Normal Ranges of Streptococcal Antibody Titers Are Similar Whether Streptococci Are Endemic to the Setting or Not

Steer, Andrew C.; Vidmar, Suzanna; Ritika, Roselyn; Kado, Joseph; Batzloff, Michael R.; Jenney, Adam; Carlin, John B.; Carapetis, Jonathan R.

doi:10.1128/cvi.00291-08

Cited by 53 publications

(51 citation statements)

References 21 publications

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“…The last pattern is likely to reflect lack of exposure to pathogens such as HSV2 and enteropathogenic bacteria rather than waning antibody titers. Background anti-streptococcal antibody titers are known to be low in adult populations of developed countries (35), which was confirmed in our study.…”

Section: Discussionsupporting

confidence: 88%

Comparative Study of Immune Status to Infectious Agents in Elderly Patients with Multiple Myeloma, Waldenstrom's Macroglobulinemia, and Monoclonal Gammopathy of Undetermined Significance

Karlsson

Andréasson

Kondori

et al. 2011

Clin. Vaccine Immunol.

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Whereas patients with multiple myeloma (MM) have a well-documented susceptibility to infections, this has been less studied in other B-cell disorders, such as Waldenstrom's macroglobulinemia (WM) and monoclonal gammopathy of undetermined significance (MGUS). We investigated the humoral immunity to 24 different pathogens in elderly patients with MM (n ‫؍‬ 25), WM (n ‫؍‬ 16), and MGUS (n ‫؍‬ 18) and in age-matched controls (n ‫؍‬ 20). Antibody titers against pneumococci, staphylococcal alpha-toxin, tetanus and diphtheria toxoids, and varicella, mumps, and rubella viruses were most depressed in MM patients, next to lowest in WM and MGUS patients, and highest in the controls. In contrast, levels of antibodies specific for staphylococcal teichoic acid, Moraxella catarrhalis, candida, aspergillus, and measles virus were similarly decreased in MM and MGUS patients. Comparable titers in all study groups were seen against Haemophilus influenzae type b (Hib), borrelia, toxoplasma, and members of the herpesvirus family. Finally, a uniform lack of antibodies was noted against Streptococcus pyogenes, salmonella, yersinia, brucella, francisella, and herpes simplex virus type 2. To conclude, although MM patients displayed the most depressed humoral immunity, significantly decreased antibody levels were also evident in patients with WM and MGUS, particularly against Staphylococcus aureus, pneumococci, and varicella. Conversely, immunity was retained for Hib and certain herpesviruses in all study groups.Patients with malignancies and dysfunctions of the B-cell lineage have impaired immunity and an increased risk of contracting severe infections. This is well documented in the case of multiple myeloma (MM), while Waldenstrom's macroglobulinemia (WM) and monoclonal gammopathy of undetermined significance (MGUS) have been less studied in this respect. Despite the use of prophylactic antimicrobial agents, infections remain a leading cause of morbidity and mortality in MM patients (7,32). Bacterial infections predominate, in particular those caused by Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, and Escherichia coli (7,23,29). However, the introduction of autologous stem cell transplantation and novel therapeutic agents, e.g., thalidomide, bortezomib, and lenalidomide, has led to a shift in the spectrum of infections in MM patients such that viral and fungal infections are increasingly diagnosed (1, 29). The highest risk of infection occurs within the first months after diagnosis of MM (32), especially in patients with renal failure (7, 29). Augustson et al. showed that 45% of early deaths in MM (within 60 days of diagnosis) were due to infections, mainly pneumonia and sepsis (5).Information regarding which types of infections that tend to afflict patients with WM or MGUS is sparse. In a study of 217 WM patients, the second most frequent cause of death next to disease progression was infectious diseases (19% of deaths); again, sepsis and pneumonia predominated (15). An increased risk of bacteremia has prev...

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Section: Discussionsupporting

confidence: 88%

Comparative Study of Immune Status to Infectious Agents in Elderly Patients with Multiple Myeloma, Waldenstrom's Macroglobulinemia, and Monoclonal Gammopathy of Undetermined Significance

Karlsson

Andréasson

Kondori

et al. 2011

Clin. Vaccine Immunol.

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“…The ULN value of ASO in adult population has been reported in a range between 177 and 250 iu/mL among different geographical regions [31, 32]. Reported rates are greater than the titers we detected in our study for pregnant women.…”

Section: Discussioncontrasting

confidence: 64%

Maternalβ-Hemolytic Streptococcal Pharyngeal Exposure and Colonization in Pregnancy

Heidari-Bateni

Brar

Hall

et al. 2014

Infectious Diseases in Obstetrics and Gynecology

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Objectives. To report the pharyngeal colonization rate of β-hemolytic streptococci and changes in the value of antistreptolysin O (ASO) and anti-DNase B serology titers during pregnancy. Methods. Healthy pregnant women were recruited and blood was drawn in each trimester. The upper limit of normal (ULN) values for ASO and anti-DNase B was calculated for each trimester. Throat swabs were collected for culture and positive cultures were further assessed for the identification of serogroup of the isolated β-hemolytic streptococcus. Results. Out of a total of 126 pregnant women, 34.1% had positive throat cultures. Group C and group G strains were isolated in 18.2% of throat cultures while group F was detected in 13.5% of cases. The rate of colonization with GAS was 1.6%. There was an overall drop in ASO titer during pregnancy while anti-DNase B titers remained relatively unchanged. ULN values of 164IU, 157IU, and 156IU were calculated for ASO at the first, second, and third trimesters, respectively. Based on the ULN values, 28.6% of patients had recent streptococcal exposure. Conclusions. These results show that pregnant women act as a reservoir for spreading potentially immunogenic (groups C and G) and disease producing (group F) virulent strains of streptococci.

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“…Therefore, in investigations performed in these regions higher ADB titers were encountered. In their study published in the year 2009, Steer et al [11] investigated adult, and pediatric populations in Fiji islands in the Pacific Ocean. ADB titers were measured using nephelometric method in serum samples of children who had not contracted GABHS infection, and ULN value for ADB in the age group of 5–14 was detected as 499 IU/ml.…”

Section: Discussionmentioning

confidence: 99%

Detection of anti- DNase B antibody upper normal values in children's age groups who were admitted to hospital with noninfectious reasons

Delice

Adaleti

Cevan³

et al. 2015

North Clin Istanbul

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OBJECTIVE:Anti-streptolysin O (ASO) and anti-DNase B (ADB) titers are used for the diagnosis of poststreptococcal complications. Ranges of normal values of ASO and ADB titers vary, depending on age, population and different time intervals. Although many studies have been performed for determination of the ASO titer in our country, only a few studies have been conducted for specification the upper limit of normal for (ULN) ADB. In our study we aimed to determine the upper limit of normal of ADB antibody titers in children aged 5–15.METHODS:One hundred and twenty one children aged from 5–15 who were admitted to our outpatient clinic of Haydarpaşa Numune Training and Research Hospital with noninfectious reasons between November 2013 and March 2014 were included in the study. Patients who met the following criteria were included in the study; absence of streptococcal infection in the last three months in physical examination and/or no growth of group A, C, and G of beta-haemolytic streptococci in throat culture, normal ranges of ASO and C reactive protein (CRP) levels. All serum samples were analyzed collectively by nephelometric method. The upper limit of normal value for anti-DNase B has been defined by separating the upper 20% from the lower 80% of all measurements.RESULTS:Anti-DNase B antibody levels were ranged between 50–576 IU/ml and its upper limit was 219.2 IU/ml. When analyzed according to age groups, anti-DNase B antibody levels in the group aged between 5–10, ranged between 50–576 IU/ml and its upper limit was 212.2 IU/ml, anti-DNase B antibody levels in the group aged 10–15, ranged between 50–408 IU/ml and its upper limit was 231.2 IU/ml (p=0.008).CONCLUSION:Based on our results, upper normal values ADB antibody showed variations with age in our results. Therefore national reference values should be detected by more comprehensive studies.

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Normal Ranges of Streptococcal Antibody Titers Are Similar Whether Streptococci Are Endemic to the Setting or Not

Cited by 53 publications

References 21 publications

Comparative Study of Immune Status to Infectious Agents in Elderly Patients with Multiple Myeloma, Waldenstrom's Macroglobulinemia, and Monoclonal Gammopathy of Undetermined Significance

Comparative Study of Immune Status to Infectious Agents in Elderly Patients with Multiple Myeloma, Waldenstrom's Macroglobulinemia, and Monoclonal Gammopathy of Undetermined Significance

Maternalβ-Hemolytic Streptococcal Pharyngeal Exposure and Colonization in Pregnancy

Detection of anti- DNase B antibody upper normal values in children's age groups who were admitted to hospital with noninfectious reasons

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