Polysaccharide responsiveness is not biased by prior pneumococcal-conjugate vaccination

Polysaccharide responsiveness is tested by measuring antibody responses to polysaccharide vaccines to diagnose for humoral immunodeficiency. A common assumption is that this responsiveness is biased by any previous exposure to the polysaccharides in the form of protein-coupled polysaccharide vaccine...

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Bibliographic Details
Published in:PloS one 2013-10, Vol.8 (10), p.e75944
Main Authors: Bernth-Jensen, Jens Magnus, Søgaard, Ole Schmeltz
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
Adult
Adults
AIDS
Analysis
Antibodies, Bacterial - blood
Antiretroviral drugs
Asthma
Bias
Children
Continuity (mathematics)
Drug therapy
Female
Guidelines
HIV
HIV Infections - immunology
HIV Infections - virology
HIV patients
Human immunodeficiency virus
Humans
Immunoconjugates - administration & dosage
Immunoconjugates - chemistry
Immunoconjugates - immunology
Immunodeficiency
Immunoglobulin G
Immunoglobulin G - blood
Immunologic Memory
Immunological memory
Immunology
Infectious diseases
Male
Pneumococcal Infections - immunology
Pneumococcal Infections - prevention & control
Pneumococcal Vaccines - administration & dosage
Pneumococcal Vaccines - biosynthesis
Pneumococcal Vaccines - immunology
Polysaccharides
Polysaccharides, Bacterial - administration & dosage
Polysaccharides, Bacterial - chemistry
Polysaccharides, Bacterial - immunology
Population studies
Practice Guidelines as Topic
Proteins
Saccharides
Streptococcus infections
Vaccination
Vaccines
Vaccines, Conjugate
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Summary:Polysaccharide responsiveness is tested by measuring antibody responses to polysaccharide vaccines to diagnose for humoral immunodeficiency. A common assumption is that this responsiveness is biased by any previous exposure to the polysaccharides in the form of protein-coupled polysaccharide vaccines, such as those used in many childhood vaccination programmes. To examine this assumption, we investigated the effect of protein-coupled polysaccharide vaccination on subsequent polysaccharide responsiveness. HIV-infected adults (n = 47) were vaccinated twice with protein-coupled polysaccharides and six months later with pure polysaccharides. We measured immunoglobulin G responses against three polysaccharides present in only the polysaccharide vaccine (non-memory polysaccharides) and seven recurring polysaccharides (memory polysaccharides). Responsiveness was evaluated according to the consensus guidelines published by the American immunology societies. Impaired responsiveness to non-memory polysaccharides was more frequent than to memory polysaccharides (51% versus 28%, P = 0.015), but the individual polysaccharides did not differ in triggering sufficient responses (74% versus 77%, P = 0.53). Closer analysis revealed important shortcomings of the current evaluation guidelines. The interpreted responses number and their specificities influenced the likelihood of impaired responsiveness in a complex manor. This influence was propelled by the dichotomous approaches inherent to the American guidelines. We therefore define a novel more robust polysaccharide responsiveness measure, the Z-score, which condenses multiple, uniformly weighted responses into one continuous variable. Using the Z-score, responsiveness to non-memory polysaccharides and memory-polysaccharides were found to correlate (R(2) = 0.59, P
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0075944