title: Pneumococcal polysaccharide vaccine responses are impaired in a subgroup of children with cystic fibrosis.
abstract: BACKGROUND
  Pneumococcal immunization is recommended in children with cystic fibrosis (CF). To date, however, there are no published studies on the efficacy of pneumococcal vaccination in this group of patients.
  
  
  METHODS
  We carried out a retrospective study of serotype-specific pneumococcal antibody responses to immunization with Prevenar 7 and Pneumovax II in a cohort of children with CF.
  
  
  RESULTS
  Nine children had been immunized with Prevenar 7, and all had serotype-specific pneumococcal antibody levels in the protective range (>0.35mg/L) to all 7 immunizing serotypes. In contrast, only 7 of 33 patients (21%) immunized with Pneumovax II made protective antibody responses to all 7 serotypes, and 3 failed to make protective antibodies to any of the serotypes. Controlling for age as a confounder in the analysis, children with impaired antibody responses to pneumococcal polysaccharide (Pneumovax II) immunization had lower Shwachman-Kulczycki scores than children with normal polysaccharide antibody responses. All isolates of Pseudomonas aeruginosa occurred in patients with impaired anti-pneumococcal antibody responses, and a broader range of respiratory pathogens was isolated from these children.
  
  
  CONCLUSIONS
  Impaired antibody responses to immunization with Pneumovax II are common in children with CF and this may be associated with increased disease severity.
authors.affiliation: Department of Immunology, Leicester Royal Infirmary, Leicester LE1 5WW, UK; Institute for Lung Health, NIHR Leicester Respiratory Biomedical Research Unit, Leicester LE1 9HN, UK; Department of Infection Immunity and Inflammation, University of Leicester, Leicester LE1 9HN, UK.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Browning
authors.affiliation: Children's Hospital, Leicester Royal Infirmary, Leicester LE1 5WW, UK.
authors.forename: Michael T C
authors.initials: MT
authors.lastname: Lim
authors.affiliation: Children's Hospital, Leicester Royal Infirmary, Leicester LE1 5WW, UK.
authors.forename: Priti
authors.initials: P
authors.lastname: Kenia
authors.affiliation: Department of Immunology, Leicester Royal Infirmary, Leicester LE1 5WW, UK.
authors.forename: Michelle
authors.initials: M
authors.lastname: Whittle
authors.affiliation: Department of Clinical Biochemistry and Immunology, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK; NIHR Biomedical Research Centre, Cambridge, UK.
authors.forename: Rainer
authors.initials: R
authors.lastname: Doffinger
authors.affiliation: Department of Clinical Biochemistry and Immunology, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Barcenas-Morales
authors.affiliation: Department of Clinical Biochemistry and Immunology, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK.
authors.forename: Dinakantha
authors.initials: D
authors.lastname: Kumararatne
authors.affiliation: Biostatistics and Bioinformatics Hub, University of Leicester, LE1 9HN, UK.
authors.forename: Maria
authors.initials: M
authors.lastname: Viskaduraki
authors.affiliation: Institute for Lung Health, NIHR Leicester Respiratory Biomedical Research Unit, Leicester LE1 9HN, UK; Department of Infection Immunity and Inflammation, University of Leicester, Leicester LE1 9HN, UK; Respiratory Medicine, Portex Unit, Institute of Child Health, UCL & Great Ormond Street Hospital, London, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: O'Callaghan
authors.affiliation: Institute for Lung Health, NIHR Leicester Respiratory Biomedical Research Unit, Leicester LE1 9HN, UK; Department of Infection Immunity and Inflammation, University of Leicester, Leicester LE1 9HN, UK; Children's Hospital, Leicester Royal Infirmary, Leicester LE1 5WW, UK. Electronic address: eag15@le.ac.uk.
authors.forename: Erol A
authors.initials: EA
authors.lastname: Gaillard
mesh_terms: D000293:Adolescent; D000907:Antibodies, Bacterial / Q000097:blood*; D000917:Antibody Formation; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000097:blood / Q000276:immunology*; D005260:Female; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D006801:Humans; D008297:Male; D011008:Pneumococcal Infections / Q000517:prevention & control*; D022242:Pneumococcal Vaccines; D011552:Pseudomonas Infections / Q000453:epidemiology; D011550:Pseudomonas aeruginosa; D012189:Retrospective Studies; D013296:Streptococcus pneumoniae / Q000276:immunology*
chemical_list: D000907:Antibodies, Bacterial; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D022242:Pneumococcal Vaccines
keywords: Antibody; Cystic fibrosis; Pneumococcus; Polysaccharide; Vaccination; Vaccine