title: Serum bactericidal antibody responses to meningococcal polysaccharide vaccination as a basis for clinical classification of common variable immunodeficiency.
abstract: Common variable immunodeficiency (CVID) is a heterogeneous group of disorders characterized by hypogammaglobulinemia and increased susceptibility to recurrent pyogenic infections. This study was performed to subclassify CVID on the basis of the bactericidal antibody responses of patients to polysaccharide meningococcal vaccine. Twenty-five patients with CVID (18 male and 7 female) and 25 healthy volunteers received meningococcal polysaccharide vaccine A + C. Serum bactericidal antibody (SBA) titers were measured at baseline and after 3 weeks. Response was correlated with clinical and immunological manifestations of CVID. Twenty-four (96%) of the 25 normal controls had a protective SBA titer of > or = 8 postvaccination, whereas only 16 (64%) of the 25 CVID patients had a protective titer (P value = 0.013). Among the patients with CVID who were nonresponders, there were significantly increased rates of bronchiectasis (P = 0.008), splenomegaly (P = 0.016), and autoimmunity (P = 0.034) in comparison with patients who had protective SBA titers. A reversed CD4/CD8 ratio was more common in the nonresponder group of patients (P = 0.053). We conclude that individuals with CVID who cannot produce protective postvaccination titers after receiving meningococcal polysaccharide vaccine are more likely to exhibit bronchiectasis, splenomegaly, and autoimmune diseases. Vaccination response may define subgroups of patients with CVID, enabling more effective monitoring and therapeutic strategies.
authors.affiliation: Immunology, Asthma and Allergy Research Institute, Medical Sciences/University of Tehran, Tehran 14194, Iran. rezaei_nima@hbi.ir
authors.forename: Nima
authors.initials: N
authors.lastname: Rezaei
authors.forename: Asghar
authors.initials: A
authors.lastname: Aghamohammadi
authors.forename: Seyed Davar
authors.initials: SD
authors.lastname: Siadat
authors.forename: Mostafa
authors.initials: M
authors.lastname: Moin
authors.forename: Zahra
authors.initials: Z
authors.lastname: Pourpak
authors.forename: Mehdi
authors.initials: M
authors.lastname: Nejati
authors.forename: Hojat
authors.initials: H
authors.lastname: Ahmadi
authors.forename: Samineh
authors.initials: S
authors.lastname: Kamali
authors.forename: Dariush
authors.initials: D
authors.lastname: Norouzian
authors.forename: Bahman
authors.initials: B
authors.lastname: Tabaraei
authors.forename: Robert C
authors.initials: RC
authors.lastname: Read
mesh_terms: D000293:Adolescent; D000328:Adult; D000917:Antibody Formation; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D017074:Common Variable Immunodeficiency / Q000145:classification* / Q000276:immunology*; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000097:blood; D008297:Male; D022401:Meningococcal Vaccines / Q000097:blood / Q000276:immunology*; D008875:Middle Aged; D015610:Serum Bactericidal Test / Q000379:methods*
chemical_list: D007136:Immunoglobulins; D022401:Meningococcal Vaccines