Vaccination against tick-borne encephalitis virus tests specific IgG production ability in patients under immunoglobulin substitution therapy

Seidel, Markus G.; Grohmann, Eva; Sadeghi, Kambis; Pollak, Arnold; Heitger, Andreas; Förster-Waldl, Elisabeth

doi:10.1016/j.vaccine.2010.07.027

Cited by 15 publications

(7 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Rabel et al had already reported geographic differences for TBE within IVIG products ( 2 ). In parallel, Seidel et al found divergent levels of protective antibodies in a small number of patients with IgG replacement therapy but did not correlate their findings to the geographic plasma origin in detail ( 3 ). Our data complement the previous results by analyzing TBE-specific serum titers in patients in relation to the geographic origin of the received IgG preparation.…”

Section: Discussionmentioning

confidence: 99%

“…Rabel et al reported 2012 geographic variation of neutralizing antibodies against TBE within intravenous IgG preparations ( 2 ). Seidel et al mention passive transfer of protective anti-TBE IgG levels via IgG replacement therapy in their publication focusing on active TBE vaccination responses in 18 patients ( 3 ). However, protective antibody levels within patients have not been systematically studied so far.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Analysis of Specific IgG Titers Against Tick-Borne Encephalitis in Patients with Primary Antibody Deficiency Under Immunoglobulin Substitution Therapy: Impact of Plasma Donor Origin

et al. 2015

View full text Add to dashboard Cite

Immunoglobulin (Ig) replacement therapy is effective in reducing infections in patients with primary antibody deficiency (PAD). Diversity of specific antibodies is achieved by pooling plasma from over 1000 donors usually of a given geographic region. However, there is no agreement with regard to an optimal vaccination schedule for plasma donors. Especially for tick-borne encephalitis (TBE), regional vaccination rates differ widely among populations due to the epidemiology of the disease. We analyzed specific antibody titers against TBE in comparison to total IgG levels in 162 serum samples collected from 110 PAD patients substituted with polyvalent intravenous IgG or subcutaneous IgG. Some patients received different IgG products over time leading to a total number of 122 different patient-IgG product combinations. Positive TBE-specific IgG levels were detected in 35 cases when measured by standard ELISA and could be confirmed by demonstration of neutralizing antibodies in 31 cases. The detection of specific antibody levels correlated with the geographic origin of the IgG preparations. No titers were detectable in patients substituted with IgG products from North-American donors, whereas variable degrees of anti-TBE titers were observed in patients receiving products from different European countries. We suggest considering the patients’ personal risk for TBE when selecting an appropriate Ig preparation. These data support regional plasma donation in order to address the diverse local infection profile.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Analysis of Specific IgG Titers Against Tick-Borne Encephalitis in Patients with Primary Antibody Deficiency Under Immunoglobulin Substitution Therapy: Impact of Plasma Donor Origin

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Since ongoing immunoglobulin replacement therapy complicates the determination of IgG antibody responses after vaccination, we choose TBEV vaccine, an antigen suitable for primary immunization in individuals not previously vaccinated, as IgG antibody titers are frequently low in IVIG products due to the use of a large share of plasma from the US, where in contrast to middle Europe, TBEV immunization is not frequently employed ( 15 ). Previous studies proposed the use of TBEV vaccine to study antibody response to booster vaccination in patients receiving immunoglobulin replacement therapy ( 16 ), but primary TBEV antibody response has not been studied in IVIG-treated CVID patients so far. Since it is known that different IVIG lots contain different TBEV antibody contents depending on the country of plasma origin ( 15 ), we examined the lots of IVIG that were used in our patients undergoing TBEV vaccination to confirm their low TBEV antibody content.…”

Section: Discussionmentioning

confidence: 99%

Detection of Impaired IgG Antibody Formation Facilitates the Decision on Early Immunoglobulin Replacement in Hypogammaglobulinemic Patients

Wolf¹,

Thon

Litzman

et al. 2015

Front. Immunol.

View full text Add to dashboard Cite

Hypogammaglobulinemia (serum IgG lower than 2 SD below the age-matched mean) and clinical symptoms such as increased susceptibility to infection, autoimmune manifestations, granulomatous disease, and unexplained polyclonal lymphoproliferation are considered to be diagnostic hallmarks in patients with common variable immunodeficiency (CVID), the most frequent clinically severe primary immunodeficiency syndrome. In the present study, we investigated patients with hypogammaglobulinemia and no clinical or immunological signs of defective cell-mediated immunity and differentiated two groups on the basis of their IgG antibody formation capacity against a variety of different antigens (bacterial toxins, polysaccharide antigens, viral antigens). Patients with hypogammaglobulinemia and intact antibody production (HIAP) displayed no or only mild susceptibility to infections, while CVID patients showed marked susceptibility to bacterial infections that normalized following initiation of IVIG or subcutaneous immunoglobulin replacement therapy. There was a substantial overlap in IgG serum levels between the asymptomatic HIAP group and the CVID patients examined before immunoglobulin treatment. HIAP patients showed normal levels of switched B-memory cells (CD19+CD27+IgD−), while both decreased and normal levels of switched B-memory cells could be found in CVID patients. IgG antibody response to a primary antigen, tick-borne encephalitis virus (TBEV), was defective in CVID patients, thus confirming their substantial defect in IgG antibody production. Defective IgG antibody production against multiple antigens could also be demonstrated in an adult patient with recurrent infections but normal IgG levels. To facilitate early treatment before recurrent infections may lead to organ damage, the antibody formation capacity should be examined in hypogammaglobulinemic patients and the decision to treat should be based on the finding of impaired IgG antibody production.

show abstract

“…The geographic variance in IVIG Ab content also needs to be taken into consideration for novel treatment approaches, as recently suggested by Seidel et al, who proposed the use of a TBE vaccine as a "neo-antigen" to test B-cell function in patients under regular IgG substitution therapy (34). The results obtained in the current investigation confirm that this proposed approach might be feasible as long as IVIG treatment is done using US-IVIG only, i.e., when no passively transferred TBEV Abs are administered at the same time as an active immunization against TBEV, as this is known to result in remarkably lower levels of actively produced antibodies (17,38).…”

mentioning

confidence: 99%

Tick-Borne Encephalitis Virus-Neutralizing Antibodies in Different Immunoglobulin Preparations

Rabel¹,

Planitzer²,

Farcet³

et al. 2012

Clin. Vaccine Immunol.

View full text Add to dashboard Cite

Patients with primary immunodeficiency (PIDs) depend on the presence of a variety of antibody specificities in intravenous immunoglobulin (IVIG). Using the tick-borne encephalitis virus (TBEV), geographic variability in IVIG antibody content was shown. Care should therefore be exercised when treating PIDs in a given geography, as only locally sourced plasma contains the antibody specificities against the circulating pathogens in the given locality. Intravenous immunoglobulin (IVIG) contains the pooled antibodies (Abs) from at least 3,000 to 60,000 healthy blood and plasma donors (10). One of the main areas of IVIG application is as Ab replacement therapy in patients with primary immunodeficiency (PIDs) (22). These persons critically depend on the presence of a variety of antibody specificities in IVIG, which ensures continued protection against any infectious agent they might encounter. As IVIG is manufactured from the variable resource human plasma, lot-to-lot variation in Ab levels of IVIG products are inevitable and have been reported (18). In addition, the Ab content in IVIG differs depending on the geographic origin of the plasma that was used in manufacture: U.S.-sourced (US-IVIG) or European Union-sourced (EU-IVIG) IVIG contains significantly different Ab levels against hepatitis A virus (8, 21), West Nile virus (WNV) (25), cytomegalovirus (21,27), and the different echovirus serotypes (24), with some evidence of a difference in Ab content for measles and rubella (21). The reason for this geographic variability in IVIG Ab content is often not clear, yet one of the more obvious variables affecting the quantity and specificity of Abs in IVIG is the endemicity of a pathogen, where a change in the temporal or geographic pattern of virus circulation affects the antibody content of the final IVIG. When a virus or microbial agent is expanding its geographical range, exposure of the formerly naïve population to this novel agent is reflected in the Ab content of IVIG. This was demonstrated, e.g., for US-IVIG after the introduction of WNV into the United States in 1999 (4,25,31) and recently also for EU-IVIG, where increasing WNV-neutralizing Ab titers were detected in EU-IVIG lots manufactured after 2009, even though no human WNV infections have yet been reported from the countries in which the plasma was sourced (31).To further increase the understanding of the geographical difference in IVIG Ab content, we determined the neutralizing Ab titers of IVIG preparations for tick-borne encephalitis virus (TBEV). This member of the Flaviviridae, for which three subtypes (European, Siberian, and Far Eastern) are distinguished, may cause tick-borne encephalitis (TBE), a potentially serious neurological disease with high fever and encephalitis (33), while 70 to 95% of human infections in regions in which the virus is endemic are either subclinical or totally asymptomatic (12). During the last 30 years, TBE morbidity has increased by 400% in Europe (36), and TBEV is currently expanding from its geographical range in Central...

show abstract

Vaccination against tick-borne encephalitis virus tests specific IgG production ability in patients under immunoglobulin substitution therapy

Cited by 15 publications

References 24 publications

Analysis of Specific IgG Titers Against Tick-Borne Encephalitis in Patients with Primary Antibody Deficiency Under Immunoglobulin Substitution Therapy: Impact of Plasma Donor Origin

Analysis of Specific IgG Titers Against Tick-Borne Encephalitis in Patients with Primary Antibody Deficiency Under Immunoglobulin Substitution Therapy: Impact of Plasma Donor Origin

Detection of Impaired IgG Antibody Formation Facilitates the Decision on Early Immunoglobulin Replacement in Hypogammaglobulinemic Patients

Tick-Borne Encephalitis Virus-Neutralizing Antibodies in Different Immunoglobulin Preparations

Contact Info

Product

Resources

About