Background

Vaccination against S. pneumoniae is recommended by national guidelines. Moderate immunogenicity of the 13-valent pneumococcal conjugate vaccine (PCV13) has been reported in adult kidney transplant recipients (KTR). This study further defines the immunogenicity of PCV13 in this cohort.

Methods

49 KTR were immunized with PCV13. A validated opsonophagocytic killing assay (OPA), a global anti-pneumococcal capsular polysaccharide (anti-PCP) IgG, IgG2, IgM and IgA ELISA, and - for selected patients - a serotype specific anti-PCP WHO reference ELISA were performed pre-vaccination and at month 1 and 12 post-vaccination.

Results

Geometric mean OPA titers increased significantly for 13/13 serotypes at month 1 and for 10/13 serotypes at month 12 post-vaccination. Vaccine response defined as an OPA titer ≥1:8 was reached in 9/13 serotypes (median). 53% reached the vaccine response criteria at month 1 and 45% at month 12. At month 1 after vaccination, the median OPA titer in an age-group matched healthy reference population was 5- to 10-fold higher than in KTR. OPA titers correlated strongly with results to the global and serotype specific anti-PCP IgG ELISA. Lower OPA titers significantly (p < 0.05) correlated with albuminuria, an interval between vaccination and transplantation <12 months, age and treatment with mycophenolate mofetil. Global IgG, IgG2, IgM and IgA, as well as serotype specific anti-PCP antibody concentrations (12/13 serotypes) increased significantly at month 1 and 12 post-vaccination.

Conclusions

Kidney transplant recipients show a significant humoral response after vaccination with PCV13. Functional antibody response exists, but is not as vigorous as in healthy adults.

中文翻译：

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肾脏移植受者对13价肺炎球菌结合疫苗的体液反应

背景

国家指导方针建议对肺炎链球菌进行疫苗接种。已在成年肾移植受者（KTR）中报告了13价肺炎球菌结合疫苗（PCV13）的中等免疫原性。这项研究进一步定义了该人群中PCV13的免疫原性。

方法

用PCV13免疫了49个KTR。疫苗接种前进行了经过验证的调理性吞噬细胞杀伤试验（OPA），全局抗肺炎球菌荚膜多糖（anti-PCP）IgG，IgG2，IgM和IgA ELISA，并且-对于部分患者-血清型特异性抗PCP WHO参考ELISA接种后的第1和12个月。

结果

接种后第1个月的13/13血清型和第12个月的10/13血清型的几何平均OPA滴度显着增加。在9/13血清型（中位数）中达到了定义为OPA滴度≥1：8的疫苗反应。53％的患者在第1个月达到疫苗反应标准，第12个月达到45％，在接种疫苗后的第1个月，年龄匹配的健康参考人群的OPA滴度中值比KTR高5至10倍。OPA滴度与总体和血清型特异性抗PCP IgG ELISA结果紧密相关。较低的OPA滴度显着（p <0.05）与白蛋白尿有关，白蛋白尿是指疫苗接种与移植之间的时间间隔<12个月，年龄和霉酚酸酯治疗。整体IgG，IgG2，IgM和IgA，

结论

肾移植受者接种PCV13后显示出明显的体液反应。存在功能性抗体应答，但不如健康成年人强烈。