Optimal assessment of the ability of children with recurrent respiratory tract infections to produce anti-polysaccharide antibodies.
(2007) Clinical and Experimental Immunology — Vol. 149, n° 2, p. 295-302 (2007)
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- Specific anti-polysaccharide antibody deficiency (SPAD) is an immune disorder. Diagnostic criteria have not yet been defined clearly. One hundred and seventy-six children evaluated for recurrent respiratory tract infections were analysed retrospectively. For each subject, specific anti-pneumococcal antibodies had been measured with two enzyme-linked immunosorbent assays (ELISAs), one overall assay (OA) using the 23-valent pneumococcal polysaccharide vaccine (23-PPSV) as detecting antigen and the other purified pneumococcal polysaccharide serotypes (serotype-specific assay, SSA) (serotypes 14, 19F and 23F). Antibody levels were measured before (n = 176) and after (n = 93) immunization with the 23-PPSV. Before immunization, low titres were found for 138 of 176 patients (78%) with OA, compared to 20 of 176 patients (11%) with the SSA. We found a significant correlation between OA and SSA results. After immunization, 88% (71 of 81) of the patients considered as responders in the OA test were also responders in the SSA; 93% (71 of 76) of the patients classified as responders according to the SSA were also responders in the OA. SPAD was diagnosed in 8% (seven of 93) of patients on the basis of the absence of response in both tests. Thus, we propose to use OA as a screening test for SPAD before 23-PPSV immunization. After immunization, SSA should be used only in case of a low response in OA. Only the absence of or a very low antibody response detected by both tests should be used as a diagnostic criterion for SPAD.
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Tuerlinckx, D., Vermeulen, F., Pékus, V., de Bilderling, G., Glupczynski, Y., Collet, S., Jamart, J., Bodart, E., & Mascart, F. (2007). Optimal assessment of the ability of children with recurrent respiratory tract infections to produce anti-polysaccharide antibodies. Clinical and Experimental Immunology, 149(2), 295-302. https://doi.org/10.1111/j.1365-2249.2007.03409.x (Original work published 2007)