2.313. In PPV23-vaccinated immunocompetent subjects (n = 28) there was a significant difference in anti-PCP responses with PCV adsorption [median values: 73.71 mg/l without and 51.04 mg/l with adsorption]. All the antibody deficiency patients (n = 17) displayed poor PPV23 responses. Although PPV23 responsiveness was not statistically different between both methods, we have observed a trend for lower anti-PCP IgG titers in PCV-adsorbed sera compared to non-adsorbed ones. Serotype-specific IgG analysis using a multiplexed bead-based immunoassay performed on 10 paired samples confirmed that the adsorption observed is specific to PCV serotypes. CONCLUSION Pre-analytical modification to the conventional ELISA by removing the PCV-specific serotypes may differentiate true polysaccharide response from recall response induced by previous PCV vaccination.
Collapse
|
23
|
Abu-Raya B, Maertens K, Edwards KM, Omer SB, Englund JA, Flanagan KL, Snape MD, Amirthalingam G, Leuridan E, Damme PV, Papaevangelou V, Launay O, Dagan R, Campins M, Cavaliere AF, Frusca T, Guidi S, O'Ryan M, Heininger U, Tan T, Alsuwaidi AR, Safadi MA, Vilca LM, Wanlapakorn N, Madhi SA, Giles ML, Prymula R, Ladhani S, Martinón-Torres F, Tan L, Michelin L, Scambia G, Principi N, Esposito S. Global Perspectives on Immunization During Pregnancy and Priorities for Future Research and Development: An International Consensus Statement. Front Immunol 2020; 11:1282. [PMID: 32670282 PMCID: PMC7326941 DOI: 10.3389/fimmu.2020.01282] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 05/20/2020] [Indexed: 12/17/2022] Open
Abstract
Immunization during pregnancy has been recommended in an increasing number of countries. The aim of this strategy is to protect pregnant women and infants from severe infectious disease, morbidity and mortality and is currently limited to tetanus, inactivated influenza, and pertussis-containing vaccines. There have been recent advancements in the development of vaccines designed primarily for use in pregnant women (respiratory syncytial virus and group B Streptococcus vaccines). Although there is increasing evidence to support vaccination in pregnancy, important gaps in knowledge still exist and need to be addressed by future studies. This collaborative consensus paper provides a review of the current literature on immunization during pregnancy and highlights the gaps in knowledge and a consensus of priorities for future research initiatives, in order to optimize protection for both the mother and the infant.
Collapse
Affiliation(s)
- Bahaa Abu-Raya
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Kirsten Maertens
- Faculty of Medicine and Health Sciences, Centre for the Evaluation of Vaccination, Vaccine and Infectious Diseases Institute, University of Antwerp, Antwerp, Belgium
| | - Kathryn M. Edwards
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, United States
| | - Saad B. Omer
- Department of Internal Medicine (Infectious Diseases), Department of Epidemiology of Microbial Diseases, Yale School of Medicine, Yale School of Public Health, New Haven, CT, United States
| | - Janet A. Englund
- Department of Pediatrics, Seattle Children's Research Institute, University of Washington, Seattle, WA, United States
| | - Katie L. Flanagan
- Faculty of Health Sciences, School of Medicine, University of Tasmania, Launceston, TAS, Australia
- School of Health and Biomedical Science, RMIT University, Melbourne, VIC, Australia
- Department of Immunology and Pathology, Monash University, Melbourne, VIC, Australia
| | - Matthew D. Snape
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Gayatri Amirthalingam
- Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, United Kingdom
| | - Elke Leuridan
- Faculty of Medicine and Health Sciences, Centre for the Evaluation of Vaccination, Vaccine and Infectious Diseases Institute, University of Antwerp, Antwerp, Belgium
| | - Pierre Van Damme
- Faculty of Medicine and Health Sciences, Centre for the Evaluation of Vaccination, Vaccine and Infectious Diseases Institute, University of Antwerp, Antwerp, Belgium
| | - Vana Papaevangelou
- Third Department of Pediatrics, University Hospital ATTIKON, National and Kapodistrian University of Athens, Athens, Greece
| | - Odile Launay
- Université de Paris, Inserm, CIC 1417, F-CRIN I REIVAC, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Ron Dagan
- The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Magda Campins
- Preventive Medicine and Epidemiology Department, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Anna Franca Cavaliere
- Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario “A. Gemelli” IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy
| | - Tiziana Frusca
- Department of Medicine and Surgery, Obstetrics and Gynaecology Unit, University of Parma, Parma, Italy
| | - Sofia Guidi
- Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario “A. Gemelli” IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy
| | - Miguel O'Ryan
- Microbiology and Mycology Program, Faculty of Medicine, Institute of Biomedical Sciences and Associate Researcher, Millennium Institute of Immunology and Immunotherapy, University of Chile, Santiago, Chile
| | - Ulrich Heininger
- Pediatric Infectious Diseases, University of Basel Children's Hospital, Basel, Switzerland
| | - Tina Tan
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Ahmed R. Alsuwaidi
- Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Marco. A. Safadi
- Department of Pediatrics, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil
| | - Luz M. Vilca
- Unit of Obstetrics and Gynecology, Buzzi Hospital - ASST Fatebenefratelli Sacco, University of Milan, Milan, Italy
| | - Nasamon Wanlapakorn
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Shabir A. Madhi
- Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Michelle L. Giles
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, VIC, Australia
| | - Roman Prymula
- School of Medicine Hradec Kralove, Institute of Social Medicine, Charles University Prague, Prague, Czechia
| | - Shamez Ladhani
- Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, United Kingdom
| | - Federico Martinón-Torres
- Translational Pediatrics and Infectious Diseases, Pediatrics Department, Hospital Clínico Universitario de Santiago de Compostela, University of Santiago, Santiago de Compostela, Spain
| | - Litjen Tan
- Immunization Action Coalition, St. Paul, MN, United States
| | - Lessandra Michelin
- Infectious Diseases and Vaccinology Division, Health Sciences Post Graduation Program, University of Caxias Do Sul, Caxias Do Sul, Brazil
| | - Giovanni Scambia
- Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario “A. Gemelli” IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Susanna Esposito
- Department of Medicine and Surgery, Pediatric Clinic, Pietro Barilla Children's Hospital, University of Parma, Parma, Italy
| |
Collapse
|
24
|
Liu J, Li Y, Dai J, Lin B, Xiao C, Zhang X, Luo L, Wang T, Li X, Yu Y, Chen S, Wu L, Liu Y, Yu X, Qin X. Comprehensive Analyses of the Immunoglobulin Proteome for the Classification of Glomerular Diseases. J Proteome Res 2020; 19:1502-1512. [PMID: 32168457 DOI: 10.1021/acs.jproteome.9b00748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Jianhua Liu
- Department of Laboratory Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Yang Li
- State Key Laboratory of Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences-Beijing (PHENIX Center), Beijing Institute of Lifeomics, Beijing 102206, China
| | - Jiayu Dai
- State Key Laboratory of Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences-Beijing (PHENIX Center), Beijing Institute of Lifeomics, Beijing 102206, China
| | - Baoxu Lin
- Department of Laboratory Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Chunying Xiao
- Department of Laboratory Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Xinpeng Zhang
- Department of Laboratory Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Lin Luo
- Department of Laboratory Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Tingting Wang
- Department of Laboratory Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Xiaoying Li
- Department of Laboratory Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Yao Yu
- Department of Laboratory Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Shixiao Chen
- Department of Laboratory Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Lina Wu
- Department of Laboratory Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Yong Liu
- Department of Laboratory Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Xiaobo Yu
- State Key Laboratory of Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences-Beijing (PHENIX Center), Beijing Institute of Lifeomics, Beijing 102206, China
| | - Xiaosong Qin
- Department of Laboratory Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, China
| |
Collapse
|
25
|
Janssen LMA, Heron M, Murk JL, Leenders ACAP, Rijkers GT, de Vries E. Focusing on Good Responders to Pneumococcal Polysaccharide Vaccination in General Hospital Patients Suspected for Immunodeficiency. A Decision Tree Based on the 23-Valent Pneumococcal IgG Assay. Front Immunol 2019; 10:2496. [PMID: 31749801 PMCID: PMC6848064 DOI: 10.3389/fimmu.2019.02496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 10/07/2019] [Indexed: 12/15/2022] Open
Abstract
Background and Aim: Recently, the 23-valent IgG-assay was suggested as screening assay to identify poor responders to pneumococcal polysaccharide (PnPS)-vaccination with the serotype-specific assay as a second-line test. However, in a low pre-test probability general hospital setting predicting good responders could be more valuable to reduce the number of samples needing serotyping. Methods: Serotype-specific PnPS antibody-assays were performed for suspected immunodeficiency in two Dutch general hospitals (Jeroen Bosch Hospital, 's-Hertogenbosch; Elisabeth Tweesteden Hospital, Tilburg). 23-Valent PnPS antibody-assays were subsequently performed in archived material. Data were analyzed using receiver operating characteristic curves (AUC) and agreement indices (ICC). Results: Sera of 284 patients (348 samples) were included; 23-valent IgG-titres and the corresponding sum of PnPS-serotype specific antibodies showed moderate correlation (ICC = 0.63). In 232 conjugated-pneumococcal-vaccine-naïve patients (270 samples), a random 23-valent IgG-titer could discriminate between samples with and without ≥7/11, ≥7/13, or ≥6/9 pneumococcal serotypes when both cut-off values 0.35 and 1.0 μg/ml were used (AUC 0.86 and 0.92, respectively). All patients with a pre-immunization-titer ≥38.2 μg/ml and/or post-immunization-titer ≥96.1 μg/ml and none with a post-immunization-titer ≤38.5 μg/ml exhibited a good response to PnPS vaccination. Using these breakpoints as screening test to predict good responders, only 24% of patients would require further serotyping, as opposed to 68% if breakpoints to predict poor responders would have been used. Conclusion: In a low pre-test probability setting, the 23-valent IgG-assay proved to be a reliable screening test for good responders in conjugated-pneumococcal-vaccine-naïve patients, reducing the overall number of patient samples needing further serotyping, thus reducing overall costs of pneumococcal vaccination response assessment.
Collapse
Affiliation(s)
- Lisanne M A Janssen
- Department of Tranzo, Tilburg University, Tilburg, Netherlands.,Department of Pediatrics, Amalia Children's Hospital, Nijmegen, Netherlands
| | - Michiel Heron
- Laboratory of Medical Microbiology and Immunology, St. Elisabeth Hospital Tilburg, Tilburg, Netherlands
| | - Jean-Luc Murk
- Laboratory of Medical Microbiology and Immunology, St. Elisabeth Hospital Tilburg, Tilburg, Netherlands
| | | | - Ger T Rijkers
- Laboratory of Medical Microbiology and Immunology, St. Elisabeth Hospital Tilburg, Tilburg, Netherlands.,Science Department, University College Roosevelt, Middelburg, Netherlands
| | - Esther de Vries
- Department of Tranzo, Tilburg University, Tilburg, Netherlands.,Laboratory of Medical Microbiology and Immunology, St. Elisabeth Hospital Tilburg, Tilburg, Netherlands
| |
Collapse
|
26
|
Pérez-Cabezas B, Cecílio P, Gaspar TB, Gärtner F, Vasconcellos R, Cordeiro-da-Silva A. Understanding Resistance vs. Susceptibility in Visceral Leishmaniasis Using Mouse Models of Leishmania infantum Infection. Front Cell Infect Microbiol 2019; 9:30. [PMID: 30881923 PMCID: PMC6407322 DOI: 10.3389/fcimb.2019.00030] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 01/31/2019] [Indexed: 01/28/2023] Open
Abstract
Every year, up to 90,000 new cases of Visceral Leishmaniasis and 30,000 resultant deaths are estimated to occur worldwide. Such numbers give relevance to the continuous study of this complex form of the disease: a zoonosis and an anthroponosis; two known etiological agents (Leishmania infantum and L. donovani, respectively); with an estimated average ratio of 1 symptomatic per 10 asymptomatic individuals; and sometimes associated with atypical clinical presentations. This complexity, which results from a long co-evolutionary process involving vector-host, host-pathogen, and pathogen-vector interactions, is still not completely understood. The determinants of visceralization are not fully defined and the dichotomy resistance vs. susceptibility remains unsolved, translating into obstacles that delay the progress of global disease control. Inbred mouse models, with different susceptibility patterns to Leishmania infection, have been very useful in exploring this dichotomy. BALB/c and C57BL/6 mice were described as susceptible strains to L. donovani visceral infection, while SV/129 was considered resistant. Here, we used these three mouse models, but in the context of L. infantum infection, the other Leishmania species that cause visceral disease in humans, and dynamically compared their local and systemic infection-induced immune responses in order to establish a parallel and to ultimately better understand susceptibility vs. resistance in visceral leishmaniasis. Overall, our results suggest that C57BL/6 mice develop an intermediate “infection-phenotype” in comparison to BALB/c and SV/129 mouse strains, considering both the splenic parasite burden and the determined target organs weights. However, the immune mechanisms associated with the control of infection seem to be different in each mouse strain. We observed that both BALB/c and SV/129, but not C57BL/6 mice, show an infection-induced increase of splenic T follicular helper cells. On the other hand, differences detected in terms of CD21 expression by B cells early after infection, together with the quantified anti-Leishmania specific antibodies, suggest that SV/129 are faster than BALB/c and C57BL/6 mice in the assembly of an efficient B-cell response. Additionally, we observed an infection-induced increase in polyfunctional CD4+ T cells in the resistant SV/129 model, opposing an infection-induced increase in CD4+IL-10+ cells in susceptible BALB/c mice. Our data aligns with the observations reported for L. donovani infection and suggest that not only a single mechanism, but an interaction of several could be necessary for the control of this parasitic disease.
Collapse
Affiliation(s)
- Begoña Pérez-Cabezas
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,Parasite Disease Group, Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal
| | - Pedro Cecílio
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,Parasite Disease Group, Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal.,Departamento de Ciências Biológicas, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal
| | - Tiago Bordeira Gaspar
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,Cancer Signalling and Metabolism Group, Institute of Molecular Pathology and Immunology of University of Porto, Porto, Portugal.,Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Fátima Gärtner
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,Department of Molecular Pathology and Immunology, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.,Glycobiology in Cancer Group, Institute of Molecular Pathology and Immunology of University of Porto, Universidade do Porto, Porto, Portugal
| | - Rita Vasconcellos
- Immunobiology Department, Biology Institute, Universidade Federal Fluminense, Rio de Janeiro, Brazil
| | - Anabela Cordeiro-da-Silva
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,Parasite Disease Group, Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal.,Departamento de Ciências Biológicas, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal
| |
Collapse
|
27
|
Conrad A, Boccard M, Valour F, Alcazer V, Tovar Sanchez AT, Chidiac C, Laurent F, Vanhems P, Salles G, Brengel-Pesce K, Meunier B, Trouillet-Assant S, Ader F. VaccHemInf project: protocol for a prospective cohort study of efficacy, safety and characterisation of immune functional response to vaccinations in haematopoietic stem cell transplant recipients. BMJ Open 2019; 9:e026093. [PMID: 30772864 PMCID: PMC6398679 DOI: 10.1136/bmjopen-2018-026093] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Immune reconstitution after haematopoietic stem cell transplantation (HSCT) is a complex and dynamic process, varying from a state of nearly complete immunosuppression to an expected full immune recovery. Specific vaccination guidelines recommend reimmunisation after HSCT but data regarding vaccine efficacy in this unique population are scarce. New immune functional assays could enable prediction of vaccine response in the setting of HSCT. METHODS AND ANALYSIS A prospective, longitudinal single-centre cohort study of autologous and allogeneic HSCT recipients was designed in order to determine the vaccine response to five vaccine targets (pneumococcus, hepatitis B virus, Haemophilus Influenzae type b, tetanus and diphtheria) and to correlate it to immune function parameters. A workflow was set up to study serological response to vaccines and to describe the functional immune status of 100 HSCT recipients (50 autologous and 50 allogeneic) before and 3, 12 and 24 months after primary immunisation. At each time point, 'basic' immune status recording (serology, immunophenotyping of lymphocyte subsets by flow cytometry) will be assessed. The immune response will furthermore be evaluated before and 3 months after primary vaccination by two ex vivo immune functional assays assessing: (1) tumour necrosis factor alpha, interferon gamma production and host messenger RNA expression on whole-blood stimulation by lipopolysaccharide or Staphylococcus aureus enterotoxin B and (2) T-lymphocyte proliferation in response to a standard mitogen (phytohaemagglutinin) or to selected recall antigens. Reference intervals will be determined from a cohort of 30 healthy volunteers. This translational study will provide data describing vaccine response, immune functionality of HSCT recipients over time and will allow mapping HSCT recipients with regard to their immune function. ETHICS AND DISSEMINATION Ethical approval has been obtained from the institutional review board (no 69HCL17_0769). Results will be communicated at scientific meetings and submitted for publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT03659773; Pre-results.
Collapse
Affiliation(s)
- Anne Conrad
- Département des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Lyon, France
- CIRI-Centre International de Recherche en Infectiologie, Inserm U1111, Université Claude Bernard Lyon, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Université Claude Bernard Lyon I, Lyon, France
| | - Mathilde Boccard
- Département des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Lyon, France
- CIRI-Centre International de Recherche en Infectiologie, Inserm U1111, Université Claude Bernard Lyon, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Université Claude Bernard Lyon I, Lyon, France
| | - Florent Valour
- Département des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Lyon, France
- CIRI-Centre International de Recherche en Infectiologie, Inserm U1111, Université Claude Bernard Lyon, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Université Claude Bernard Lyon I, Lyon, France
| | - Vincent Alcazer
- Université Claude Bernard Lyon I, Lyon, France
- Département d’Hématologie Clinique, Hospices Civils de Lyon, Lyon, France
| | - Aydee-Tamara Tovar Sanchez
- Service d’Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France
- Équipe Épidémiologie et Santé Internationale, Laboratoire des Pathogènes Émergents, Fondation Mérieux, Centre International de Recherche en Infectiologie, Inserm U1111, Centre National de la Recherche Scientifique Unité Mixte de Recherche 5308, Ecole Nationale Supérieure de Lyon, Université Claude Bernard Lyon, Lyon, France
| | - Christian Chidiac
- Département des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Lyon, France
- Université Claude Bernard Lyon I, Lyon, France
| | - Frédéric Laurent
- Département des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Lyon, France
- CIRI-Centre International de Recherche en Infectiologie, Inserm U1111, Université Claude Bernard Lyon, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Université Claude Bernard Lyon I, Lyon, France
- Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Philippe Vanhems
- CIRI-Centre International de Recherche en Infectiologie, Inserm U1111, Université Claude Bernard Lyon, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Université Claude Bernard Lyon I, Lyon, France
- Service d’Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France
- Équipe Épidémiologie et Santé Internationale, Laboratoire des Pathogènes Émergents, Fondation Mérieux, Centre International de Recherche en Infectiologie, Inserm U1111, Centre National de la Recherche Scientifique Unité Mixte de Recherche 5308, Ecole Nationale Supérieure de Lyon, Université Claude Bernard Lyon, Lyon, France
| | - Gilles Salles
- Université Claude Bernard Lyon I, Lyon, France
- Département d’Hématologie Clinique, Hospices Civils de Lyon, Lyon, France
| | | | - Boris Meunier
- Joint Research Unit, Hospices Civils de Lyon/BioMerieux, Lyon, France
- Soladis, Lyon, France
| | - Sophie Trouillet-Assant
- CIRI-Centre International de Recherche en Infectiologie, Inserm U1111, Université Claude Bernard Lyon, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Université Claude Bernard Lyon I, Lyon, France
- Joint Research Unit, Hospices Civils de Lyon/BioMerieux, Lyon, France
- Virpath, Inserm U1111, Lyon, France
| | - Florence Ader
- Département des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Lyon, France
- CIRI-Centre International de Recherche en Infectiologie, Inserm U1111, Université Claude Bernard Lyon, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Université Claude Bernard Lyon I, Lyon, France
| |
Collapse
|
28
|
Damelang T, Rogerson SJ, Kent SJ, Chung AW. Role of IgG3 in Infectious Diseases. Trends Immunol 2019; 40:197-211. [PMID: 30745265 DOI: 10.1016/j.it.2019.01.005] [Citation(s) in RCA: 118] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 01/14/2019] [Accepted: 01/14/2019] [Indexed: 12/20/2022]
Abstract
IgG3 comprises only a minor fraction of IgG and has remained relatively understudied until recent years. Key physiochemical characteristics of IgG3 include an elongated hinge region, greater molecular flexibility, extensive polymorphisms, and additional glycosylation sites not present on other IgG subclasses. These characteristics make IgG3 a uniquely potent immunoglobulin, with the potential for triggering effector functions including complement activation, antibody (Ab)-mediated phagocytosis, or Ab-mediated cellular cytotoxicity (ADCC). Recent studies underscore the importance of IgG3 effector functions against a range of pathogens and have provided approaches to overcome IgG3-associated limitations, such as allotype-dependent short Ab half-life, and excessive proinflammatory activation. Understanding the molecular and functional properties of IgG3 may facilitate the development of improved Ab-based immunotherapies and vaccines against infectious diseases.
Collapse
Affiliation(s)
- Timon Damelang
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia
| | - Stephen J Rogerson
- Department of Medicine, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia
| | - Stephen J Kent
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia
| | - Amy W Chung
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia.
| |
Collapse
|
29
|
Parker AR, Park MA, Harding S, Abraham RS. The total IgM, IgA and IgG antibody responses to pneumococcal polysaccharide vaccination (Pneumovax®23) in a healthy adult population and patients diagnosed with primary immunodeficiencies. Vaccine 2019; 37:1350-1355. [DOI: 10.1016/j.vaccine.2019.01.035] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 10/05/2018] [Accepted: 01/08/2019] [Indexed: 12/17/2022]
|
30
|
Stammen RL, Cohen JK, Meeker TL, Crane MM, Amara RR, Hicks SL, Meyer JS, Ethun KF. Effect of Chronic Social Stress on Prenatal Transfer of Antitetanus Immunity in Captive Breeding Rhesus Macaques ( Macaca mulatta). JOURNAL OF THE AMERICAN ASSOCIATION FOR LABORATORY ANIMAL SCIENCE : JAALAS 2018; 57:357-367. [PMID: 29764539 PMCID: PMC6059219 DOI: 10.30802/aalas-jaalas-17-000102] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Because tetanus can cause significant morbidity and mortality in NHP, colonywide vaccination with tetanus toxoid is recommended for outdoor breeding colonies of rhesus macaques, with primary immunizations commonly given to infants at 6 mo of age followed by booster vaccines every 10 y. Maternal antibodies are thought to offer protective immunity to infants younger than 6 mo. However, historical colony data from the Yerkes National Primate Research Center show a higher incidence of tetanus among infants (≤ 6 mo old) born to subordinate dams. Whether this higher incidence of infantile tetanus is due to a higher incidence of trauma among subordinate animals or is a stress-induced impairment of maternal antibody protection is unknown. Studies in other NHP species suggest that chronic exposure to social stressors interferes with the receptor-mediated transplacental transfer of IgG. Therefore, the primary aim of this study was to determine whether chronic stress associated with social subordination impairs prenatal transfer of antitetanus immunity in breeding female rhesus macaques. Subjects included 26 high- and 26 low-ranking adult female rhesus macaques that were nearly 5 or 10 y after their initial immunization and their nonimmunized infants. We hypothesized that infants born to subordinate dams that were nearly 10 y after immunization would have the lowest infant-to-dam antibody ratios and thus would be at greatest risk for infection. Results revealed no significant intergroup differences in infant antitetanus IgG levels. However, infant-to-dam IgG ratios against tetanus were significantly lower among subordinate animals compared with dominant macaques, after accounting for the number of years since the dam's initial vaccination. In addition, higher maternal hair cortisol levels predicted lower infantto-dam tetanus toxoid IgG ratios. Together, these findings suggest that chronic social stress in female rhesus macaques may hamper the prenatal transfer of antitetanus immunity to offspring.
Collapse
Affiliation(s)
- Rachelle L Stammen
- Divisions of Animal Resources, Emory University School of Medicine, Atlanta, Georgia
| | - Joyce K Cohen
- Divisions of Animal Resources, Emory University School of Medicine, Atlanta, Georgia
| | - Tracy L Meeker
- Divisions of Animal Resources, Emory University School of Medicine, Atlanta, Georgia
| | - Maria M Crane
- Divisions of Animal Resources, Emory University School of Medicine, Atlanta, Georgia
| | - Rama R Amara
- Divisions of Microbiology and Immunology, Departments of Microbiology and Immunology, Emory University School of Medicine, Atlanta, Georgia
| | - Sakeenah L Hicks
- Divisions of Microbiology and Immunology, Emory Vaccine Center, Emory University School of Medicine, Atlanta, Georgia
| | - Jerrold S Meyer
- Departments of Neuroscience and Behavior Program, Department of Psychology, University of Massachusetts, Amherst, Massachusetts
| | - Kelly F Ethun
- Divisions of Animal Resources, Developmental and Cognitive Neurosciences, Yerkes National Primate Research Center, Emory University School of Medicine, Atlanta, Georgia, Departments of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia;,
| |
Collapse
|
31
|
Unger PP, Makuch M, Aalbers M, Derksen NIL, ten Brinke A, Aalberse RC, Rispens T, van Ham SM. Repeated vaccination with tetanus toxoid of plasma donors with pre-existing specific IgE transiently elevates tetanus-specific IgE but does not induce allergic symptoms. Clin Exp Allergy 2018; 48:479-482. [DOI: 10.1111/cea.13107] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- P. P. Unger
- Sanquin Research; Department of Immunopathology; Amsterdam The Netherlands
- Landsteiner Laboratory; Academic Medical Centre; University of Amsterdam; Amsterdam The Netherlands
| | - M. Makuch
- Sanquin Research; Department of Immunopathology; Amsterdam The Netherlands
- Landsteiner Laboratory; Academic Medical Centre; University of Amsterdam; Amsterdam The Netherlands
| | - M. Aalbers
- Sanquin Research; Department of Immunopathology; Amsterdam The Netherlands
- Landsteiner Laboratory; Academic Medical Centre; University of Amsterdam; Amsterdam The Netherlands
| | - N. I. L. Derksen
- Sanquin Research; Department of Immunopathology; Amsterdam The Netherlands
- Landsteiner Laboratory; Academic Medical Centre; University of Amsterdam; Amsterdam The Netherlands
| | - A. ten Brinke
- Sanquin Research; Department of Immunopathology; Amsterdam The Netherlands
- Landsteiner Laboratory; Academic Medical Centre; University of Amsterdam; Amsterdam The Netherlands
| | - R. C. Aalberse
- Sanquin Research; Department of Immunopathology; Amsterdam The Netherlands
- Landsteiner Laboratory; Academic Medical Centre; University of Amsterdam; Amsterdam The Netherlands
| | - T. Rispens
- Sanquin Research; Department of Immunopathology; Amsterdam The Netherlands
- Landsteiner Laboratory; Academic Medical Centre; University of Amsterdam; Amsterdam The Netherlands
| | - S. M. van Ham
- Sanquin Research; Department of Immunopathology; Amsterdam The Netherlands
- Landsteiner Laboratory; Academic Medical Centre; University of Amsterdam; Amsterdam The Netherlands
- University of Amsterdam; Swammerdam Institute for Life Sciences; Amsterdam The Netherlands
| |
Collapse
|
32
|
Beaulieu DB, Ananthakrishnan AN, Martin C, Cohen RD, Kane SV, Mahadevan U. Use of Biologic Therapy by Pregnant Women With Inflammatory Bowel Disease Does Not Affect Infant Response to Vaccines. Clin Gastroenterol Hepatol 2018; 16:99-105. [PMID: 28870657 PMCID: PMC5735029 DOI: 10.1016/j.cgh.2017.08.041] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 08/14/2017] [Accepted: 08/24/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS In women with inflammatory bowel diseases (IBDs), exposure to immunomodulator or biologic therapy has not been associated with adverse events during pregnancy or outcomes of newborns. We investigated whether exposure of patients to these agents during pregnancy affects serologic responses to vaccines in newborns. METHODS We collected data from the Pregnancy in IBD and Neonatal Outcomes registry, which records outcomes of pregnant women with diagnosis of IBD receiving care at multiple centers in the United States, from 2007 through 2016. Serum samples collected from infants at least 7 months old were analyzed for titers of antibodies to Haemophilus influenzae B (HiB) or tetanus toxin; mothers completed a survey of vaccine practices and outcomes from July 2013 through October 2016. Umbilical cord blood samples from 33 infants were assayed for concentration of biologic agents. Vaccination response was compared between infants born to mothers exposed to biologic therapy (infliximab, adalimumab, certolizumab pegol, golimumab, natalizumab, vedolizumab, or ustekinumab-either as a single agent or in combination with an immunomodulator, at any time between conception and delivery) and infants born to unexposed mothers. RESULTS A total of 179 women completed the vaccine survey (26 biologic unexposed, 153 exposed to a biologic agent). We found no significant difference in proportions of infants with protective antibody titers against HiB born to exposed mothers (n = 42, 71%) vs unexposed mothers (n = 8, 50%) (P = .41). We also found no difference in the proportion of infants with protective antibody titers to tetanus toxoid born to exposed mothers (80%) vs unexposed mothers (75%) (P = .66). The median concentration of infliximab in cord blood did not differ significantly between infants with vs without protective antibody titers to HiB (P = .30) or tetanus toxoid (P = .93). Mild reactions were observed in 7/40 infants who received rotavirus vaccine and whose mothers had been exposed to biologic therapies. CONCLUSIONS Vaccination of infants against HiB and tetanus toxin, based on antibody titers measured when infants were at least 7 months old, does not appear to be affected by in utero exposure to biologic therapy.
Collapse
Affiliation(s)
- Dawn B. Beaulieu
- Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, TN
| | | | - Christopher Martin
- Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina, Chapel Hill, NC
| | - Russell D. Cohen
- Section of Gastroenterology, Hepatology and Nutrition, University of Chicago Medicine, Chicago, IL
| | - Sunanda V. Kane
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN
| | - Uma Mahadevan
- Division of Gastroenterology, University of California-San Francisco, San Francisco, CA
| |
Collapse
|
33
|
Lopez B, Bahuaud M, Fieschi C, Mehlal S, Jeljeli M, Rogeau S, Brabant S, Deleplancque AS, Dubucquoi S, Poizot S, Terriou L, Launay D, Batteux F, Labalette M, Lefèvre G. Value of the Overall Pneumococcal Polysaccharide Response in the Diagnosis of Primary Humoral Immunodeficiencies. Front Immunol 2017; 8:1862. [PMID: 29326723 PMCID: PMC5742330 DOI: 10.3389/fimmu.2017.01862] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 12/07/2017] [Indexed: 01/04/2023] Open
Abstract
Background An overall response assay [OVA, based on a 23-valent pneumococcal polysaccharide vaccine (PPV23)] is widely used to screen for anti-pneumococcal antibodies. Given the heterogeneity of response from one polysaccharide (PS) to another, a World Health Organization-standardized serotype-specific enzyme-linked immunosorbent assay (SSA) is considered to be the only reliable method for testing anti-PS antibody responses in individuals with suspected primary immunodeficiencies (PIDs). Objective To evaluate the OVA relative to the reference SSA. Methods Serum samples of adult patients referred for a suspected PID were collected before and then 4–8 weeks after immunization with PPV23. The anti-pneumococcal response was systematically assessed with an SSA (7–16 serotypes) and interpreted according to the American Academy of Asthma, Allergy and Immunology’s current guidelines. We used receiver operating characteristic curves and agreement indices to assess the OVA’s diagnostic value in a first cohort. In order to validate these findings, a second (validation) cohort was then prospectively included. Results Sixty-two adult patients were included, and 42 (67.7%) were defined as poor responders according to the SSA. Only the post-immunization titer in the OVA was able to correctly identify poor responders; a titer below 110 mg/L gave a positive predictive value of 100% [identifying 24 (57.1%) of the 42 poor responders], and similar levels of diagnostic performance were observed in the validation cohort. The pre-vaccination antibody titer, the post/pre-vaccination antibody titer ratio and a post-vaccination titer above 110 mg/L in the OVA were not predictive of the response in the SSA. Conclusion A post-vaccination antibody titer below 110 mg/L in the OVA was constantly associated with a poor PPV23 response using the SSA. In all other cases, SSA is the only reliable method for assessing diagnostic vaccination with PPV23.
Collapse
Affiliation(s)
- Benjamin Lopez
- CHU Lille, Institut d'Immunologie, Lille, France.,Univ. Lille, U995 - LIRIC - Lille Inflammation Research International Center, Lille, France
| | - Mathilde Bahuaud
- CHU Hôpital Cochin, Laboratoire d'Immunologie Biologique, Plateforme d'Immuno-monitoring Vaccinal, AP-HP, Paris, France
| | - Claire Fieschi
- Sorbonne Paris Cité, Université Paris Diderot, Hôpital Saint-Louis, Service d'Immunopathologie Clinique, Paris, France
| | - Souad Mehlal
- CHU Hôpital Cochin, Laboratoire d'Immunologie Biologique, Plateforme d'Immuno-monitoring Vaccinal, AP-HP, Paris, France
| | - Mohamed Jeljeli
- CHU Hôpital Cochin, Laboratoire d'Immunologie Biologique, Plateforme d'Immuno-monitoring Vaccinal, AP-HP, Paris, France
| | - Stéphanie Rogeau
- CHU Lille, Institut d'Immunologie, Lille, France.,Univ. Lille, U995 - LIRIC - Lille Inflammation Research International Center, Lille, France
| | | | | | - Sylvain Dubucquoi
- CHU Lille, Institut d'Immunologie, Lille, France.,Univ. Lille, U995 - LIRIC - Lille Inflammation Research International Center, Lille, France
| | | | - Louis Terriou
- Univ. Lille, U995 - LIRIC - Lille Inflammation Research International Center, Lille, France.,CHU Lille, Département de Médecine Interne et Immunologie Clinique, Centre National de Référence Maladies Systémiques et Auto-immunes Rares, Lille, France
| | - David Launay
- CHU Lille, Département de Médecine Interne et Immunologie Clinique, Centre National de Référence Maladies Systémiques et Auto-immunes Rares, Lille, France
| | - Frédéric Batteux
- CHU Hôpital Cochin, Laboratoire d'Immunologie Biologique, Plateforme d'Immuno-monitoring Vaccinal, AP-HP, Paris, France
| | - Myriam Labalette
- CHU Lille, Institut d'Immunologie, Lille, France.,Univ. Lille, U995 - LIRIC - Lille Inflammation Research International Center, Lille, France
| | - Guillaume Lefèvre
- CHU Lille, Institut d'Immunologie, Lille, France.,Univ. Lille, U995 - LIRIC - Lille Inflammation Research International Center, Lille, France.,CHU Lille, Département de Médecine Interne et Immunologie Clinique, Centre National de Référence Maladies Systémiques et Auto-immunes Rares, Lille, France
| |
Collapse
|
34
|
Parker A, Irure Ventura J, Sims D, Echeverría de Carlos A, Gómez de la Torre R, Tricas Aizpún L, Ocejo-Vinyals JG, López-Hoyos M, Wallis G, Harding S. Measurement of the IgG2 response to Pneumococcal capsular polysaccharides may identify an antibody deficiency in individuals referred for immunological investigation. J Immunoassay Immunochem 2017; 38:514-522. [PMID: 28613137 DOI: 10.1080/15321819.2017.1340897] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
IgG2 is the most efficient subclass for providing protection against pneumococcal pathogens. We hypothesised that some individuals may be unable to mount an effective pneumococcal capsular polysaccharide (PCP) IgG2 response despite having a normal PCP IgG concentration (PCP IgG2 deficient). The median pre-vaccination PCP IgG2 concentration was significantly lower in individuals referred for immunological investigation compared to healthy controls (2.8 mg/L range, 95% CI 1.1-88 vs. 29.5mg/L, 95% CI 13.5-90, p = 0.0002). PCP IgG:IgG2 ratios were significantly higher for the referral population than for healthy controls suggesting the increased production of PCP specific subclasses other than IgG2. The percentage of individuals with PCP IgG2 deficiency was significantly higher in referral groups compared to controls (31% vs. 5%; p = 0.0009) and in an individual with PCP IgG2 deficiency, the balance of PCP specific IgG subclass antibodies post vaccination changed from IgG2>IgG1>IgG3>IgG4 to IgG1>IgG3>IgG2>IgG4. The median PCP IgG2 concentration in those with PCP IgG2 deficiency was significantly lower in the referral groups compared to controls (7.8 mg/L, 95% CI 1.1-12 vs. 12.7 mg/L, 95% CI 11.8-13.1; p = 0.006). The data suggests a defect in the production PCP IgG2 may be present in individuals with normal PCP IgG referred for immunological investigation.
Collapse
Affiliation(s)
- Antony Parker
- a The Binding Site Group Limited , Edgbaston , Birmingham
| | - Juan Irure Ventura
- b Immunology Department , Hospital Universitario Marqués de Valdecilla-IDIVAL , Santander , Spain
| | - Dawn Sims
- a The Binding Site Group Limited , Edgbaston , Birmingham
| | | | | | - Lourdes Tricas Aizpún
- c Immnunology Department , Hospital Universitario Central de Asturias , Oviedo , Spain
| | - J Gonzalo Ocejo-Vinyals
- b Immunology Department , Hospital Universitario Marqués de Valdecilla-IDIVAL , Santander , Spain
| | - Marcos López-Hoyos
- b Immunology Department , Hospital Universitario Marqués de Valdecilla-IDIVAL , Santander , Spain
| | - Gregg Wallis
- a The Binding Site Group Limited , Edgbaston , Birmingham
| | | |
Collapse
|
35
|
Tagliabue G, Faoro V, Rizzo S, Sblattero D, Saccani A, Riccio G, Bellini T, Salina M, Buscaglia M, Marcello A. A label-free immunoassay for Flavivirus detection by the Reflective Phantom Interface technology. Biochem Biophys Res Commun 2017; 492:558-564. [PMID: 28501619 DOI: 10.1016/j.bbrc.2017.05.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 05/03/2017] [Indexed: 01/25/2023]
Abstract
Flaviviruses are widespread and cause clinically relevant arboviral diseases that impact locally and as imported travel-related infections. Direct detection of viraemia is limited, being typically undetectable at onset of symptoms. Therefore, diagnosis is primarily based on serology, which is complicated by high cross-reactivity across different species. The overlapping geographical distribution of the vectors in areas with a weak healthcare system, the increase of international travel and the similarity of symptoms highlight the need for rapid and reliable multi-parametric diagnostic tests in point-of-care formats. To this end we developed a bi-parametric serological microarray using recombinant NS1 proteins from Tick-borne encephalitis virus and West Nile virus coupled to a low-cost, label-free detection device based on the Reflective Phantom Interface (RPI) principle. Specific sequential detection of antibodies in solution demonstrates the feasibility of the approach for the surveillance and diagnosis of Flaviviruses.
Collapse
Affiliation(s)
| | - Valentina Faoro
- Molecular Virology Laboratory, International Centre for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy
| | - Serena Rizzo
- Dipartimento di Scienze della Vita, Università degli Studi di Trieste, 34100 Trieste, Italy
| | - Daniele Sblattero
- Dipartimento di Scienze della Vita, Università degli Studi di Trieste, 34100 Trieste, Italy
| | | | | | - Tommaso Bellini
- Proxentia S.r.l., 20139 Milano, Italy; Dipartimento di Biotecnologie Mediche e Medicina Traslazionale, Università degli Studi di Milano, 20090 Segrate, Italy
| | | | - Marco Buscaglia
- Proxentia S.r.l., 20139 Milano, Italy; Dipartimento di Biotecnologie Mediche e Medicina Traslazionale, Università degli Studi di Milano, 20090 Segrate, Italy
| | - Alessandro Marcello
- Molecular Virology Laboratory, International Centre for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy.
| |
Collapse
|
36
|
Sánchez-Ramón S, de Gracia J, García-Alonso AM, Rodríguez Molina JJ, Melero J, de Andrés A, García Ruiz de Morales JM, Ferreira A, Ocejo-Vinyals JG, Cid JJ, García Martínez JM, Lasheras T, Vargas ML, Gil-Herrera J, García Rodríguez MC, Castañer JL, González Granado LI, Allende LM, Soler-Palacin P, Herráiz L, López Hoyos M, Bellón JM, Silva G, Gurbindo DM, Carbone J, Rodríguez-Sáinz C, Matamoros N, Parker AR, Fernández-Cruz E. Multicenter study for the evaluation of the antibody response against salmonella typhi Vi vaccination (EMPATHY) for the diagnosis of Anti-polysaccharide antibody production deficiency in patients with primary immunodeficiency. Clin Immunol 2016; 169:80-84. [PMID: 27236002 DOI: 10.1016/j.clim.2016.05.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 02/07/2016] [Accepted: 05/21/2016] [Indexed: 11/28/2022]
Affiliation(s)
- S Sánchez-Ramón
- Clinical Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
| | - J de Gracia
- Pneumology, Hospital Universitari Vall d'Hebrón, Barcelona, Spain
| | - A M García-Alonso
- Immunology, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
| | - J J Rodríguez Molina
- Clinical Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - J Melero
- Immunology, Hospital Infanta Cristina, Badajoz, Spain
| | - A de Andrés
- Immunology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | - A Ferreira
- Immunology, Hospital Universitario La Paz, Madrid, Spain
| | | | - J J Cid
- Immunology, Hospital Juan Canalejo, La Coruña, Spain
| | | | - T Lasheras
- Pneumology, Hospital Universitari Vall d'Hebrón, Barcelona, Spain
| | - M L Vargas
- Immunology, Hospital Infanta Cristina, Badajoz, Spain
| | - J Gil-Herrera
- Clinical Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - J L Castañer
- Immunology, Hospital Universitario La Paz, Madrid, Spain
| | - L I González Granado
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Pediatrics, Hospital 12 de Octubre, Madrid, Spain
| | - L M Allende
- Immunology, Hospital 12 de octubre, Madrid, Spain
| | - P Soler-Palacin
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - L Herráiz
- Clinical Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - M López Hoyos
- Immunology, Hospital Marqués de Valdecilla, Santander, Spain
| | - J M Bellón
- Statistics, Hospital General Universitario Gregorio Marañón, Spain
| | - G Silva
- Immunology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - D M Gurbindo
- Immunopediatrics, Hospital Maternoinfantil de O'Donnell, Madrid, Spain
| | - J Carbone
- Clinical Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - C Rodríguez-Sáinz
- Clinical Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - N Matamoros
- Immunology, Hospital Son Espases, Palma de Mallorca, Spain
| | - A R Parker
- The Binding Site Group Ltd, Birmingham, UK
| | - E Fernández-Cruz
- Clinical Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | |
Collapse
|
37
|
Cimaz R, Meregalli E, Biggioggero M, Airò P, Danieli E, Antonioli CM, Motta M, Chirico G, Columbrita D, Frassi M, Meroni PL, Tincani A. Response to tetanus vaccination in infants exposed in utero to immunosuppressants for maternal autoimmune disorders. Lupus 2016; 16:129-32. [PMID: 17402369 DOI: 10.1177/0961203306075738] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Immunosuppressive drugs given during pregnancy to mothers suffering from a systemic autoimmune disease (AID) can cross the placenta, thus being potentially able to affect the offspring immune system. Aim of our study was to evaluate the in vivo immune function of a series of these newborns. Twenty-two babies born from mothers suffering from autoimmune diseases (AID) who had been taking immunosuppressive drugs during pregnancy were evaluated for their response to vaccination with C. Tetani toxoid. Six babies born from mothers receiving low-dose aspirin only were used as controls. The immune response to C. Tetani vaccination was evaluated with an ELISA to detect circulating antibodies. Five children out of 28 (17%) did not achieve a protective titer of anti C. Tetanitoxoid IgG. No clear relationship was found between specific drug exposure and antibody response. Our findings suggest that maternal immunosuppressive treatment given for a systemic AID can affect the response to an active immunization, without specificities for drug types used.
Collapse
Affiliation(s)
- R Cimaz
- Hospices Civils de Lyon- Universitè Lyon 1, Lyon, France.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Persistence of long-lived plasma cells and humoral immunity in individuals responding to CD19-directed CAR T-cell therapy. Blood 2016; 128:360-70. [PMID: 27166358 DOI: 10.1182/blood-2016-01-694356] [Citation(s) in RCA: 182] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 04/29/2016] [Indexed: 12/28/2022] Open
Abstract
The mechanisms underlying the maintenance of long-lasting humoral immunity are not well understood. Studies in mice indicate that plasma cells (PCs) can survive up to a lifetime, even in the absence of regeneration by B cells, implying the presence of long-lived PCs as a mechanism for long-lasting immunity. Evidence from humans treated with anti-CD20, which depletes circulating B cells, also suggests B-cell-independent long-term survival of some PCs. On the other hand, antibody responses may be sustained solely by short-lived PCs with repopulation from clonally related memory B cells. To explore PC longevity and humoral immunity in humans, we investigated the fate of PCs and their antibodies in adult and pediatric patients who received chimeric antigen receptor-based adoptive T-cell immunotherapy targeting CD19 to treat B-cell lineage malignancies (CTL019). Treatment with CTL019 is frequently associated with B-cell aplasia that can persist for years. Serum antibody titers to vaccine-related antigens were measured, and quantitative assessment of B cells and PCs in blood and bone marrow was performed at various time points before and after CTL019 therapy. While total serum immunoglobulin concentrations decline following CTL019-induced B-cell aplasia, several vaccine/pathogen-specific serum immunoglobulin G and A (IgG and IgA) titers remain relatively stable for at least 6 and 12 months posttreatment, respectively. Analysis of bone marrow biopsies after CTL019 revealed 8 patients with persistence of antibody-secreting PCs at least 25 months post-CTL019 infusion despite absence of CD19(+)CD20(+) B cells. These results provide strong evidence for the existence of memory B-cell-independent, long-lived PCs in humans that contribute to long-lasting humoral immunity.
Collapse
|
39
|
Long-Term Stable Mixed Chimerism after Hematopoietic Stem Cell Transplantation in Patients with Non-Malignant Disease, Shall We Be Tolerant? PLoS One 2016; 11:e0154737. [PMID: 27152621 PMCID: PMC4859543 DOI: 10.1371/journal.pone.0154737] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 04/18/2016] [Indexed: 11/19/2022] Open
Abstract
Long-term stable mixed chimerism is a rare and poorly understood phenomenon post hematopoietic stem cell transplantation. This study aims to shed light on whether the two hematopoietic systems in patients with mixed chimerism remain functional. Additionally, we investigate possible immunologic differences in these individuals compared to patients with only donor derived immune cells. Patients with donor and mixed chimerism, at median 10 (5–16) years post-HSCT for non-malignant diseases, were assessed regarding clinical situation and immune system (phenotypical and functional). No difference in long-term outcome was seen in terms of general wellbeing, central phenotypic immune system features (e.g., differentiation status, CD4/CD8 ratio, B and NK-cell frequency) and antibody responses to immunizations. At a median of 10 years post transplantation, patients with mixed chimerism had significantly higher IgG3 and platelet levels. Additionally, these patients had higher NKT-cell levels (CD94+CD8+ and CD56+CD8+) than patients with donor chimerism. In depth phenotypic analysis of patients with mixed chimerism demonstrated recipient-derived fractions in most immune cell lineages (e.g., T-cell, B-cell and NK-cell subsets). Recipient cells were also capable of responding to mitogenic stimulation with production of several cytokines. In conclusion, long-term mixed chimerism did not negatively affect patient wellbeing and long-term outcome. Moreover, recipient-derived immunity may still be functional in these patients, suggesting an active state of tolerance and immunologic dependence on both hematopoietic systems.
Collapse
|
40
|
Broyde A, Arad U, Madar-Balakirski N, Paran D, Kaufman I, Levartovsky D, Wigler I, Caspi D, Elkayam O. Longterm Efficacy of an Antipneumococcal Polysaccharide Vaccine among Patients with Autoimmune Inflammatory Rheumatic Diseases. J Rheumatol 2016; 43:267-72. [PMID: 26773117 DOI: 10.3899/jrheum.150397] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2015] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To estimate the longterm humoral response of an antipneumococcal polysaccharide vaccine (PPSV23) in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), or inflammatory bowel disease (IBD)-associated spondyloarthropathy (SpA), and the effect of demographic and clinical factors and treatment on the longterm efficacy of the vaccine. METHODS A total of 145 consecutive patients treated with biologics [tumor necrosis factor-α (TNF-α) or interleukin 6 (IL-6) receptor inhibitors] or methotrexate (MTX) participated in this study. Fifteen were excluded because of absent information regarding their vaccination status (n = 9) or because of technical problems in obtaining their serum sample (n = 6). They were diagnosed with RA (n = 63, 48.5%), PsA (n = 29, 22.3%), AS (n = 28, 21.5%), or IBD-associated SpA (n = 3, 2.3%). Their mean age was 54.6 years, and 61.5% were women. Data were collected on the timing of vaccination, demographic and clinical characteristics, and treatment, and patients' serum antipneumococcal antibody levels were tested. RESULTS Two-thirds of the patients (67.7%) had received PPSV23 45 months (mean) earlier. Treatment included TNF-α inhibitors (73.9%), IL-6 receptor inhibitors (13.1%), or MTX without a biological treatment (13%). The uptake of vaccination was significantly higher in the older population (> 65 yrs). Vaccinated patients had significantly higher antibody levels compared with vaccine-naive patients. The antibody levels had been preserved after 10 years. MTX use, but not biologics, was associated with significantly lower antibody levels. CONCLUSION The longterm efficacy of the PPSV23 vaccination seems to be preserved among patients with RA, PsA, AS, and IBD-associated SpA for at least 10 years. Efficacy is slightly impaired by MTX, but it is not affected by biologics. These findings suggest that revaccination after 5 years might not be needed for all, and testing the antibody titers should be considered to identify those who may benefit from revaccination.
Collapse
Affiliation(s)
- Adi Broyde
- From the Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.A. Broyde, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; U. Arad, MD, PhD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; N. Madar-Balakirski, PhD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; D. Paran, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; I. Kaufman, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; D. Levartovsky, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; I. Wigler, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; D. Caspi, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; O. Elkayam, M.D, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University
| | - Uri Arad
- From the Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.A. Broyde, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; U. Arad, MD, PhD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; N. Madar-Balakirski, PhD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; D. Paran, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; I. Kaufman, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; D. Levartovsky, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; I. Wigler, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; D. Caspi, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; O. Elkayam, M.D, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University
| | - Noa Madar-Balakirski
- From the Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.A. Broyde, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; U. Arad, MD, PhD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; N. Madar-Balakirski, PhD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; D. Paran, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; I. Kaufman, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; D. Levartovsky, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; I. Wigler, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; D. Caspi, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; O. Elkayam, M.D, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University
| | - Daphna Paran
- From the Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.A. Broyde, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; U. Arad, MD, PhD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; N. Madar-Balakirski, PhD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; D. Paran, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; I. Kaufman, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; D. Levartovsky, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; I. Wigler, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; D. Caspi, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; O. Elkayam, M.D, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University
| | - Ilana Kaufman
- From the Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.A. Broyde, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; U. Arad, MD, PhD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; N. Madar-Balakirski, PhD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; D. Paran, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; I. Kaufman, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; D. Levartovsky, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; I. Wigler, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; D. Caspi, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; O. Elkayam, M.D, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University
| | - David Levartovsky
- From the Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.A. Broyde, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; U. Arad, MD, PhD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; N. Madar-Balakirski, PhD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; D. Paran, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; I. Kaufman, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; D. Levartovsky, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; I. Wigler, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; D. Caspi, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; O. Elkayam, M.D, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University
| | - Irena Wigler
- From the Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.A. Broyde, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; U. Arad, MD, PhD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; N. Madar-Balakirski, PhD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; D. Paran, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; I. Kaufman, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; D. Levartovsky, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; I. Wigler, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; D. Caspi, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; O. Elkayam, M.D, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University
| | - Dan Caspi
- From the Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.A. Broyde, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; U. Arad, MD, PhD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; N. Madar-Balakirski, PhD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; D. Paran, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; I. Kaufman, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; D. Levartovsky, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; I. Wigler, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; D. Caspi, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; O. Elkayam, M.D, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University
| | - Ori Elkayam
- From the Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.A. Broyde, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; U. Arad, MD, PhD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; N. Madar-Balakirski, PhD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; D. Paran, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; I. Kaufman, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; D. Levartovsky, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; I. Wigler, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; D. Caspi, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University; O. Elkayam, M.D, Department of Rheumatology, Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University.
| |
Collapse
|
41
|
Chang ET, Adami HO, Boffetta P, Wedner HJ, Mandel JS. A critical review of perfluorooctanoate and perfluorooctanesulfonate exposure and immunological health conditions in humans. Crit Rev Toxicol 2016; 46:279-331. [PMID: 26761418 PMCID: PMC4819831 DOI: 10.3109/10408444.2015.1122573] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Whether perfluorooctanoate (PFOA) and perfluorooctanesulfonate (PFOS), two widely used and biopersistent synthetic chemicals, are immunotoxic in humans is unclear. Accordingly, this article systematically and critically reviews the epidemiologic evidence on the association between exposure to PFOA and PFOS and various immune-related health conditions in humans. Twenty-four epidemiologic studies have reported associations of PFOA and/or PFOS with immune-related health conditions, including ten studies of immune biomarker levels or gene expression patterns, ten studies of atopic or allergic disorders, five studies of infectious diseases, four studies of vaccine responses, and five studies of chronic inflammatory or autoimmune conditions (with several studies evaluating multiple endpoints). Asthma, the most commonly studied condition, was evaluated in seven studies. With few, often methodologically limited studies of any particular health condition, generally inconsistent results, and an inability to exclude confounding, bias, or chance as an explanation for observed associations, the available epidemiologic evidence is insufficient to reach a conclusion about a causal relationship between exposure to PFOA and PFOS and any immune-related health condition in humans. When interpreting such studies, an immunodeficiency should not be presumed to exist when there is no evidence of a clinical abnormality. Large, prospective studies with repeated exposure assessment in independent populations are needed to confirm some suggestive associations with certain endpoints.
Collapse
Affiliation(s)
- Ellen T Chang
- a Health Sciences Practice, Exponent, Inc , Menlo Park , CA , USA ;,b Division of Epidemiology, Department of Health Research and Policy , Stanford University School of Medicine , Stanford , CA , USA
| | - Hans-Olov Adami
- c Department of Epidemiology , Harvard T. H. Chan School of Public Health , Boston , MA , USA
| | - Paolo Boffetta
- d Icahn School of Medicine at Mount Sinai, Tisch Cancer Institute , New York , NY , USA
| | - H James Wedner
- e Division of Allergy and Immunology , Washington University School of Medicine , St. Louis , MO , USA
| | - Jack S Mandel
- a Health Sciences Practice, Exponent, Inc , Menlo Park , CA , USA
| |
Collapse
|
42
|
Baroncelli S, Galluzzo CM, Mancinelli S, Andreotti M, Jere H, Amici R, Marazzi MC, Vella S, Palombi L, Giuliano M. Antibodies against pneumococcal capsular polysaccharide in Malawian HIV-positive mothers and their HIV-exposed uninfected children. Infect Dis (Lond) 2015; 48:317-321. [PMID: 26609569 DOI: 10.3109/23744235.2015.1115895] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background HIV-exposed uninfected children have a higher risk of infection and mortality compared to HIV-unexposed children and the reasons for this vulnerability are still under investigation. AIM This study aimed to evaluate the influence of maternal HIV parameters on the passive transfer of anti-pneumococcal capsular polysaccharide (PCP) IgG and to determine whether the concentrations of specific IgG might be related to the morbidity and mortality in HIV-exposed uninfected children. Methods One hundred and twenty-six Malawian HIV-infected pregnant women and their uninfected children were studied. Antiretroviral treatment-naive women started a nevirapine-based triple combination regimen from the third trimester of pregnancy until at least 6 months of exclusive breastfeeding. Mother/child pairs were followed until 2 years after delivery. Plasma anti-PCP IgG titers (in mothers at 26 weeks of gestation and in infants at 1 and 6 months) were determined by an enzyme-linked immunosorbent assay. None of these women and children had received any vaccination against pneumococcal polysaccharides. Results Maternal anti-PCP IgG concentration was independent from viral load (p = 0.848), CD4 count (p = 0.740) and WHO stage (p = 0.450). However, the child/mother ratio of anti-PCP IgG measured at 1 month among infants was significantly reduced in pairs whose mothers had HIV-RNA > 10 000 copies/ml (p = 0.043) and CD4 < 350 cells/μl (p = 0.090) before antiretroviral therapy (ART). No clear associations between anti-PCP IgG and respiratory-related deaths were found, but respiratory infection episodes were more frequent among children with lower anti-PCP IgG ratio (p = 0.046). Conclusion This study indicates that HIV pre-ART conditions in mothers may influence the rate of specific immunoglobulins transfer, increasing infants vulnerability to respiratory infections.
Collapse
Affiliation(s)
- Silvia Baroncelli
- a Department of Therapeutic Research and Medicines Evaluation , Istituto Superiore di Sanità , Rome , Italy
| | - Clementina Maria Galluzzo
- a Department of Therapeutic Research and Medicines Evaluation , Istituto Superiore di Sanità , Rome , Italy
| | - Sandro Mancinelli
- b Department of Biomedicine and Prevention , University of Rome Tor Vergata , Rome , Italy
| | - Mauro Andreotti
- a Department of Therapeutic Research and Medicines Evaluation , Istituto Superiore di Sanità , Rome , Italy
| | - Haswell Jere
- c DREAM Program , Community of S. Egidio , Blantyre , Malawi
| | - Roberta Amici
- a Department of Therapeutic Research and Medicines Evaluation , Istituto Superiore di Sanità , Rome , Italy
| | | | - Stefano Vella
- a Department of Therapeutic Research and Medicines Evaluation , Istituto Superiore di Sanità , Rome , Italy
| | - Leonardo Palombi
- b Department of Biomedicine and Prevention , University of Rome Tor Vergata , Rome , Italy
| | - Marina Giuliano
- a Department of Therapeutic Research and Medicines Evaluation , Istituto Superiore di Sanità , Rome , Italy
| |
Collapse
|
43
|
Eyer K, Root K, Verboket PE, Dittrich PS. Detection of Infertility-related Neutralizing Antibodies with a Cell-free Microfluidic Method. Sci Rep 2015; 5:16551. [PMID: 26585778 PMCID: PMC4653734 DOI: 10.1038/srep16551] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 10/15/2015] [Indexed: 01/22/2023] Open
Abstract
The unwanted emergence of neutralizing antibodies (nAbs) against an endogenous or a therapeutic protein can result in deficiency diseases or therapy failure. Here, we developed a cell-free microfluidic method for the sensitive detection and quantification of nAbs in human serum that are associated with infertility. We used cell-derived vesicles containing the luteinizing hormone (LH)/choriogonadotropin receptor (LHHCGR) to detect nAbs against LH. The method exploits the entire cellular signal amplification mechanism, and facilitates the detection of as little as 0.44 nM of LH-nAb (Kd 1.5 nM) in human serum matrix within only 15 minutes. In addition, dose-response curves can be generated in less than 2 hours to evaluate the nAB concentration and dissociation constant. The developed system is devoid of problems associated with cell-based assays and we believe that this simple effect-directed analysis can be used in clinical environments, and is adaptable to other hormones or cytokines and their respective nAbs.
Collapse
Affiliation(s)
- Klaus Eyer
- Department of Chemistry and Applied Biosciences, ETH Zurich Switzerland
| | - Katharina Root
- Department of Chemistry and Applied Biosciences, ETH Zurich Switzerland
| | - Pascal E. Verboket
- Department of Chemistry and Applied Biosciences, ETH Zurich Switzerland
- Department of Biosystems Science and Engineering, ETH Zurich Switzerland
| | - Petra S. Dittrich
- Department of Chemistry and Applied Biosciences, ETH Zurich Switzerland
- Department of Biosystems Science and Engineering, ETH Zurich Switzerland
| |
Collapse
|
44
|
Astute Clinician Report: A Novel 10 bp Frameshift Deletion in Exon 2 of ICOS Causes a Combined Immunodeficiency Associated with an Enteritis and Hepatitis. J Clin Immunol 2015; 35:598-603. [PMID: 26399252 PMCID: PMC4628077 DOI: 10.1007/s10875-015-0193-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 09/04/2015] [Indexed: 01/28/2023]
Abstract
ICOS encodes the Inducible T-cell Co-Stimulator (ICOS). Deficiency of this receptor in humans causes a common variable immunodeficiency (CVID) characterised by an absence of class-switched memory B cells and hypogammaglobulinemia. Three pathogenic mutations in ICOS have been described to date in a total of 13 cases. Here we report a novel homozygous 10 base pair frameshift deletion in exon 2 discovered by whole exome sequencing of two siblings from a family of Pakistani origin. Both patients presented in early childhood with diarrhea, colitis and transaminitis and one showed defective handling of human herpesvirus 6. Activated patient CD3+CD4+ T lymphocytes demonstrated a complete absence of ICOS expression and, consistent with previous reports, we detected a reduction in circulating T follicular helper cells. Findings in this kindred emphasise the phenotypic variability of ICOS deficiency and, in particular, the variably impaired antiviral immunity that is a poorly understood facet of this rare disorder.
Collapse
|
45
|
Fusil F, Calattini S, Amirache F, Mancip J, Costa C, Robbins JB, Douam F, Lavillette D, Law M, Defrance T, Verhoeyen E, Cosset FL. A Lentiviral Vector Allowing Physiologically Regulated Membrane-anchored and Secreted Antibody Expression Depending on B-cell Maturation Status. Mol Ther 2015; 23:1734-1747. [PMID: 26281898 DOI: 10.1038/mt.2015.148] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 08/07/2015] [Indexed: 12/24/2022] Open
Abstract
The development of lentiviral vectors (LVs) for expression of a specific antibody can be achieved through the transduction of mature B-cells. This approach would provide a versatile tool for active immunotherapy strategies for infectious diseases or cancer, as well as for protein engineering. Here, we created a lentiviral expression system mimicking the natural production of these two distinct immunoglobulin isoforms. We designed a LV (FAM2-LV) expressing an anti-HCV-E2 surface glycoprotein antibody (AR3A) as a membrane-anchored Ig form or a soluble Ig form, depending on the B-cell maturation status. FAM2-LV induced high-level and functional membrane expression of the transgenic antibody in a nonsecretory B-cell line. In contrast, a plasma cell (PC) line transduced with FAM2-LV preferentially produced the secreted transgenic antibody. Similar results were obtained with primary B-cells transduced ex vivo. Most importantly, FAM2-LV transduced primary B-cells efficiently differentiated into PCs, which secreted the neutralizing anti-HCV E2 antibody upon adoptive transfer into immunodeficient NSG (NOD/SCIDγc(-/-)) recipient mice. Altogether, these results demonstrate that the conditional FAM2-LV allows preferential expression of the membrane-anchored form of an antiviral neutralizing antibody in B-cells and permits secretion of a soluble antibody following B-cell maturation into PCs in vivo.
Collapse
Affiliation(s)
- Floriane Fusil
- CIRI, International Center for Infectiology Research, Université de Lyon, Lyon, France; Inserm, U1111, Lyon, France; Ecole Normale Supérieure de Lyon, Lyon, France; Université Claude Bernard Lyon 1, Centre International de Recherche en Infectiologie, Lyon, France; CNRS, UMR5308, Lyon, France; LabEx Ecofect, Université de Lyon, Lyon, France
| | - Sara Calattini
- CIRI, International Center for Infectiology Research, Université de Lyon, Lyon, France; Inserm, U1111, Lyon, France; Ecole Normale Supérieure de Lyon, Lyon, France; Université Claude Bernard Lyon 1, Centre International de Recherche en Infectiologie, Lyon, France; CNRS, UMR5308, Lyon, France; LabEx Ecofect, Université de Lyon, Lyon, France
| | - Fouzia Amirache
- CIRI, International Center for Infectiology Research, Université de Lyon, Lyon, France; Inserm, U1111, Lyon, France; Ecole Normale Supérieure de Lyon, Lyon, France; Université Claude Bernard Lyon 1, Centre International de Recherche en Infectiologie, Lyon, France; CNRS, UMR5308, Lyon, France; LabEx Ecofect, Université de Lyon, Lyon, France
| | - Jimmy Mancip
- CIRI, International Center for Infectiology Research, Université de Lyon, Lyon, France; Inserm, U1111, Lyon, France; Ecole Normale Supérieure de Lyon, Lyon, France; Université Claude Bernard Lyon 1, Centre International de Recherche en Infectiologie, Lyon, France; CNRS, UMR5308, Lyon, France; LabEx Ecofect, Université de Lyon, Lyon, France
| | - Caroline Costa
- CIRI, International Center for Infectiology Research, Université de Lyon, Lyon, France; Inserm, U1111, Lyon, France; Ecole Normale Supérieure de Lyon, Lyon, France; Université Claude Bernard Lyon 1, Centre International de Recherche en Infectiologie, Lyon, France; CNRS, UMR5308, Lyon, France; LabEx Ecofect, Université de Lyon, Lyon, France
| | - Justin B Robbins
- Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla, California, USA; Present address: Organovo Holdings, Inc., San Diego, California, USA
| | - Florian Douam
- CIRI, International Center for Infectiology Research, Université de Lyon, Lyon, France; Inserm, U1111, Lyon, France; Ecole Normale Supérieure de Lyon, Lyon, France; Université Claude Bernard Lyon 1, Centre International de Recherche en Infectiologie, Lyon, France; CNRS, UMR5308, Lyon, France; LabEx Ecofect, Université de Lyon, Lyon, France; Present address: Department of Molecular Biology, Princeton University, Princeton, New Jersey, USA
| | - Dimitri Lavillette
- CIRI, International Center for Infectiology Research, Université de Lyon, Lyon, France; Inserm, U1111, Lyon, France; Ecole Normale Supérieure de Lyon, Lyon, France; Université Claude Bernard Lyon 1, Centre International de Recherche en Infectiologie, Lyon, France; CNRS, UMR5308, Lyon, France; LabEx Ecofect, Université de Lyon, Lyon, France; Present address: Institut Pasteur Shanghai, Chinese Academy of Sciences, Shanghai, China
| | - Mansun Law
- Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla, California, USA
| | - Thierry Defrance
- CIRI, International Center for Infectiology Research, Université de Lyon, Lyon, France; Inserm, U1111, Lyon, France; Ecole Normale Supérieure de Lyon, Lyon, France; Université Claude Bernard Lyon 1, Centre International de Recherche en Infectiologie, Lyon, France; CNRS, UMR5308, Lyon, France
| | - Els Verhoeyen
- CIRI, International Center for Infectiology Research, Université de Lyon, Lyon, France; Inserm, U1111, Lyon, France; Ecole Normale Supérieure de Lyon, Lyon, France; Université Claude Bernard Lyon 1, Centre International de Recherche en Infectiologie, Lyon, France; CNRS, UMR5308, Lyon, France; LabEx Ecofect, Université de Lyon, Lyon, France; Inserm, U1065, Centre Méditerranéen de Médecine Moléculaire (C3M), équipe "contrôle métabolique des morts cellulaires", Nice, France
| | - François-Loïc Cosset
- CIRI, International Center for Infectiology Research, Université de Lyon, Lyon, France; Inserm, U1111, Lyon, France; Ecole Normale Supérieure de Lyon, Lyon, France; Université Claude Bernard Lyon 1, Centre International de Recherche en Infectiologie, Lyon, France; CNRS, UMR5308, Lyon, France; LabEx Ecofect, Université de Lyon, Lyon, France.
| |
Collapse
|
46
|
Baroncelli S, Galluzzo CM, Liotta G, Andreotti M, Jere H, Erba F, Sagno JB, Amici R, Mancinelli S, Marazzi MC, Vella S, Palombi L, Giuliano M. Anti-Streptococcus pneumoniae and rotavirus IgG levels in HIV-positive women do not correlate with maternal status and infant morbidity and mortality. J Med Microbiol 2015; 64:795-797. [PMID: 25976002 DOI: 10.1099/jmm.0.000087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Silvia Baroncelli
- Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Regina Elena, 299, 00161 Rome, Italy
| | - Clementina Maria Galluzzo
- Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Regina Elena, 299, 00161 Rome, Italy
| | - Giuseppe Liotta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Mauro Andreotti
- Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Regina Elena, 299, 00161 Rome, Italy
| | - Haswell Jere
- DREAM Program, Community of S. Egidio, P.O. Box 30355, Blantyre, Malawi
| | - Fulvio Erba
- Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | | | - Roberta Amici
- Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Regina Elena, 299, 00161 Rome, Italy
| | - Sandro Mancinelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | | | - Stefano Vella
- Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Regina Elena, 299, 00161 Rome, Italy
| | - Leonardo Palombi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Marina Giuliano
- Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Regina Elena, 299, 00161 Rome, Italy
| |
Collapse
|
47
|
|
48
|
Evaluation of antibody levels over 3 years after 23-valent pneumococcal polysaccharide vaccination in patients with pulmonary diseases receiving steroids and immunosuppressive agents. Clin Biochem 2014; 48:125-9. [PMID: 25448031 DOI: 10.1016/j.clinbiochem.2014.11.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 11/04/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Pneumococcal capsular polysaccharide vaccine is a mainstay for prevention of Streptococcus pneumoniae infection in adults. There is the possibility that this vaccine is less effective in patients undergoing immunosuppressive therapy. In the present study, we aimed to evaluate the immune response following 23-valent pneumococcal polysaccharide vaccination in pulmonary disease patients receiving steroids and immunosuppressive agents (immunosuppressive group). DESIGN AND METHODS Antibody levels were measured over 3 years in the immunosuppressive group (median age: 68.5 years) and in aged-match pulmonary disease patients not being treated with immunosuppressive therapy (control group) using enzyme-linked immunosorbent assays. RESULTS The geometric mean antibody levels were significantly increased after vaccination in both groups (p < 0.05) and remained above baseline for 3 years. The fold increases 1 month after vaccination were 9.4 (95% confidence interval [CI]: 5.7-15.6) and 8.8 (95% CI: 5.8-13.2) in the immunosuppressive and control groups, respectively (p = 0.813). There was no significant difference in the proportion of subjects with a ≥ two-fold increase of antibody level between the immunosuppressive and control groups at any point. CONCLUSIONS These results suggest that immunization with the 23-valent pneumococcal polysaccharide vaccine was effective, even in patients undergoing immunosuppressive therapy and should be recommended for such patients.
Collapse
|
49
|
Vidarsson G, Dekkers G, Rispens T. IgG subclasses and allotypes: from structure to effector functions. Front Immunol 2014; 5:520. [PMID: 25368619 PMCID: PMC4202688 DOI: 10.3389/fimmu.2014.00520] [Citation(s) in RCA: 1645] [Impact Index Per Article: 164.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 10/06/2014] [Indexed: 12/21/2022] Open
Abstract
Of the five immunoglobulin isotypes, immunoglobulin G (IgG) is most abundant in human serum. The four subclasses, IgG1, IgG2, IgG3, and IgG4, which are highly conserved, differ in their constant region, particularly in their hinges and upper CH2 domains. These regions are involved in binding to both IgG-Fc receptors (FcγR) and C1q. As a result, the different subclasses have different effector functions, both in terms of triggering FcγR-expressing cells, resulting in phagocytosis or antibody-dependent cell-mediated cytotoxicity, and activating complement. The Fc-regions also contain a binding epitope for the neonatal Fc receptor (FcRn), responsible for the extended half-life, placental transport, and bidirectional transport of IgG to mucosal surfaces. However, FcRn is also expressed in myeloid cells, where it participates in both phagocytosis and antigen presentation together with classical FcγR and complement. How these properties, IgG-polymorphisms and post-translational modification of the antibodies in the form of glycosylation, affect IgG-function will be the focus of the current review.
Collapse
Affiliation(s)
- Gestur Vidarsson
- Department of Experimental Immunohematology, Sanquin Research, and Landsteiner Laboratory, Academic Medical Center, University of Amsterdam , Amsterdam , Netherlands
| | - Gillian Dekkers
- Department of Experimental Immunohematology, Sanquin Research, and Landsteiner Laboratory, Academic Medical Center, University of Amsterdam , Amsterdam , Netherlands
| | - Theo Rispens
- Department of Immunopathology, Sanquin Research, and Landsteiner Laboratory, Academic Medical Center, University of Amsterdam , Amsterdam , Netherlands
| |
Collapse
|
50
|
Kumagai T, Nakayama T, Okuno Y, Kase T, Nishimura N, Ozaki T, Miyata A, Suzuki E, Okafuji T, Okafuji T, Ochiai H, Nagata N, Tsutsumi H, Okamatsu M, Sakoda Y, Kida H, Ihara T. Humoral immune response to influenza A(H1N1)pdm2009 in patients with natural infection and in vaccine recipients in the 2009 pandemic. Viral Immunol 2014; 27:368-74. [PMID: 25211638 DOI: 10.1089/vim.2014.0010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The 2009 pandemic H1N1 mainly affected adolescents and children, and most of the elderly in Japan escaped clinical illness. To clarify the role of humoral immunity in the infection, the time kinetics of hemagglutination inhibition (HI), neutralization (NT), and IgG subclass antibody response directed against influenza A(H1N1)pdm2009 were analyzed in three consecutive specimens obtained from 51 young adults and children (group 1) who contracted pandemic influenza and from 74 pediatric clinic employees (group 2) inoculated with pandemic monovalent vaccine. In group 1 patients, 6 and 30 patients had lower HI and NT antibody in the acute phase respectively. Thereafter, HI and NT antibody titers increased fourfold or more in 50 patients with peak response in the third specimens obtained four weeks after the onset. IgG1 in 45 patients, IgG3 in 18 patients, and IgG4 in 29 patients showed elevated responses. Forty (54%) and 70 (95%) subjects in group 2 had positive HI and NT antibodies in the prevaccination samples, with increased antibody responses in the follow-up peaking in the second specimens. Forty of those vaccinated had increased IgG1 responses peaking in the third specimens, whereas elevated IgG3 was observed in 22 recipients with the highest level in the second samples. IgG4 did not show any increase in subjects in group 2. A few participants showed an IgG2 response in both groups. An immunologically naive population contracted influenza with apparent clinical symptoms. However, already primed subjects through subclinical infection elicited the unique pattern of IgG subclass responses by vaccination, which differed from those of naive populations.
Collapse
Affiliation(s)
- Takuji Kumagai
- 1 Pediatric Allergy and Infectious Diseases Society of Sapporo, Kumagai Pediatric Clinic , Sapporo, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|