Pneumococcal vaccination of patients with systemic lupus erythematosus: effects on generation of autoantibodies.
OBJECTIVE
To assess the effect of vaccination against streptococcus pneumoniae on the generation of autoantibodies in patients with SLE.


METHODS
Twenty-four consecutive patients with SLE were vaccinated against streptococcus pneumoniae. Assessment was performed the day of vaccination and 2 months later and included evaluation of disease activity using the SLEDAI, serum levels of ESR, CRP, C3 and C4. The sera of the patients were tested by ELISA for anti-dsDNA, anticardiolipin (IgG and IgM), anti-Sm, anti-nRNP, anti-Ro/SSA, and anti-La/SSB.


RESULTS
The mean age at enrollment into the study was 39, mean disease duration 6.9 years. The SLEDAI score (mean +/- SD) was 4.41 +/- 2.92 at the time of vaccination and 4.47 +/- 3.11, 2 months apart. At the time of vaccination, 10 patients had anti-dsDNA, 2 patients had anti-Sm, 5 had anti-nRNP, and 9 had anti-Ro/SSA, 4 had anti-La/SSB, 4 had anticardiolipin IgG and IgM. Two months after vaccination, no change was observed in the proportion of patients with anti-Sm, anti-dsDNA, anti-RNP, anti-Ro/SSA and anticardiolipin IgM. A single patient developed anticardiolipin IgG and another one turned anti-RNP negative.


CONCLUSIONS
Vaccination against streptococcus pneumoniae did not trigger the generation of autoantibodies and confirms the clinical safety of this vaccine in SLE patients.
Elkayam
Ori
O
"Sackler" Faculty of Medicine, Department of Rheumatology, Tel Aviv "Sourasky" Medical Center, Tel Aviv University, Tel Aviv, Israel. oribe14@netvision.net.il
Paran
Daphna
D
Burke
Michael
M
Zakut
Vera
V
Ben-Yitshak
Ronit
R
Litinsky
Ira
I
Caspi
Dan
D
D000328:Adult; D000907:Antibodies, Bacterial / Q000096:biosynthesis* / Q000097:blood; D001323:Autoantibodies / Q000096:biosynthesis* / Q000097:blood; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000276:immunology / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000008:administration & dosage* / Q000276:immunology; D013296:Streptococcus pneumoniae / Q000276:immunology*
D000907:Antibodies, Bacterial; D001323:Autoantibodies; D022242:Pneumococcal Vaccines