Abstract
Purpose
Patients with antibody deficiency rely on immunoglobulin products for protection against many vaccine-preventable diseases. We measured antibody titers against Bordetella pertussis and Neisseria meningitidis in patients receiving immunoglobulin (IG) therapy to determine if they have any protection against infections from these organisms.
Methods
In an unblinded, prospective assessment we measured antibody titers against B. pertussis filamentous hemagglutinin (FHA) and pertussis toxin (PT) antigens and N. meningitidis serogroups A, C, W-135, and Y in patients receiving immunoglobulin therapy for primary immune deficiency (PI). We measured steady state levels in patients receiving subcutaneous immunoglobulin therapy while in patients receiving intravenous immunoglobulin therapy we measured titers immediately before and after infusion to more clearly define the contribution of the infused product.
Results
Thirty subjects, 17 females and 13 males, participated in the study, 22 were receiving intravenous IG products and 8 were receiving subcutaneous IG products. Diagnoses included common variable immunodeficiency in 12, combined immunodeficiency in 6, specific antibody deficiency in 6, X-linked agammaglobulinemia in 4 and ataxia telangiectasia and hyper-IgE syndrome in one each. All subjects had detectable IgG antibodies against the pertussis antigens measured and most had antibody to the meningococcus serotypes measured. However, only 26.6 % had protective levels (>= 2 mcg/mL) against serogroup C at trough or steady state.
Conclusions
Patients receiving immunoglobulin therapy have antibodies against B. pertussis and most of them have antibodies against the four measured serogroups of N. meningitidis. There is significant variability in the levels of antibody between patients and the low titers against group C may suggest a role for active immunization in those who may respond to conjugated polysaccharide vaccine administration.
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References
Maranich AM, Rajnik M. Varicella-specific immunoglobulin G titers in commercial intravenous immunoglobulin preparations. Pediatrics. 2009;124:e484–8.
Farcet MR, Planitzer CB, Stein O, Modrof J, Kreil TR. Hepatitis a virus antibodies in immunoglobulin preparations. J Allergy Clin Immunol. 2010;125:198–202.
Code of Federal Regulations, 21 CFR 640.104 - Potency
Lear S, Eren E, Findlow J, Borrow R, Webster D, Jolles S. Meningococcal meningitis in two patients with primary antibody deficiency treated with replacement intravenous immunoglobulin. J Clin Pathol. 2006;59:1191–3.
Abolhassani H, Sadaghiani MS, Aghamohammadi A, et al. Home-based subcutaneous immunoglobulin versus hospital-based intravenous immunoglobulin in treatment of primary antibody deficiencies: systematic review and meta analysis. J Clin Immunol. 2012;32:1180–92.
Prince HE, Lapé-Nixon M, Matud J. Evaluation of a tetraplex microsphere assay for Bordetella pertussis antibodies. Clin Vaccine Immunol. 2006;13:266–70.
Plotkin SA. Correlates of protection induced by vaccination. Clin Vaccine Immunol. 2010;17:1055–65.
Cherry JD, Gornbein J, Heininger U, Stehr K. A search for serologic correlates of immunity to Bordetella pertussis cough illnesses. Vaccine. 1998;16:1901–6.
Peltola H, Mäkelä PH, Käyhty H, et al. Clinical efficacy of meningococcus group a capsular polysaccharide vaccine in children 3 months to 5 years of age. N Engl J Med. 1977;297:686–91.
Acknowledgments
This research was supported in part by the Jeffrey Modell foundation and the NIH NCRR CTSI GRANT 1UL1RR031986 and was performed at the CTSI at Children’s Hospital Los Angeles.
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Adam, E., Church, J.A. Antibody Levels to Bordetella pertussis and Neisseria meningitidis in Immunodeficient Patients Receiving Immunoglobulin Replacement Therapy. J Clin Immunol 35, 213–217 (2015). https://doi.org/10.1007/s10875-015-0131-y
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DOI: https://doi.org/10.1007/s10875-015-0131-y