反复呼吸道感染儿童的肺炎球菌抗体反应:一项描述性研究。

IF 1.3 4区 医学 Q3 PEDIATRICS Archives De Pediatrie Pub Date : 2024-07-01 DOI:10.1016/j.arcped.2023.12.006
Falke Ceuppens , Isabelle Meyts , Xavier Bossuyt , Kris De Boeck
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引用次数: 0

摘要

背景:非结合型肺炎球菌疫苗接种后的肺炎球菌抗体反应可作为反复呼吸道感染儿童诊断工作的一部分进行评估,以检测潜在的多糖抗体缺乏症。人们对多糖抗体缺乏症在这一人群中的发病率及其治疗后果知之甚少:本研究旨在调查反复呼吸道感染儿童中多糖抗体缺乏症的患病率,并将多糖反应性与临床严重程度相关联。此外,我们还旨在评估免疫球蛋白 (Ig)G2/IgG 比率、IgA 水平和年龄与血清型特异性抗体应答缺乏数量之间的差异:方法: 对 103 名反复呼吸道感染儿童的肺炎球菌血清型 8、9N 和 15B 的多糖抗体滴度、临床特征和免疫球蛋白水平进行了回顾性评估。美国过敏、哮喘和免疫学学会指南用于解释多糖抗体反应:共有 28 名儿童(27.2%)被诊断为多糖抗体缺乏症。血清型特异性抗体反应缺乏的数量与临床严重程度之间没有相关性。对三种血清型均有正常应答的研究参与者的 IgG2/IgG 比率高于有一种或多种应答缺乏的研究参与者(P < 0.003)。IgA水平与多糖反应性之间没有发现明显的相关性。对三种检测血清型多糖反应正常的儿童的中位年龄高于对一种或多种血清型反应不足的儿童(p < 0.0025):对于一大批反复呼吸道感染的儿童(18.4%)来说,诊断性非结合型肺炎球菌多糖疫苗接种确定了他们易感性的潜在机制。还需要进一步研究,以制定特定年龄的多糖反应性正常值,并调查 IgG2/IgG 比值在确定是否需要接种诊断性非结合肺炎球菌多糖疫苗方面的作用。
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Pneumococcal antibody response in children with recurrent respiratory tract infections: A descriptive study

Background

The pneumococcal antibody response after vaccination with unconjugated pneumococcal vaccine can be evaluated as part of the diagnostic work-up of children with recurrent respiratory tract infections to detect an underlying polysaccharide antibody deficiency. Little is known about the prevalence of polysaccharide antibody deficiency in this population and its therapeutic consequences.

Objectives

This study aimed to investigate the prevalence of polysaccharide antibody deficiency in children with recurrent respiratory tract infections and to correlate polysaccharide responsiveness with clinical severity. In addition, we aimed to evaluate differences in the immunoglobulin (Ig)G2/IgG ratio, IgA level, and age in relation to the number of deficient serotype-specific antibody responses.

Methods

Polysaccharide antibody titers for pneumococcal serotypes 8, 9N, and 15B; clinical characteristics; and immunoglobulin levels of 103 children with recurrent respiratory tract infections were retrospectively assessed. American Academy of Allergy, Asthma, and Immunology guidelines were used for the interpretation of the polysaccharide antibody response.

Results

Overall, 28 children (27.2 %) were diagnosed with polysaccharide antibody deficiency. No correlation was found between the number of deficient serotype-specific antibody responses and clinical severity. The study participants with a normal response to all three serotypes had a higher IgG2/IgG ratio than those with one or more deficient responses (p < 0.003). No significant correlation between IgA levels and polysaccharide responsiveness was found. The median age of children with normal polysaccharide responsiveness for the three tested serotypes was higher than that of children with a deficient response to one or more serotypes (p < 0.0025).

Conclusion

For a large group of children (18.4 %) with recurrent respiratory tract infections, an underlying mechanism for their susceptibility was defined thanks to diagnostic unconjugated pneumococcal polysaccharide vaccination. Further research is needed to formulate age-specific normal values for polysaccharide responsiveness and to investigate the usefulness of the IgG2/IgG ratio in determining the need for diagnostic unconjugated pneumococcal polysaccharide vaccination.

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来源期刊
Archives De Pediatrie
Archives De Pediatrie 医学-小儿科
CiteScore
2.80
自引率
5.60%
发文量
106
审稿时长
24.1 weeks
期刊介绍: Archives de Pédiatrie publishes in English original Research papers, Review articles, Short communications, Practice guidelines, Editorials and Letters in all fields relevant to pediatrics. Eight issues of Archives de Pédiatrie are released annually, as well as supplementary and special editions to complete these regular issues. All manuscripts submitted to the journal are subjected to peer review by international experts, and must: Be written in excellent English, clear and easy to understand, precise and concise; Bring new, interesting, valid information - and improve clinical care or guide future research; Be solely the work of the author(s) stated; Not have been previously published elsewhere and not be under consideration by another journal; Be in accordance with the journal''s Guide for Authors'' instructions: manuscripts that fail to comply with these rules may be returned to the authors without being reviewed. Under no circumstances does the journal guarantee publication before the editorial board makes its final decision. Archives de Pédiatrie is the official publication of the French Society of Pediatrics.
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