Thirteen-Valent Pneumococcal Conjugate Vaccine-Induced Immunoglobulin G (IgG) Responses in Serum Associated With Serotype-Specific IgG in the Lung.

Elena Mitsi,Andrea M Collins,David Goldblatt,Angela D Hyder-Wright,Scott Jones,Stephen B Gordon,Daniela M Ferreira,Asia-Sophia Wolf,Daniella McLenaghan,Robert S Heyderman

doi:10.1093/infdis/jiab331

Abstract

Pneumococcal conjugate vaccine (PCV) efficacy is lower for noninvasive pneumonia than invasive disease. In this study, participants were immunized with 13-valent PCV (PCV13) or hepatitis A vaccine (control). Bronchoalveolar lavage samples were taken between 2 and 6 months and serum at 4 and 7 weeks postvaccination. In the lung, anti-capsular immunoglobulin G (IgG) levels were higher in the PCV13 group compared to controls for all serotypes, except 3 and 6B. Systemically, IgG levels were elevated in the PCV13 group at 4 weeks for all serotypes, except serotype 3. IgG in bronchoalveolar lavage and serum positively correlated for nearly all serotypes. PCV13 shows poor immunogenicity to serotype 3, implying lack of protective efficacy. Clinical Trials Registration. ISRCTN 45340436.

Highlights

Colonization of the human nasopharynx with Streptococcus pneumoniae is a frequent and immunizing event, but local/distal tissue invasion leads to a spectrum of diseases, including pneumonia
The highest fold difference in Bronchoalveolar lavage (BAL) immunoglobulin G (IgG) levels between the 2 groups was measured for serotype 23F, whereas the lowest significant difference was measured for serotype 19F (Supplementary Table 2)
Anti-capsular polysaccharide (CPS) IgG to 23F and 19F was, respectively, 8.4- and 1.8-fold higher in the PCV13 group compared to controls

Summary

Introduction

Colonization of the human nasopharynx with Streptococcus pneumoniae (pneumococcus [Spn]) is a frequent and immunizing event, but local/distal tissue invasion leads to a spectrum of diseases, including pneumonia. The licensed 7-, 10-, and 13-valent pneumococcal conjugate vaccines (PCV7, PCV10, and PCV13, respectively) are designed to elicit anti-capsular immune responses to some of the most prevalent serotypes causing disease. PCV13 efficacy against CAP has been reported to be lower compared to invasive pneumococcal disease (IPD), with a study finding 45% vaccine efficacy for a first episode of vaccine-type nonbacteremic, noninvasive CAP, compared to 75% for IPD [4]. We described the anti–capsular polysaccharide (CPS) immunoglobulin G (IgG) responses in the lung lining fluid of healthy adults in response to PCV13 vaccination and compared the levels of anti-CPS IgG to 6B induced by experimental nasal pneumococcal colonization or immunization

Methods

Results

Conclusion