title: Evaluation of antibody response to polysaccharide vaccine and switched memory B cells in pediatric patients with inflammatory bowel disease.
abstract: OBJECTIVE
  Inflammatory bowel disease (IBD) is a chronic disease of the gastrointestinal tract, whose etiologies are still unknown. This study was performed to evaluate the humoral immune response in terms of B cell functions in selected IBD patients.
  
  
  METHODS
  Eighteen pediatric patients with IBD, including 12 cases of ulcerative colitis (UC) and six with Crohn disease (CD), were enrolled in this study. The pneumococcal vaccine was injected in all patients, and the IgG antibody level to the polysaccharide antigen was measured before and 4 weeks after injection. The B cell switch-recombination process was evaluated.
  
  
  RESULTS
  Five patients with IBD (three CD and two UC) had defects in B cell switching, which was significantly higher than in controls (p=0.05). Ten patients had a specific antibody deficiency and exhibited a higher frequency of bacterial infection than the healthy group. The mean increased level of IgG after vaccination was lower in IBD patients (82.9±32.5 µg/mL vs 219.8±59.0 µg/mL; p=0.001). Among the patients who had an insufficient response, no significant difference in the number of switched memory B-cell was observed.
  
  
  CONCLUSIONS
  A defect in B lymphocyte switching was observed in pediatric IBD patients, and especially in those patients with CD. Owing to an increased risk of bacterial infections in those patients with antibody production defects, pneumococcal vaccination could be recommended. However, not all patients can benefit from the vaccination, and several may require other prophylactic methods.
authors: Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Gholamhossein
authors: G
authors: Fallahi
authors: Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. ; Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Asghar
authors: A
authors: Aghamohammadi
authors: Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Ahmad
authors: A
authors: Khodadad
authors: Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Mojtaba
authors: M
authors: Hashemi
authors: Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Payam
authors: P
authors: Mohammadinejad
authors: Department of Immunology, Tehran University of Medical Sciences School of Public Health, Tehran, Iran.
authors: Hossein
authors: H
authors: Asgarian-Omran
authors: Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Mehri
authors: M
authors: Najafi
authors: Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Fatemeh
authors: F
authors: Farhmand
authors: Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Farzaneh
authors: F
authors: Motamed
authors: Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Khadije
authors: K
authors: Soleimani
authors: Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Habib
authors: H
authors: Soheili
authors: Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. ; Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Nima
authors: N
authors: Parvaneh
authors: Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Behzad
authors: B
authors: Darabi
authors: Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Rasoul
authors: R
authors: Nasiri Kalmarzi
authors: Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Shabnam
authors: S
authors: Pourhamdi
authors: Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Hassan
authors: H
authors: Abolhassani
authors: Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Babak
authors: B
authors: Mirminachi
authors: Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. ; Molecular Immunology Research Center and Department of Immunology, Tehran University of Medical Sciences School of Medicine, Tehran, Iran.
authors: Nima
authors: N
authors: Rezaei
mesh_terms: D000293:Adolescent; D000917:Antibody Formation / Q000187:drug effects*; D001402:B-Lymphocytes / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000150:complications / Q000276:immunology*; D003424:Crohn Disease / Q000150:complications / Q000276:immunology*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000378:metabolism; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000276:immunology*; D008297:Male; D022242:Pneumococcal Vaccines / Q000494:pharmacology*; D011134:Polysaccharides / Q000494:pharmacology*; D016896:Treatment Outcome
chemical_list: D007074:Immunoglobulin G; D022242:Pneumococcal Vaccines; D011134:Polysaccharides
keywords: Colitis, ulcerative; Crohn disease; Inflammatory bowel diseases; Polysaccharide vaccine; Switched memory B cells