Five winters of pneumococcal serotype replacement in UK carriage following PCV introduction

Gladstone, Rebecca A.; Jefferies, Johanna M.C.; Tocheva, Anna S.; Beard, Kate; Garley, David; Chong, Wei Wei; Bentley, Stephen D.; Faust, Saul N; Clarke, Stuart C.

doi:10.1016/j.vaccine.2015.03.012

Cited by 117 publications

(102 citation statements)

References 40 publications

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“…Thus, it appears that anti-CPS antibodies generated during a colonization episode do not have a role in its clearance, though they may be protective against the future acquisition of colonization and subsequent development of disease. This role of anti-CPS antibodies is supported by clinical studies demonstrating the virtual elimination of vaccine serotype pneumococcal colonization in vaccinated children (53). The functional importance of anti-CPS antibodies is summarized in Fig.…”

Section: Clearance Of Colonization Is a Complex Processmentioning

confidence: 81%

Pneumococcal Capsular Polysaccharide Immunity in the Elderly

Adler

Ferreira

Gordon

et al. 2017

Clin Vaccine Immunol

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Immunity to pneumococcal infections is impaired in older people, and current vaccines are poorly protective against pneumococcal disease in this population. Naturally acquired immunity to pneumococcal capsular polysaccharides develops during childhood and is robust in young adults but deteriorates with advanced age. In particular, antibody levels and function are reduced in older people. Pneumococcal vaccines are recommended for people Ͼ65 years old. However, the benefits of polysaccharide and protein-conjugated vaccines in this population are small, because of both serotype replacement and incomplete protection against vaccine serotype pneumococcal disease. In this review, we overview the immune mechanisms by which naturally acquired and vaccine-induced pneumococcal capsular polysaccharide immunity declines with age, including altered colonization dynamics, reduced opsonic activity of antibodies (particularly IgM), and impaired mucosal immunity.

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Section: Clearance Of Colonization Is a Complex Processmentioning

confidence: 81%

Pneumococcal Capsular Polysaccharide Immunity in the Elderly

Adler

Ferreira

Gordon

et al. 2017

Clin Vaccine Immunol

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“…It is well established that antibodymediated immune responses targeting serotype-specific PSs protect against pneumococcal disease (17). Serotype replacement, which has been observed after the introduction of PCV, highlights the role of PS-mediated immunity in protection against carriage (8,11). We have previously demonstrated 0% carriage acquisition after rechallenge with a homologous strain up to 11 months after clearance of the first carriage episode (3).…”

Section: Levels Of 6bps Igg and Iga In Serum And Nasal Wash Are Not Amentioning

confidence: 96%

“…Coated plates were stored at 4 8 supplemented with 2% bovine serum albumin for 2 hours. Plates were then washed six times with DPBS.…”

Section: Preparation Of Enzyme-linked Immunospot Assay Platesmentioning

confidence: 99%

“…Several protein-based vaccines are currently in development and it is important to assess whether these vaccines will impact carriage both directly, in immunized volunteers, and indirectly, via a herd effect, as observed for PCV vaccines (8,11,26). The role of T-cell responses in the control of carriage density and in clearance of carriage suggests that protein-based vaccines capable of inducing this type of immunity may offer several advantages over currently licensed vaccines, facilitating control of carriage intensity (density and duration), while maintaining the opportunity for immunization through natural carriage acquisition (5,27,28).…”

Section: Levels Of 6bps Igg and Iga In Serum And Nasal Wash Are Not Amentioning

confidence: 99%

“…Epidemiologic data support the role of polysaccharide (PS)-mediated immunity in protection against carriage. Vaccination with pneumococcal conjugate vaccine (PCV) has reduced carriage of vaccine-type strains (8), and has resulted in serotype replacement in vaccinated communities (9,10). We have recently demonstrated the direct impact of PCV vaccination on pneumococcal carriage acquisition (11).…”

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confidence: 99%

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Polysaccharide-Specific Memory B Cells Predict Protection against Experimental Human Pneumococcal Carriage

Pennington

Pojar

Mitsi

et al. 2016

Am J Respir Crit Care Med

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Rationale: We have previously demonstrated that experimental pneumococcal carriage enhances immunity and protects healthy adults against carriage reacquisition after rechallenge with a homologous strain.Objectives: To investigate the role of naturally acquired pneumococcal protein and polysaccharide (PS)-specific immunity in protection against carriage acquisition using a heterologous challenge model. Methods:We identified healthy volunteers that were naturally colonized with pneumococcus and, after clearance of their natural carriage episode, challenged them with a heterologous 6B strain. In another cohort of volunteers we assessed 6BPS-specific, PspA-specific, and PspC-specific IgG and IgA plasma and memory B-cell populations before and 7, 14, and 35 days after experimental pneumococcal inoculation.Measurements and Main Results: Heterologous challenge with 6B resulted in 50% carriage among volunteers with previous natural pneumococcal carriage. Protection from carriage was associated with a high number of circulating 6BPS IgG-secreting memory B cells at baseline. There were no associations between protection from carriage and baseline levels of 6BPS IgG in serum or nasal wash, PspA-specific, or PspC-specific memory B cells or plasma cells. In volunteers who did not develop carriage, the number of circulating 6BPS memory B cells decreased and the number of 6BPS plasma cells increased postinoculation.Conclusions: Our data indicate that naturally acquired PS-specific memory B cells, but not levels of circulating IgG at time of pneumococcal exposure, are associated with protection against carriage acquisition.

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Changes in the pneumococcal disease-related hospitalisations in Spain after the replacement of 7-valent by 13-valent conjugate vaccine

Georgalis

Mozalevskis

Aragón

et al. 2016

Eur J Clin Microbiol Infect Dis

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In Spain, anti-pneumococcal vaccination is recommended for all children under 2 years old, high-risk groups and adults ≥65 years old. However, it is not funded in most autonomous communities. This study aims to compare pneumococcal disease hospitalisation rates between Period 1 (2007-2009), when 7-valent (PCV7) vaccine was available, and Period 2 (2011-2013), after the change to 13-valent (PCV13) vaccine in Spain. Data on hospitalisations were obtained from the National Registry of Hospitalisations. We calculated hospitalisation rates (HRs) and hospitalisation rate ratios (HRRs) among periods by age group and autonomous community, for all and by clinical presentation. From 138,361 patients hospitalised, 83,528 (60.4 %) were males. The median age was 73.8 years. The most common clinical presentation was pneumonia (133,204 hospitalisations; 96.3 %), followed by septicaemia (7053 hospitalisations; 5.1 %) and meningitis (3182 hospitalisations; 2.3 %). In Period 2, hospitalisations among children <5 years old decreased for pneumonia [HRR: 0.37; 95 % confidence interval (95 % CI): 0.35 to 0.39] and meningitis (HRR: 0.53; 95 % CI: 0.44 to 0.65). For adults ≥65 years old, pneumonia (HRR: 0.49; 95 % CI: 0.49 to 0.50) and peritonitis (HRR: 0.34; 95 % CI: 0.19 to 0.63) hospitalisations decreased and septicaemia hospitalisations (HRR: 1.27; 95 % CI: 1.18 to 1.36) increased. Significant changes in HRs for pneumococcal disease were observed even without an integrated and continuous vaccination programme after the introduction of PCV13, especially in children <5 years old and for pneumonia. The impact of the PCV13 adult vaccination new recommendations on the septicaemia increase reported should be evaluated in the future.

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Five winters of pneumococcal serotype replacement in UK carriage following PCV introduction

Cited by 117 publications

References 40 publications

Pneumococcal Capsular Polysaccharide Immunity in the Elderly

Pneumococcal Capsular Polysaccharide Immunity in the Elderly

Polysaccharide-Specific Memory B Cells Predict Protection against Experimental Human Pneumococcal Carriage

Changes in the pneumococcal disease-related hospitalisations in Spain after the replacement of 7-valent by 13-valent conjugate vaccine

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