The effect of pneumococcal immunization on total and antigen-specific B cells in patients with severe chronic kidney disease

Autor: William McCready, Gabrielle N. Gaultier, Marina Ulanova
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
0301 basic medicine
T-cell independent response
Chronic kidney disease (CKD)
Severity of Illness Index
Pneumococcal conjugate vaccine
Pneumococcal Vaccines
0302 clinical medicine
Flow cytometry
030212 general & internal medicine
Aged
80 and over
B-Lymphocytes
Enzyme-linked immunospot assay (ELISPOT)
biology
Immunogenicity
Vaccination
Middle Aged
T-cell dependent response
Antibodies
Bacterial
Streptococcus pneumoniae
Epitopes
B-Lymphocyte
Female
Antibody
Research Article
medicine.drug
Adult
lcsh:Immunologic diseases. Allergy
Immunology
B-Lymphocyte Subsets
chemical and pharmacologic phenomena
Pneumococcal Infections
Immunophenotyping
Young Adult
03 medical and health sciences
Immune system
Antigen
medicine
Humans
Renal Insufficiency
Chronic
Aged
B cells
business.industry
Memory B cells
Pneumococcal polysaccharide vaccine
23-valent pneumococcal polysaccharide vaccine (PPV23)
030104 developmental biology
Pneumococcal vaccine
13-valent pneumococcal conjugate vaccine (PCV13)
biology.protein
Immunization
business
lcsh:RC581-607
Zdroj: BMC Immunology, Vol 20, Iss 1, Pp 1-13 (2019)
BMC Immunology
ISSN: 1471-2172
0237-0069
DOI: 10.1186/s12865-019-0325-9
Popis: Background While the 23-valent pneumococcal polysaccharide vaccine (PPV23) is routinely used in Canada and some other countries to prevent pneumococcal infection in adults with chronic kidney disease (CKD), patients develop a suboptimal antibody response to PPV23 due to their immune dysfunction. The 13-valent pneumococcal conjugate vaccine (PCV13) has superior immunogenicity in some categories of immunocompromised adults; however, its effect on the immune response in CKD patients has only been addressed by two recent studies with conflicting results. The effect of PPV23 or PCV13 on B cells in these patients has not been previously studied. We studied the absolute numbers and proportions of B cells and subpopulations in two groups of adult patients with severe CKD pre- and 7 days post-immunization with PCV13: pneumococcal vaccine naïve and previously immunized with PPV23 (over one year ago). Results PPV23 immunized patients had significantly lower proportions and absolute numbers of class switched memory (CD19 + CD27 + IgM-), as well as lower absolute numbers of IgM memory (CD19 + CD27 + IgM+) and class switched B cells (CD19 + CD27-IgM-) compared to PPV23 naïve patients. Following PCV13 immunization, the differences in absolute numbers of B-cell subpopulations between groups remained significant. The PPV23 immunized group had higher proportions of CD5- B cells along with lower proportions and absolute numbers of CD5+ B cells compared to PPV23 naïve patients both pre- and post-immunization with PCV13. However, previous PPV23 immunization did not have a noticeable effect on the numbers of total IgG or serotype 6B and 14 specific antibody-secreting cells detected 7 days post-immunization with PCV13. Nevertheless, fold increase in anti-serotype 14 IgG concentrations 28 days post-PCV13 was greater in PPV23 naïve than in previously immunized patients. Conclusions The results suggest that immunization with PPV23 may result in long-term changes in B-cell subpopulations such as increased prevalence of CD5- B cells and decreased prevalence of class switched memory B cells in the peripheral blood. Because previous immunization with PPV23 in patients with CKD is associated with a significant decrease in the total class switched memory B cells in response to subsequent immunization with PCV13, this may reduce PCV13 immunogenicity in the setting of PPV23 followed by PCV13. Trial registration Registered February 24, 2015 at ClinicalTrials.gov (NCT 02370069).
Databáze: OpenAIRE
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