Anti-pneumococcal antibody levels three to seven years after first booster immunization in children with sickle cell disease, and after a second booster

Rao, Sumathi; Rajkumar, K.; Schiffman, Gerald; Desai, Ninad; Unger, Carol; Miller, Scott T.

doi:10.1016/s0022-3476(95)70119-2

Cited by 20 publications

(11 citation statements)

References 9 publications

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“…The most striking finding in the present study was the correlation of the peak systemic anti-Ad5 neutralizing antibody response with the level of baseline anti-Ad5 neutralizing titers. Irrespective of route of administration and underlying disorder, we observed that individuals with higher baseline anti-Ad neutralizing antibody titer mounted a higher neutralizing antibody response after vector administration, consistent with a secondary immune response in those individuals previously exposed to Ad of a similar serotype (29,92,94).…”

Section: Discussionsupporting

confidence: 55%

Variability of Human Systemic Humoral Immune Responses to Adenovirus Gene Transfer Vectors Administered to Different Organs

Harvey

Hackett

El-Sawy

et al. 1999

J Virol

137

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Administration of adenovirus (Ad) vectors to immunologically naive experimental animals almost invariably results in the induction of systemic anti-Ad neutralizing antibodies. To determine if the human systemic humoral host responses to Ad vectors follow a similar pattern, we evaluated the systemic (serum) anti-Ad serotype 5 (Ad5) neutralizing antibodies in humans after administration of first generation (E1− E3−) Ad5-based gene transfer vectors to different hosts. AdGVCFTR.10 (carrying the normal human cystic fibrosis [CF] transmembrane regulator cDNA) was sprayed (8 × 107 to 2 × 1010 particle units [PU]) repetitively (every 3 months or every 2 weeks) to the airway epithelium of 15 individuals with CF. AdGVCD.10 (carrying the Escherichia coli cytosine deaminase gene) was administered (8 × 108 to 8 × 109PU; once a week, twice) directly to liver metastasis of five individuals with colon cancer and by the intradermal route (8 × 107 to 8 × 109 PU, single administration) to six healthy individuals. AdGVVEGF121.10 (carrying the human vascular endothelial growth factor 121 cDNA) was administered (4 × 108 to 4 × 109.5 PU, single administration) directly to the myocardium of 11 individuals with ischemic heart disease. Ad vector administration to the airways of individuals with CF evoked no or minimal serum neutralizing antibodies, even with repetitive administration. In contrast, intratumor administration of an Ad vector to individuals with metastatic colon cancer resulted in a robust antibody response, with anti-Ad neutralizing antibody titers of 102 to >104. Healthy individuals responded to single intradermal Ad vector variably, from induction of no neutralizing anti-Ad antibodies to titers of 5 × 103. Likewise, individuals with ischemic heart disease had a variable response to single intramyocardial vector administration, ranging from minimal neutralizing antibody levels to titers of 104. Evaluation of the data from all trials showed no correlation between the peak serum neutralizing anti-Ad response and the dose of Ad vector administered (P > 0.1, all comparisons). In contrast, there was a striking correlation between the peak anti-Ad5 neutralizing antibody levels evoked by vector administration and the level of preexisting anti-Ad5 antibodies (P = 0.0001). Thus, unlike the case for experimental animals, administration of Ad vectors to humans does not invariably evoke a systemic anti-Ad neutralizing antibody response. In humans, the extent of the response is dictated by preexisting antibody titers and modified by route of administration but is not dose dependent. Since the extent of anti-Ad neutralizing antibodies will likely modify the efficacy of administration of Ad vectors, these observations are of fundamental importance in designing human gene therapy trials and in interpreting the efficacy of Ad vector-mediated gene transfer.

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Section: Discussionsupporting

confidence: 55%

Variability of Human Systemic Humoral Immune Responses to Adenovirus Gene Transfer Vectors Administered to Different Organs

Harvey

Hackett

El-Sawy

et al. 1999

J Virol

137

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“…An early study examining vaccine response to PPV-23 in pediatric patients with SCD demonstrated a marked drop-off in antibody titer level 3 years after administration [25]. However, this study used older methods of antibody analysis that has been proven to be less serotype specific (compared to our study).…”

Section: Discussionmentioning

confidence: 89%

Assessing the Immunogenic Response of a Single Center’s Pneumococcal Vaccination Protocol in Sickle Cell Disease

Santoro

Myers

Kanter

2016

Journal of Pediatric Hematology/Oncology

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Sickle cell disease (SCD) is the most common inherited hematologic disorder in the United States. Patients with SCD are at increased risk of invasive pneumococcal disease (IPD) and are reliant on both early penicillin prophylaxis and anti-pneumococcal vaccination for prevention of infection. Although studies examining vaccine response have demonstrated a drop off of titer response after 3 years, an optimal vaccination regimen has not been identified. Our study sought to assess the immunogenicity of our center's pneumococcal vaccination strategy which included Prevnar® (PCV-7) (prior to the introduction of PCV-13) followed by Pneumovax® (PPV-23) given routinely at 2 and 5 years of age and then every 5 years thereafter. Our goal was to assess vaccine response in a population of patients with SCD who had received vaccines according to this regimen using multiplex bead analysis. Our study demonstrated a significant percentage of persons with SCD do not maintain a sufficient vaccination response to PPV-23 for 5 years. Our study revealed that only 36% of patients had protective levels of anti-pneumococcal antibody titers at an average of 37 months following vaccination. Most alarmingly, within the group of patients with sub-therapeutic titers, 64% demonstrated vaccine response to less than 25% of the tested serotypes. These findings were significantly associated with duration of time since last vaccine administration but the mean age of lack of response was below the 3-year window where vaccine response was previously reported to wane. Our results indicate anti-pneumococcal immunity may not be optimally maintained using this vaccination strategy in patients with SCD leaving them vulnerable to IPD. Many pediatric hematologists stop prophylactic penicillin at 5 years of age making these results alarming. We recommend further investigation into an optimal vaccine schedule and monitoring of anti-pneumococcal titers in at risk patients.

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“…Splenectomized children and adults without underlying cancer manifest antibody responses similar to those of normal controls (80). The immunogenicity of pneumococcal vaccination in children with sickle cell disease was evaluated extensively in the 1980s (29,30,60,61,139,211,219,287,288). The success of pneumococcal vaccination in this population has been assessed by measurements of serotype-specific antibody concentrations and serum opsonic activity and by attempts to discern vaccine efficacy based on predicted rates of pneumococcal infection (287).…”

Section: Polyvalent Pneumococcal Polysaccharide Vaccinesmentioning

confidence: 99%

“…Antibody levels frequently decline in children with sickle cell disease; revaccination increases antibody levels (219,277), but rarely above primary postvaccination levels (277). The major risk of pneumococcal infection in children with sickle cell disease begins at the age of 4 months and continues until the age of 4 to 5 years (80).…”

Section: Polyvalent Pneumococcal Polysaccharide Vaccinesmentioning

confidence: 99%

Use of Licensed Vaccines for Active Immunization of the Immunocompromised Host

1998

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SUMMARY The latter part of the 20th century has witnessed an unprecedented rise in the number of individuals with impaired immunity. This is primarily attributable to the increased development and use of antineoplastic therapy for malignancies, organ and bone marrow transplantation, and the AIDS epidemic. Individuals with impaired immunity are often at increased risk for infections, and they can experience more severe and complicated courses of infection. The lack of therapy for a variety of viruses and the rise in antimicrobial resistance of many pathogens have focused attention on vaccination to prevent infectious diseases. The efficacy of most licensed vaccines has been established in immunocompetent hosts. However, there is also considerable experience with most vaccines in those with impaired immunity. We reviewed the use of licensed live, inactivated, and polysaccharide vaccines in this group, and several themes emerged: (i) most vaccines are less immunogenic in those with impaired immunity than in normal individuals; (ii) live vaccines are generally contraindicated in this group; and (iii) the efficacy of many commonly used vaccines has not been established in people with impaired immunity. This review suggests that for most vaccines there are little or no efficacy data in those with impaired immunity but their use in this patient group is generally safe.

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Anti-pneumococcal antibody levels three to seven years after first booster immunization in children with sickle cell disease, and after a second booster

Cited by 20 publications

References 9 publications

Variability of Human Systemic Humoral Immune Responses to Adenovirus Gene Transfer Vectors Administered to Different Organs

Variability of Human Systemic Humoral Immune Responses to Adenovirus Gene Transfer Vectors Administered to Different Organs

Assessing the Immunogenic Response of a Single Center’s Pneumococcal Vaccination Protocol in Sickle Cell Disease

Use of Licensed Vaccines for Active Immunization of the Immunocompromised Host

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