Evaluation of Antibody Response to Polysaccharide Vaccine and Switched Memory B Cells in Pediatric Patients with Inflammatory Bowel Disease
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background/Aims: Inflammatory bowel disease (IBD) is a chronic disease of the gastrointestinal tract, whose etiologies are still unknown. This study was performed to evaluate the humoral immune response in terms of B cell functions in selected IBD patients. Methods: Eighteen pediatric patients with IBD, including 12 cases of ulcerative colitis (UC) and six with Crohn disease (CD), were enrolled in this study. The pneumococcal vaccine was injected in all patients, and the IgG antibody level to the polysaccharide antigen was measured before and 4 weeks after injection. The B cell switch-recombination process was evaluated. Results: Five patients with IBD (three CD and two UC) had defects in B cell switching, which was significantly higher than in controls (p=0.05). Ten patients had a specific antibody deficiency and exhibited a higher frequency of bacterial infection than the healthy group. The mean increased level of IgG after vaccination was lower in IBD patients (82.9±32.5 μg/mL vs 219.8±59.0 μg/mL; p=0.001). Among the patients who had an insufficient response, no significant difference in the number of switched memory B-cell was observed. Conclusions: A defect in B lymphocyte switching was observed in pediatric IBD patients, and especially in those patients with CD. Owing to an increased risk of bacterial infections in those patients with antibody production defects, pneumococcal vaccination could be recommended. However, not all patients can benefit from the vaccination, and several may require other prophylactic methods.
Abstract
Background/Aims: Inflammatory bowel disease (IBD) is a chronic disease of the gastrointestinal tract, whose etiologies are still unknown. This study was performed to evaluate the humoral immune response in terms of B cell functions in selected IBD patients. Methods: Eighteen pediatric patients with IBD, including 12 cases of ulcerative colitis (UC) and six with Crohn disease (CD), were enrolled in this study. The pneumococcal vaccine was injected in all patients, and the IgG antibody level to the polysaccharide antigen was measured before and 4 weeks after injection. The B cell switch-recombination process was evaluated. Results: Five patients with IBD (three CD and two UC) had defects in B cell switching, which was significantly higher than in controls (p=0.05). Ten patients had a specific antibody deficiency and exhibited a higher frequency of bacterial infection than the healthy group. The mean increased level of IgG after vaccination was lower in IBD patients (82.9±32.5 μg/mL vs 219.8±59.0 μg/mL; p=0.001). Among the patients who had an insufficient response, no significant difference in the number of switched memory B-cell was observed. Conclusions: A defect in B lymphocyte switching was observed in pediatric IBD patients, and especially in those patients with CD. Owing to an increased risk of bacterial infections in those patients with antibody production defects, pneumococcal vaccination could be recommended. However, not all patients can benefit from the vaccination, and several may require other prophylactic methods.
참고문헌 (26)
- Aberra FN, "Methods to avoid infections in patients with inflammatory bowel disease", Inflamm Bowel Dis, 11, pp.685~695 (2005)
- Viget N, "Opportunistic infections in patients with inflammatory bowel disease: prevention and diagnosis", Gut, 5, pp.549~558 (2008)
- Cucino C, "The comorbid occurrence of other diagnoses in patients with ulcerative colitis and Crohn’s disease", Am J Gastroenterol, 96, pp.2107~2112 (2001)
- Melmed GY, "Vaccination strategies for patients with inflammatory bowel disease on immunomodulators and biologics", Inflamm Bowel Dis, 15, pp.1410~1416 (2009)
- Sands BE, "Guidelines for immunizations in patients with inflammatory bowel disease", Inflamm Bowel Dis, 10, pp.677~692 (2004)
- Kaine JL, "Immune responses following administration of influenza and pneumococcal vaccines to patients with rheumatoid arthritis receiving adalimumab", J Rheumatol, 34, pp.272~279 (2007)
- Kapetanovic MC, "Influence of methotrexate, TNF blockers and prednisolone on antibody responses to pneumococcal polysaccharide vaccine in patients with rheumatoid arthritis", Rheumatology (Oxford), 45, pp.106~111 (2006)
- Elkayam O, "The effect of tumor necrosis factor blockade on the response to pneumococcal vaccination in patients with rheumatoid arthritis and ankylosing spondylitis", Semin Arthritis Rheum, 33, pp.283~288 (2004)
- Mease PJ, "Pneumococcal vaccine response in psoriatic arthritis patients during treatment with etanercept", J Rheumatol, 31, pp.1356~1361 (2004)
- Melmed GY, "TNF blockers and immunomodulators impair antibody responses to pneumococcal polysaccharide vaccine (PPV) in patients with inflammatory bowel disease (IBD)", Gastroenterology, 134(4 Suppl 1), pp.A68~ (2008)
- Dotan I, "Normal response to vaccines in inflammatory bowel disease patients treated with thiopurines", Inflamm Bowel Dis, 18, pp.261~268 (2012)
- Tangye SG, "Identification of functional human splenic memory B cells by expression of CD148 and CD27", J Exp Med, 188, pp.1691~1703 (1998)
- Liu YJ, "Within germinal centers, isotype switching of immunoglobulin genes occurs after the onset of somatic mutation", Immunity, 4, pp.241~250 (1996)
- Di Sabatino A, "Immunoglobulin M memory B cell decrease in inflammatory bowel disease", Eur Rev Med Pharmacol Sci, 8, pp.199~203 (2004)
- Di Sabatino A, "Depletion of immunoglobulin M memory B cells is associated with splenic hypofunction in inflammatory bowel disease", Am J Gastroenterol, 100, pp.1788~1795 (2005)
- Fallahi GH, "Clinical characteristics of Iranian pediatric patients with inflammatory bowel disease", Act Gastroenterol Belg, 72, pp.230~234 (2009)
- Wernette CM, "Enzyme-linked immunosorbent assay for quantitation of human antibodies to pneumococcal polysaccharides", Clin Diagn Lab Immunol, 10, pp.514~519 (2003)
- Vendrell M, "Antibody production deficiency with normal IgG levels in bronchiectasis of unknown etiology", Chest, 127, pp.197~204 (2005)
- Piqueras B, "Common variable immunodeficiency patient classification based on impaired B cell memory differentiation correlates with clinical aspects", J Clin Immunol, 23, pp.385~400 (2003)
- Motamed F, "Response to induction therapy in a pediatric population of inflammatory bowel disease", Z Gastroenterol, 48, pp.748~752 (2010)
- Martinez-Gamboa L, "Role of the spleen in peripheral memory B-cell homeostasis in patients with autoimmune thrombocytopenia purpura", Clin Immunol, 130, pp.199~212 (2009)
- Stevens R, "Defective generation of tetanus-specific antibody-producing B cells after in vivo immunization of Crohn’s disease and ulcerative colitis patients", Gastroenterology, 88, pp.1860~1866 (1985)
- Brogan MD, "Defective memory B cell formation in patients with inflammatory bowel disease following tetanus toxoid booster immunization", J Clin Lab Immunol, 24, pp.69~74 (1987)
- Mamula P, "Immune response to influenza vaccine in pediatric patients with inflammatory bowel disease", Clin Gastroenterol Hepatol, 5, pp.851~856 (2007)
- Carsetti R, "Peripheral development of B cells in mouse and man", Immunol Rev, 197, pp.179~191 (2004)
- Kruetzmann S, "Human immunoglobulin M memory B cells controlling Streptococcus pneumoniae infections are generated in the spleen", J Exp Med, 197, pp.939~945 (2003)