BACKGROUND We sought to compare Pneumovax®23 responses in adults with subnormal IgG subclass concentrations. We studied adults with normal total IgG, frequent/severe respiratory infection, and subnormal IgG1, IgG3, or IgG1 + IgG3 before and after Pneumovax®23. We defined response as serotype-specific IgG > 1.3 μg/mL and aggregate response as IgG > 1.3 μg/mL for ≥70% of all serotypes tested. We compared patients with and without serotype-specific responses and performed logistic regression on aggregate responses using: age; male sex; body mass index; autoimmune condition(s); atopy; other allergies; subnormal IgGSc immunophenotypes; IgA; and IgM. RESULTS There were 59 patients (mean age 44 ± 13 (SD) years; 83.1% women). Median days between pre- and post-Pneumovax®23 testing was 33 (range 19-158). The median post-vaccination summated concentration of serotype-specific IgG was higher in patients with subnormal IgG1 than subnormal IgG3 (responders and non-responders). All subnormal IgG1 + IgG3 non-responders responded to serotypes 8, 9 and 26, unlike other non-responders. Subnormal IgG3 responders had lower responses to serotypes 1, 4, 12, 23, 26, and 51. Subnormal IgG3 non-responders had higher responses to serotypes 1, 3, 8, 9, 12, 14, 19, 51, and 56. Response rates decreased with increasing age. Aggregate responders were: subnormal IgG1, 54%; IgG3, 46%; and IgG1 + IgG3, 46%. Regression on aggregate response revealed lower response with male sex (odds ratio 0.09 [95% CI 0.01, 0.77]) and atopy (0.17 [0.03, 0.83]). CONCLUSIONS Serotype-specific IgG responses to Pneumovax®23 were greater in patients with subnormal IgG1 than subnormal IgG3. Male sex and atopy were associated with lower aggregate responses.

中文翻译：

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IgG亚类浓度低于正常水平的成年人中的肺炎球菌疫苗接种反应。

发明背景我们试图比较具有亚正常IgG亚类浓度的成年人中的23响应。我们研究了Pneumovax®23前后总IgG正常，频繁/重度呼吸道感染以及IgG1，IgG3或IgG1 + IgG3亚正常的成年人。对于≥70％的所有血清型，我们将应答定义为血清型特异性IgG> 1.3μg/ mL，总应答定义为IgG> 1.3μg/ mL。我们比较了有血清型特异性反应和无血清型特异性反应的患者，并使用以下方法对总体反应进行了逻辑回归：男性; 体重指数 自身免疫性疾病；特应性 其他过敏；亚正常IgGSc免疫表型; IgA；和IgM。结果有59例患者（平均年龄44±13（SD）岁；女性83.1％）。在Pneumovax®23测试之前和之后的中间天数为33（范围为19-158）。亚正常IgG1的患者中血清型特异性IgG的接种后总浓度中位数高于亚正常IgG3的患者（应答者和非应答者）。与其他无反应者不同，所有亚正常IgG1 + IgG3无反应者都对血清型8、9和26有反应。亚正常IgG3响应者对血清型1、4、12、23、26和51的响应较低。亚正常IgG3无响应者对血清型1、3、8、9、12、14、19、51和56的响应较高。响应率随年龄增长而降低。总体反应者为：IgG1低于正常水平，为54％；IgG3，46％；和IgG1 + IgG3，占46％。总体反应的回归显示，男性（奇数比为0.09 [95％CI 0.01，0.77]）和特应性（0.17 [0.03，0.83]）反应较低。结论IgG1亚正常的患者对Pneumovax®23的血清型特异性IgG反应要高于IgG3亚正常的患者。