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

Authors

  • D. A. van Kessel,

    1. Department of Pulmonology, Sint Antonius Hospital, Nieuwegein, the Netherlands
    2. Division of Heart and Lungs, University Medical Center, Utrecht, the Netherlands
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  • T. W. Hoffman,

    1. Department of Pulmonology, Sint Antonius Hospital, Nieuwegein, the Netherlands
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  • H. van Velzen-Blad,

    1. Department of Medical Microbiology and Immunology, Sint Antonius Hospital, Nieuwegein, the Netherlands
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  • P. Zanen,

    1. Department of Pulmonology, Sint Antonius Hospital, Nieuwegein, the Netherlands
    2. Division of Heart and Lungs, University Medical Center, Utrecht, the Netherlands
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  • G. T. Rijkers,

    1. Department of Medical Microbiology and Immunology, Sint Antonius Hospital, Nieuwegein, the Netherlands
    2. Science Department, University College Roosevelt, Middelburg, the Netherlands
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  • J. C. Grutters

    Corresponding author
    1. Department of Pulmonology, Sint Antonius Hospital, Nieuwegein, the Netherlands
    2. Division of Heart and Lungs, University Medical Center, Utrecht, the Netherlands
    • Correspondence: J. C. Grutters, Department of Pulmonology, Sint Antonius Hospital, Koekoekslaan 1 3435 CM Nieuwegein, the Netherlands.

      E-mail: j.grutters@antoniusziekenhuis.nl

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Summary

Mannose-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 MBL-sufficient 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.

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