Serum IgG2 levels predict long-term protection following pneumococcal vaccination in systemic lupus erythematosus (SLE)
•SLE patients are highly susceptible to pneumococcal infection.•>50% of SLE patients fail to reach immune protection after pneumococcal vaccination.•IgG2 serum level before vaccination is strongly indicative of long-term protection. Systemic lupus erythematosus (SLE) patients are at risk for pneu...
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Veröffentlicht in: | Vaccine 2020-10, Vol.38 (44), p.6859-6863 |
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Sprache: | eng |
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Zusammenfassung: | •SLE patients are highly susceptible to pneumococcal infection.•>50% of SLE patients fail to reach immune protection after pneumococcal vaccination.•IgG2 serum level before vaccination is strongly indicative of long-term protection.
Systemic lupus erythematosus (SLE) patients are at risk for pneumococcal infection. Twenty-one consecutive SLE patients (40[25–75] years) received the sequential PCV13/PPSV23 vaccine and factors associated with long-term protection were analyzed. Immune protection, defined by an antigen-specific IgG concentration ≥1.3 µg/mL for at least 70% of 7 pneumococcal serotypes was assessed at baseline, 2, 6, 12 and 36 months defining long-term protection. Only 10 patients showed pneumococcal immune protection 36 months after vaccination. Eleven (52.4%) patients had no long-term protection with a seroconversion that never or only transiently occurred. SLE disease features, treatment received and immunological characteristics did not differ between protected and unprotected patients except for the pre-vaccination IgG2 serum levels. Serum IgG2 level >2.125 µg/ml showed a sensitivity of 100% and a specificity of 90.9% for long-term protection. Sequential pneumococcal vaccination conferred poor immune protection in SLE. Baseline IgG2 serum level identified patients able to benefit from pneumococcal vaccination. |
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ISSN: | 0264-410X 1873-2518 0264-410X |
DOI: | 10.1016/j.vaccine.2020.08.065 |