Humoral response to a 13-valent pneumococcal conjugate vaccine in kidney transplant recipients. Issue 17 (9th April 2020)

• Record Type: Journal Article
• Authors: Oesterreich, Simon; Lindemann, Monika; Goldblatt, David; Horn, Peter A.; Wilde, Benjamin; Witzke, Oliver
• Is Part Of: Vaccine. Volume 38:Issue 17(2020)
• Page Start: 3339
• Page End: 3350
• Publication Date: 2020-04-09
• Subjects: Pneumococcal conjugate vaccine -- Opsonophagocytic assay -- Kidney transplant recipients -- Serotype specific -- Pneumococcal antibody global serum assays -- Pneumococcal vaccination in immunocompromised individuals; CKD-EPI Chronic Kidney Disease Epidemiology Collaboration -- ELISA enzyme linked immuosorbent assay -- eGFR estimated glomerular filtration rate -- GMC Geometric mean concentration -- GMCR geometric mean concentration ratio -- GMT geometric mean titer -- GMTR geometric mean titer ratio -- HA healthy adults of the reference populations -- Ig immunoglobulin -- IPD invasive pneumococcal disease -- LLOQ lower limit of quantification -- KTR kidney transplant recipients -- MMF mycophenolate mofetil -- OPA opsonophagocytic assay -- PCP pneumococcal capsular polysaccharide -- PCV7 7-valent pneumococcal conjugate vaccine -- PCV13 13-valent pneumococcal conjugate vaccine -- S. pneumoniae Streptococcus pneumoniae; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2020.02.088
• Languages: English
• ISSNs: 0264-410X

Abstract

Abstract: Background: Vaccination against S. pneumoniae is recommended by national guidelines. Moderate immunogenicity of the 13-valent pneumococcal conjugate vaccine (PCV13) has been reported in adult kidney transplant recipients (KTR). This study further defines the immunogenicity of PCV13 in this cohort. Methods: 49 KTR were immunized with PCV13. A validated opsonophagocytic killing assay (OPA), a global anti-pneumococcal capsular polysaccharide (anti-PCP) IgG, IgG2, IgM and IgA ELISA, and - for selected patients - a serotype specific anti-PCP WHO reference ELISA were performed pre-vaccination and at month 1 and 12 post-vaccination. Results: Geometric mean OPA titers increased significantly for 13/13 serotypes at month 1 and for 10/13 serotypes at month 12 post-vaccination. Vaccine response defined as an OPA titer ≥1:8 was reached in 9/13 serotypes (median). 53% reached the vaccine response criteria at month 1 and 45% at month 12. At month 1 after vaccination, the median OPA titer in an age-group matched healthy reference population was 5- to 10-fold higher than in KTR. OPA titers correlated strongly with results to the global and serotype specific anti-PCP IgG ELISA. Lower OPA titers significantly (p < 0.05) correlated with albuminuria, an interval between vaccination and transplantation <12 months, age and treatment with mycophenolate mofetil. Global IgG, IgG2, IgM and IgA, as well as serotype specific anti-PCP antibody concentrations (12/13 serotypes) increased significantly at month 1 and 12 post-vaccination. Conclusions: Kidney transplant recipients show a significant humoral response after vaccination with PCV13. Functional antibody response exists, but is not as vigorous as in healthy adults.