Anti-polysaccharide and anti-diphtheria protective antibodies after 13-valent pneumococcal conjugate vaccination in rheumatoid arthritis patients under immunosuppressive therapy

Publication date: Available online 21 July 2018

Source: Clinical Immunology

Author(s): Sara Caporuscio, Roberto Ieraci, Guido Valesini, Raffaela Teloni, Sabrina Mariotti, Francesca Romana Spinelli, Claudia Ferlito, Simonetta Salemi, Andrea Picchianti Diamanti, Giorgia Meneguzzi, Milica Markovic, Mayla Sgrulletti, Christina von Hunolstein, Luisa Ralli, Antonietta Pinto, Gerardo Salerno, Marco Canzoni, Maria Laura Sorgi, Bruno Laganà, Roberta Di Rosa

Abstract

Immunogenicity of 13-valent pneumococcal polysaccharide (PnPS) conjugate vaccine (PCV13) was evaluated in 38 rheumatoid arthritis patients under immunosuppressive treatment and 20 healthy controls (HC). Antibodies to all PnPS and diphtheria-toxin analogue conjugate protein were measured pre- (T0), 1 (T1), 6 (T2), 12 (T3) months post-immunization. Patients and HC had similar response to individual PnPS. Mean antibody levels to all PnPS but one doubled at T1 compared with T0, with T3 persistence for only 8-7/13 PnPS. Baseline antibody levels was inversely associated with the rate of responders at T1 (T1/T0≥2) to 11/13 PnPS. Few subjects reached protective IgG levels against some serotypes frequently isolated in Italian patients with invasive pneumococcal disease. Antibody response was not influenced by therapy, except the one to PS7F, which was reduced by tumor necrosis factor-α-inhibitors. Vaccination increased also anti-diphtheria IgG. Despite this study substantially confirmed the PCV13 immunogenicity in immunocompromised patients, it also revealed some limitations.

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