Immunogenicity and safety of the 13-valent Pneumococcal Conjugate vaccine in 23-valent pneumococcal polysaccharide vaccine-naive and pre-immunized patients under treatment with chronic haemodialysis: a longitudinal quasi-experimental phase IV study

Vandecasteele, SJ; Bacquer, Dirk De; Caluwé, Rogier; Ombelet, Sara; Vlem, Bruno Van

doi:10.1016/j.cmi.2017.05.016

Cited by 22 publications

(23 citation statements)

References 17 publications

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“…No studies have assessed the effect of pneumococcal immunizations on B cells in patients with CKD. Vandecasteele et al (2018) found that severe CKD patients previously immunized with PPV23 had lower antibody response to PCV13 compared to pneumococcal vaccine naïve patients [23]. Our results agree with this study, as PPV23 immunized patients had a slightly lower fold change in pneumococcal 6B IgG antibodies, and significantly lower fold change in pneumococcal 14 antibodies in response to PCV13 immunization.…”

Section: Discussionsupporting

confidence: 89%

“…Mitra et al (2016) showed that the antibody concentrations in patients with CKD declined significantly 12 months after immunization with PCV13, compared to 2 months post-immunization for 11 of the 13 serotypes tested [22]. Vandecasteele et al (2018) demonstrated that immunization of CKD patients with PPV23 may have a negative effect on the immune response to PCV13 [23]. It was suggested that immunization with PPV23 could lead to depletion of memory B cells following exposure to purified polysaccharide antigens potentially affecting the development of antibody responses to polysaccharide antigens administered via protein-conjugate vaccines [24].…”

Section: Introductionmentioning

confidence: 98%

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The effect of pneumococcal immunization on total and antigen-specific B cells in patients with severe chronic kidney disease

2019

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BackgroundWhile the 23-valent pneumococcal polysaccharide vaccine (PPV23) is routinely used in Canada and some other countries to prevent pneumococcal infection in adults with chronic kidney disease (CKD), patients develop a suboptimal antibody response to PPV23 due to their immune dysfunction. The 13-valent pneumococcal conjugate vaccine (PCV13) has superior immunogenicity in some categories of immunocompromised adults; however, its effect on the immune response in CKD patients has only been addressed by two recent studies with conflicting results. The effect of PPV23 or PCV13 on B cells in these patients has not been previously studied. We studied the absolute numbers and proportions of B cells and subpopulations in two groups of adult patients with severe CKD pre- and 7 days post-immunization with PCV13: pneumococcal vaccine naïve and previously immunized with PPV23 (over one year ago).ResultsPPV23 immunized patients had significantly lower proportions and absolute numbers of class switched memory (CD19 + CD27 + IgM-), as well as lower absolute numbers of IgM memory (CD19 + CD27 + IgM+) and class switched B cells (CD19 + CD27-IgM-) compared to PPV23 naïve patients. Following PCV13 immunization, the differences in absolute numbers of B-cell subpopulations between groups remained significant. The PPV23 immunized group had higher proportions of CD5- B cells along with lower proportions and absolute numbers of CD5+ B cells compared to PPV23 naïve patients both pre- and post-immunization with PCV13. However, previous PPV23 immunization did not have a noticeable effect on the numbers of total IgG or serotype 6B and 14 specific antibody-secreting cells detected 7 days post-immunization with PCV13. Nevertheless, fold increase in anti-serotype 14 IgG concentrations 28 days post-PCV13 was greater in PPV23 naïve than in previously immunized patients.ConclusionsThe results suggest that immunization with PPV23 may result in long-term changes in B-cell subpopulations such as increased prevalence of CD5- B cells and decreased prevalence of class switched memory B cells in the peripheral blood. Because previous immunization with PPV23 in patients with CKD is associated with a significant decrease in the total class switched memory B cells in response to subsequent immunization with PCV13, this may reduce PCV13 immunogenicity in the setting of PPV23 followed by PCV13.Trial registrationRegistered February 24, 2015 at ClinicalTrials.gov (NCT 02370069).

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 98%

The effect of pneumococcal immunization on total and antigen-specific B cells in patients with severe chronic kidney disease

2019

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“…Revaccination with PPV23 has been controversial because of the fear of hyporesponsiveness associated with polysaccharide vaccines in general 36‐38 . To the best of the authors’ knowledge, no hyporesponsiveness has been reported in relation to boosting conjugate vaccines 11,16 . Vandecasteele et al 11 reported that hemodialysis patients who were vaccine‐naïve and vaccinated with PCV13 showed better immunologic response than those who had received a previous PPV23 vaccination.…”

Section: Discussionmentioning

confidence: 99%

“…Both vaccines have been shown to be immunogenic and safe in patients with end‐stage chronic kidney disease (CKD Stage 5), patients in hemodialysis and kidney transplant recipients 6‐13 . There are no randomized controlled studies among SOT patients on the clinical efficacy of either of these two vaccines against IPD.…”

Section: Introductionmentioning

confidence: 99%

A randomized, controlled trial comparing the immunogenecity and safety of a 23‐valent pneumococcal polysaccharide vaccination to a repeated dose 13‐valent pneumococcal conjugate vaccination in kidney transplant recipients

Eriksson

Käyhty

Saha

et al. 2020

Transplant Infectious Dis

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Background The risk of invasive pneumococcal disease is significant among solid organ transplant (SOT) recipients. The optimal pneumococcal vaccination strategy for SOT patients is not known. Methods The potential kidney transplant recipients in dialysis were randomized into two arms: to receive a 23‐valent pneumococcal polysaccharide vaccine (PPV23) before transplantation or to receive a 13‐valent pneumococcal conjugate vaccine (PCV13) before transplantation and a second dose of PCV13 six months after the transplantation. Serotype‐specific antibody concentrations and opsonophagocytic activity (OPA) were measured before and after the first vaccination (visits V1,V2) and six and seven months after the transplantation, for example, before and after the second PCV13 (visits V3,V4). Results Out of 133 participants, 48 (PCV13 arm) and 46 (PPV23 arm) received a kidney transplant, and 37 + 37 in both arms completed the study. After the first vaccination, the geometric mean concentrations (GMCs) in the PCV13 arm were significantly higher for 9/13 serotypes and the OPA geometric mean titers (GMTs) were significantly higher for 4/13 serotypes. At V3, the antibody levels had declined but OPA remained significantly higher for 7/13 (PCV13) vs 4/13 (PPV23) serotypes. At V4, the GMCs for 9/13 serotypes and the GMTs for 12/13 serotypes were significantly higher in the PCV13 arm. The GMCs but not GMTs were lower than at V2. There was no difference in adverse effects. No vaccine‐related allograft rejection was detected. Conclusions The immunogenicity of PCV13 was better in dialysis patients, and revaccination with PCV13 was immunogenic and safe.

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“…This result was corroborated by Jackson, Gurtman, van Cleeff, Jansen et al (2013), who also found that a booster vaccination with a polysaccharide vaccine after a glycoconjugate vaccine gave a greater antibody response than polysaccharide vaccine alone. Vandecasteele, De Bacquer, Caluwe, Ombelet, and Van Vlem (2018) found that a conjugate vaccine was less able to provide a boosting effect on vaccination against St. pneumoniae in patients previously inoculated with unconjugated vaccine, but at the 1-year endpoint all vaccines studied provided acceptable levels of protection. Conversely, other papers found that booster vaccination may be more effective if they are glycoconjugate, particularly in populations immunocompromised by HIV (Lu, O'Halloran, Williams, & Harpaz, 2017).…”

Section: Comparison Of Glycoconjugate and Polysaccharide Vaccinesmentioning

confidence: 89%

Glycoconjugate vaccines: some observations on carrier and production methods

MacCalman

Phillips‐Jones

Harding

2019

Biotechnology and Genetic Engineering Reviews

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Glycoconjugate vaccines use protein carriers to improve the immune response to polysaccharide antigens. The protein component allows the vaccine to interact with T cells, providing a stronger and longer-lasting immune response than a polysaccharide interacting with B cells alone. Whilst in theory the mere presence of a protein component in a vaccine should be sufficient to improve vaccine efficacy, the extent of improvement varies. In the present review, a comparison of the performances of vaccines developed with and without a protein carrier are presented. The usefulness of analytical tools for macromolecular integrity assays, in particular nuclear magnetic resonance, circular dichroism, analytical ultracentrifugation and SEC coupled to multi-angle light scattering (MALS) is indicated. Although we focus mainly on bacterial capsular polysaccharideprotein vaccines, some consideration is also given to research on experimental cancer vaccines using zwitterionic polysaccharides which, unusually for polysaccharides, are able to invoke T-cell responses and have been used in the development of potential all-polysaccharide-based cancer vaccines.A general trend of improved immunogenicity for glycoconjugate vaccines is described. Since the immunogenicity of a vaccine will also depend on carrier protein type and the way in which it has been linked to polysaccharide, the effects of different carrier proteins and production methods are also reviewed. We suggest that, in general, there is no single best carrier for use in glycoconjugate vaccines. This indicates that the choice of carrier protein is optimally made on a case-by-case basis, based on what generates the best immune response and can be produced safely in each individual case.

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Immunogenicity and safety of the 13-valent Pneumococcal Conjugate vaccine in 23-valent pneumococcal polysaccharide vaccine-naive and pre-immunized patients under treatment with chronic haemodialysis: a longitudinal quasi-experimental phase IV study

Cited by 22 publications

References 17 publications

The effect of pneumococcal immunization on total and antigen-specific B cells in patients with severe chronic kidney disease

The effect of pneumococcal immunization on total and antigen-specific B cells in patients with severe chronic kidney disease

A randomized, controlled trial comparing the immunogenecity and safety of a 23‐valent pneumococcal polysaccharide vaccination to a repeated dose 13‐valent pneumococcal conjugate vaccination in kidney transplant recipients

Glycoconjugate vaccines: some observations on carrier and production methods

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