Measurement of Typhim Vi IgG as a Diagnostic Tool to Determine Anti-polysaccharide Antibody Production Deficiency in Children

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dc.contributor.authorGuevara-Hoyer, Kissy et al.
dc.contributor.authorPérez de Diego, Rebeca
dc.contributor.authorGil López, Celia
dc.contributor.authorRecio Hoyas, María José
dc.contributor.authorFernández Arquero, Miguel
dc.contributor.authorRamos Amador, José Tomás
dc.contributor.authorSánchez Ramón, Silvia María
dc.date.accessioned2024-01-11T18:05:47Z
dc.date.available2024-01-11T18:05:47Z
dc.date.issued2019-04-02
dc.description.abstractBackground: The assessment of specific polysaccharide antibody production plays a pivotal role in the diagnosis of humoral primary immunodeficiencies (PID). The response to 23-valent pneumococcal vaccine (PPV) remains the gold standard for the diagnosis of polysaccharide antibodies. However, in Spain, the interpretation of pure polysaccharide 23-valent immunization is hampered by the high endemicity of pneumococcal disease and the generalization of the 13-valent adjuvant pneumococcal vaccination. Specific Typhim Vi vaccination (TV) immunoglobulin G IgG response to immunization is useful in adult PID, but there is no data regarding children. Objectives: To evaluate the clinical utility of TV IgG production as a diagnostic tool to determine anti-polysaccharide antibody production deficiency in children, when the response to PPV is unclear and isolated determination of serotypes is unfeasible. Methods: We conducted a single-institution prospective observational study on 61 children with recurrent infections. Baseline specific antibodies against PPV and TV were evaluated. In 28 children (46%), the response to the production of antibodies confirmed a clinical suspicion of humoral PID, and they were therefore immunized with 23-valent pneumococcal vaccine and Typhim Vi. Both specific antibody responses were measured by ELISA (The Binding Site Group Ltd, Birmingham, UK) using previously published cut-offs. Results: Seventy percent of the 61 children displayed baseline PPV IgG > 27 mg/L, whereas only 8% showed TV IgG > 28 U/mL (p < 0.0001). Twenty-one of 28 children (75%) achieved a 3-fold increase in post-vaccination TV IgG levels, whereas only 3% achieved a 4-fold increase in PPV IgG post vaccination, mainly due to high baseline PPV IgG titers. When we classified children according to their response to TV as responders or non-responders and compared this with the well-known clinical warning signs of the Jeffrey Modell Foundation. The proportions of children with history of pneumonia and the need for intravenous antibiotics were significantly higher in TV IgG non-responders than in TV IgG responders (p = 0.02 and p = 0.01, respectively). Conclusion: Response to TV can be considered an ancillary diagnostic tool to determine polysaccharide antibodies in children, particularly when isolated determination of pneumococcal serotypes is not feasible. TV provides a useful asset for clinicians in the era of conjugate PPV vaccination, with clinical relevance. Further research is warranted for validation.
dc.description.departmentDepto. de Inmunología, Oftalmología y ORL
dc.description.facultyFac. de Medicina
dc.description.refereedTRUE
dc.description.statuspub
dc.identifier.citationGuevara-Hoyer K, Gil C, Parker AR, Williams LJ, Orte C, Rodriguez de la Peña A, Ochoa-Grullón J, Rodriguez De Frias E, García IS, García-Gómez S, Recio MJ, Fernández-Arquero M, Pérez de Diego R, Ramos JT, Sánchez-Ramón S. Front Immunol. 2019 Apr 2;10:654.
dc.identifier.doi10.3389/fimmu.2019.00654
dc.identifier.issn1664-3224
dc.identifier.officialurlhttps://www.frontiersin.org/articles/10.3389/fimmu.2019.00654/full
dc.identifier.urihttps://hdl.handle.net/20.500.14352/92632
dc.journal.titleFrontiers in Immunology
dc.language.isoeng
dc.page.initial654
dc.publisherFrontiers Media S.A
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 Internationalen
dc.rights.accessRightsopen access
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subject.cdu612.017
dc.subject.keywordTyphim Vi, , polyssaccharide, vaccine, antibody deficiencies, immunodefiency
dc.subject.keywordPolyssaccharide
dc.subject.keywordVaccine
dc.subject.keywordAntibody deficiencies
dc.subject.keywordImmunodefiency
dc.subject.ucmInmunología
dc.subject.unesco2412 Inmunología
dc.titleMeasurement of Typhim Vi IgG as a Diagnostic Tool to Determine Anti-polysaccharide Antibody Production Deficiency in Children
dc.typejournal article
dc.type.hasVersionVoR
dc.volume.number10
dspace.entity.typePublication
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