Low opsonic activity to the infecting serotype in pediatric patients with invasive pneumococcal disease

Oishi, Tomohiro; Ishiwada, Naruhiko; Matsubara, Kousaku; Nishi, Junichiro; Chang, Bin; Tamura, Kazuyo; Akeda, Yukihiro; Ihara, Toshiaki; Nahm, Moon H.; Oishi, Kazunori

doi:10.1016/j.vaccine.2012.11.010

Cited by 29 publications

(29 citation statements)

References 22 publications

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“…A higher avidity of antibodies has been postulated to contribute to enhanced functionality and to represent a surrogate marker of successful priming of immunological memory after vaccination against H. influenzae and N. meningitidis (35,36). However, the literature on the relationship between anti-pneumococcal IgG avidity and OPA is currently conflicting; therefore, the impact of this parameter remains debated (36)(37)(38).…”

Section: Discussionmentioning

confidence: 99%

Streptococcus pneumoniae Serotype 1 Burden in the African Meningitis Belt: Exploration of Functionality in Specific Antibodies

Blumental¹,

Moïsi²,

Roalfe³

et al. 2015

Clin. Vaccine Immunol.

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f Streptococcus pneumoniae serotype 1 (Sp1) constitutes an important cause of seasonal endemic meningitis in all age groups in the African meningitis belt. Despite a higher meningitis incidence, the Burkinabé population has an Sp1-specific antibody seroprevalence similar to that reported in the United Kingdom (UK). We aimed to establish whether the opsonophagocytic activity (OPA) of pneumococcal IgG naturally present in Burkina Faso differs from that seen in individuals in the UK and to compare the OPAs generated by natural and vaccine-induced immunity. Samples collected from pneumococcal vaccine-naive Burkinabé and UK subjects were matched for age (1 to 39 years) and anti-Sp1 IgG level, analyzed for OPA to 3 S. pneumoniae serotypes (1, 5, and 19A), and compared to postvaccine samples. Furthermore, the Burkinabé samples were assessed for IgG avidity and serotype-specific IgM concentrations. One hundred sixty-nine matched serum samples from both populations were selected. A greater proportion of Burkinabé subjects aged 1 to 19 years had functional Sp1 activity (OPA > 8) compared to UK subjects (12% versus 2%, P < 0.001); however, the proportions were similar among adults (9%). The correlation between Sp1 IgG concentration and OPA was good (P < 0.001), but many individuals had nonfunctional IgG, which was not related to avidity. While the Sp1 IgM concentrations correlated with OPA, not all of the function in serum samples with low IgG could be attributed to IgM. Finally, vaccine-induced Sp1-specific IgG was more functional than equivalent amounts of naturally occurring IgG. In conclusion, despite a substantially higher pneumococcal meningitis incidence, no decreased functional immunity to Sp1 could be evidenced in the Burkinabé population compared to that in the population from the UK. Furthermore, the naturally induced antibodies were less functional than vaccine-induced antibodies.

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Section: Discussionmentioning

confidence: 99%

Streptococcus pneumoniae Serotype 1 Burden in the African Meningitis Belt: Exploration of Functionality in Specific Antibodies

Blumental¹,

Moïsi²,

Roalfe³

et al. 2015

Clin. Vaccine Immunol.

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“…Some pneumococcal isolates were serotyped by multiplex serotyping PCR at the prefectural public health institutes [9]. All pneumococcal isolates, including isolates serotyped by multiplex serotyping PCR at the prefectural public health institutes, were sent to the Department of Bacteriology I, NIID and serotyped by capsule quelling reaction with rabbit antisera (Statens Serum Institute, Copenhagen, Denmark), as described elsewhere [10]. …”

Section: Methodsmentioning

confidence: 99%

Invasive pneumococcal disease among adults in Japan, April 2013 to March 2015: disease characteristics and serotype distribution

et al. 2017

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BackgroundIn Japan, the clinical characteristics and recent serotype distribution among adult patients of invasive pneumococcal disease (IPD) have not been fully investigated since the introduction of the pneumococcal conjugate vaccine (PCV) in children. From November 2010, PCV7 was encouraged by an official program, funded by government, subsequently included in the routine schedule in April 2013, and replaced with a PCV13 in November 2013.MethodsBetween April 2013 and March 2015, patients with IPD older than 15 years were evaluated based on the enhanced national surveillance in ten prefectures of Japan. The serotype distribution of the isolates was analyzed in these patients.ResultsThe analysis included 291 patients: 107 patients (37%) were female and the median age was 70 years. Of 281 patients with available data, 202 (72%) had underlying diseases, including 107 patients (38%) with immunocompromised status. The case fatality proportion for all case was 20%. In subgroup analysis, the case fatality proportion (29%) in immunocompromised patients was much higher than that (0–16%) in each age group of nonimmunocompromised patients (15–39 years, 40–64 years, and ≥ 65 years). While the proportion of bacteremia without any focus (27%) was higher than that (8–10%) in nonimmunocompromised patients, the proportions of vaccine types (PCV13, 32%; PPSV23, 51%) of the causative isolates were lower than those in each age group of nonimmunocompromised patients. Among 291 isolates, the most frequent serotypes were 3 (17%), 19A (13%), and 22F (10%). Twelve percent of the isolates were PCV7 serotypes, 46% were PCV13 serotypes, and 66% were PPSV23 serotypes.ConclusionsThe majority of adult patients of IPD had underlying diseases, including immunocompromised conditions. A low proportion (12%) of PCV7-type IPD was observed in this population where PCV7 for children had been included in the routine immunization schedule.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-2113-y) contains supplementary material, which is available to authorized users.

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“…First, no marked increase in IgG for a specific serotype was detected after vaccination, probably because of immune paralysis (27). Second, no sufficient opsonization activity was found, probably because of the lower avidity of serotype-specific IgG against pneumococcal infection (17,30). Third, pneumococcal carriage in the nasopharynx was detected, which may also be caused by immune paralysis (32,33).…”

Section: Discussionmentioning

confidence: 99%

“…Serum samples from the patient were submitted to the Research Institute for Microbial Diseases (RIMD), Osaka University, Japan, for determination of the IgG levels by an enzyme-linked immunosorbent assay (ELISA) and of the opsonization indices (OIs) by a multiplex opsonophagocytic assay (MOPA). Concentrations of serotype-specific IgG antibodies and OIs were measured as described previously (17). The cutoff for IgG antibodies was 0.05 g/ml, whereas that of the MOPA was a serum dilution of 1:4.…”

Section: Methodsmentioning

confidence: 99%

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Capsule Switching and Antimicrobial Resistance Acquired during Repeated Streptococcus pneumoniae Pneumonia Episodes

et al. 2015

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e Streptococcus pneumoniae colonizes the nasopharyngeal mucus in healthy people and causes otitis media, pneumonia, bacteremia, and meningitis. In this study, we analyzed an S. pneumoniae strain that caused 7 repeated pneumonia episodes in an 80-month-old patient with cerebral palsy during a period of 25 months. A total of 10 S. pneumoniae strains were obtained from sputum samples, and serotype 6B was isolated from samples from the first 5 episodes, whereas serotype 6A was isolated from samples from the last 2. Whole-genome sequencing showed clonality of the 10 isolates with 10 single nucleotide polymorphisms (SNPs) in the genomes. Among these SNPs, one single point mutation in the wciP gene was presumed to relate to the serotype switching from 6B to 6A, and the other mutations in parC and gyrA were related to fluoroquinolone resistance. These results suggested that an S. pneumoniae strain, which asymptomatically colonized the patient's nasopharynx or was horizontally transmitted from an asymptomatic carrier, caused the repeated pneumonia events. Phenotypic variations in the capsule type and antimicrobial susceptibility occurred during the carrier state. Hyporesponsiveness to serotypes 6B and 6A of S. pneumoniae was found even after vaccination with the 7-valent pneumococcal conjugate vaccine and the 23-valent pneumococcal polysaccharide vaccine. After an additional vaccination with the 13-valent pneumococcal conjugate vaccine, opsonic activities for both serotypes 6A and 6B significantly increased and are expected to prevent relapse by the same strain. Streptococcus pneumoniae is the etiologic agent of several bacterial diseases, such as otitis media, pneumonia, bacteremia, and meningitis (1-3), and it can asymptomatically colonize a child's nasopharynx for months (4). Colonization by S. pneumoniae is a prerequisite for various types of pneumococcal diseases and the source of transmission of the bacterium between people (5, 6). In Japan, approximately 80% of 3-year-old children were colonized by this bacterium, which may cause pneumococcal diseases, at least once (7).Since 2000, the widespread use of 7-and 13-valent pneumococcal conjugate vaccines (PCV7 and PCV13, respectively) has reduced the incidence of pneumococcal infections (8-11) and the colonization rate of the vaccine serotypes but has not affected the overall colonization (12-15). In Japan, PCV7 was introduced in 2010 and was replaced by PCV13 in November 2013. After 2011, invasive pneumococcal disease (IPD) caused by S. pneumoniae isolates belonging to serotypes included in the PCV7 decreased (16). However, some unusual vaccine failures and/or breakthrough infection cases were reported together with the hyporesponsiveness to one or several serotypes (17).Since 2011, we have observed repeated pneumococcal pneumonia episodes in a child who has an underlying disease. Although vaccinations with PCV7 were performed, an additional 6 pneumococcal pneumonia infections occurred during the following 24 months. In this longitudinal study, we analyzed 10 S. pneu...

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Low opsonic activity to the infecting serotype in pediatric patients with invasive pneumococcal disease

Cited by 29 publications

References 22 publications

Streptococcus pneumoniae Serotype 1 Burden in the African Meningitis Belt: Exploration of Functionality in Specific Antibodies

Streptococcus pneumoniae Serotype 1 Burden in the African Meningitis Belt: Exploration of Functionality in Specific Antibodies

Invasive pneumococcal disease among adults in Japan, April 2013 to March 2015: disease characteristics and serotype distribution

Capsule Switching and Antimicrobial Resistance Acquired during Repeated Streptococcus pneumoniae Pneumonia Episodes

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