Serotypes With Low Invasive Potential Are Associated With an Impaired Antibody Response in Invasive Pneumococcal Disease.

Nils Littorin,Kristian Riesbeck,Simon Athlin,Hans-Christian Slotved,Fabian Uddén,Jonas Ahl,Fredrik Resman

doi:10.3389/fmicb.2018.02746

Nils Littorin, Kristian Riesbeck + Show 5 more

Open Access

https://doi.org/10.3389/fmicb.2018.02746

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Abstract

Pneumococcal polysaccharide vaccines may elicit a hyporesponse under certain conditions. There is limited knowledge, however, on the type of specific antibody response in individuals with invasive pneumococcal disease (IPD). The aim of this study was to investigate the functional antibody response in patients with IPD caused by different serotypes. Pre-immune and convalescent sera from 40 patients (age 14–91 years) with IPD caused by serotypes with low (serotype 3, 19F, and 23F) and high (1, 4, 7F, and 14) invasive potential were investigated. For each patient, the homologous serotype-specific antibody concentration was determined. The functionality of induced antibodies post-IPD was evaluated in an opsonophagocytic assay (OPA). Undetectable or decreased pneumococcal killing in OPA following IPD, i.e., a nonfunctional antibody response, was observed in 24 of 40 patients (60%). Patients with nonfunctional antibody responses had lower serotype specific IgG antibody ratios post-IPD than patients with increased OPA titres. A nonfunctional antibody response was associated with low invasive serotypes (3, 19F, and 23F, p = 0.015). In conclusion, a nonfunctional antibody response may follow IPD, and was in our cohort associated to serotypes with low invasive potential. These findings need to be confirmed in a larger material.

Highlights

Despite widespread immunization with pneumococcal conjugate vaccines (PCVs) and effective antimicrobial therapy, Streptococcus pneumoniae is still a major cause of upper and lower respiratory tract infection as well as invasive pneumococcal disease (IPD)
To determine whether IPD related to certain pneumococcal serotypes induces a nonfunctional antibody response, patient sera were collected from two different counties in Sweden
We analyzed sera from patients with IPD in a single serotype opsonophagocytic assay (OPA) comprising activated human phagocytes according to a well established protocol

Summary

Introduction

Despite widespread immunization with pneumococcal conjugate vaccines (PCVs) and effective antimicrobial therapy, Streptococcus pneumoniae is still a major cause of upper and lower respiratory tract infection as well as invasive pneumococcal disease (IPD). Streptococcus pneumoniae and Functional Antibody Response carriage in the nasopharynx (Dagan et al, 2010a; Väkeväinen et al, 2010; Rodenburg et al, 2011). Pneumovax R (PPV23), a polysaccharide-based vaccine advocated for immunocompromised hosts and individuals >65 years of age, has been associated with an attenuated antibody response upon revaccination (O’Brien et al, 2007). Excessive concentrations of polysaccharide have been found to reduce the antibody response (Dagan et al, 2010b)

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