Response to pneumococcal vaccination in mannose-binding lectin-deficient adults with recurrent respiratory tract infections

Abstract

SummaryMannose-binding lectin (MBL)-deficiency is associated with an increased susceptibility to pneumococcal infections and other forms of disease. Pneumococcal vaccination is recommended in MBL-deficient patients with recurrent respiratory tract infections (RRTI). The response to pneumococcal vaccination in MBL-deficient individuals has not yet been studied in detail. An impaired response to pneumococcal polysaccharides in MBL-deficient patients might explain the association between MBL deficiency and pneumococcal infections. This study investigates the antibody response to pneumococcal vaccination in MBL-deficient adult patients with RRTI. Furthermore, we investigated whether there was a difference in clinical presentation between MBL-deficient and -sufficient patients with RRTI. Eighteen MBL-deficient and 63 MBL-sufficient adult patients with RRTI were all vaccinated with the 23-valent pneumococcal polysaccharide vaccine and antibodies to 14 pneumococcal serotypes were measured on a Luminex platform. There were no differences observed in the response to pneumococcal vaccination between MBL-sufficient and -deficient patients. Forty-three MBLsufficient patients could be classified as responders to pneumococcal vaccination and 20 as low responders, compared to 15 responders and three low responders in the MBL-deficient patients. We found no clear difference in clinical, radiological, lung function and medication parameters between MBL-sufficient and -deficient patients. In conclusion, our study suggests that MBL-deficient adults with RRTI have a response to a pneumococcal capsular polysaccharide vaccine comparable with MBL-sufficient patients. Moreover, we did not find a clear clinical role of MBL deficiency in adults with RRTI. As MBL deficiency is associated with an increased susceptibility to pneumococcal infections, pneumococcal vaccination might be protective in MBL-deficient patients with RRTI.

Mannose-binding lectin and ficolin-2 do not influence humoral immune response to hepatitis B vaccine

“…Of note, two very recent studies in individuals after pertussis and pneumococcal vaccination yielded similar results with regards to antibody production and persistence in MBL deficient individuals [35, 36]. However, the influence of ficolin-2 was not investigated.…”

Clinical and laboratory associations of mannose-binding lectin in 219 adults with IgG subclass deficiency

“…Decreased IgG responses to 23-valent pneumococcal polysaccharide vaccination are common in adults with IgGSD [10, 12, 42, 43]. In Dutch adults with recurrent respiratory tract infections who were unselected for total IgG or IgG subclass levels, responses to 23-valent pneumococcal polysaccharide vaccination were similar in subjects with or without functional MBL activity < 10% of normal [11].…”

“…IgG subclass deficiency (IgGSD) in adults is characterized by: levels of IgG1–3 subclasses more than two standard deviations (SD) below the population mean; frequent or severe respiratory tract infection; suboptimal IgG responses to pneumococcal polysaccharides; and increased prevalence of autoimmune conditions [9, 10]. A study of Dutch adults with recurrent respiratory tract infection revealed no significant clinical differences between subjects with or without MBL2 genotypes that predict low MBL production after subjects with subnormal serum Ig levels or suboptimal responses to 23-valent pneumococcal polysaccharide vaccine were excluded from the analyses [11].…”

Mannose-binding lectin protein and its association to clinical outcomes in COPD: a longitudinal study

“…Furthermore, a large study in Caucasian showed no association of exon 1 MBL2 genotypes and infection [ 37 ]. Bacterial surface lipopolysaccharide capsular antigen of Streptococcus pneumoniae causes airway inflammation, stimulating and binding with MBL protein and potentially leading to exacerbations [ 38 ]. Another study found the high-MBL expressing HYPA haplotype more frequent among controls than in patients with infection [ 39 ].…”