title: Association between serotype-specific antibody response and serotype characteristics in patients with pneumococcal pneumonia, with special reference to degree of encapsulation and invasive potential.
abstract: We studied the immunoglobulin (Ig) response to causative serotype-specific capsular polysaccharides in adult pneumococcal pneumonia patients. The serotypes were grouped according to their degree of encapsulation and invasive potential. Seventy patients with pneumococcal pneumonia, 20 of whom were bacteremic, were prospectively studied. All pneumococcal isolates from the patients were serotyped, and the Ig titers to the homologous serotype were determined in acute- and convalescent-phase sera using a serotype-specific enzyme-linked immunosorbent assay. The Ig titers were lower in bacteremic cases than in nonbacteremic cases (P < 0.042). The Ig titer ratio (convalescent/acute titer) was ≥2 in 33 patients, 1 to 1.99 in 20 patients, and <1 in 17 patients. Patients ≥65 years old had a lower median Ig titer ratio than did younger patients (P < 0.031). The patients with serotypes with a thin capsule (1, 4, 7F, 9N, 9V, and 14) and medium/high invasive potential (1, 4, 7F, 9N, 9V, 14, and 18C) had higher Ig titer ratios than did patients with serotypes with a thick capsule (3, 6B, 11A, 18C, 19A, 19F, and 23F) and low invasive potential (3, 6B, 19A, 19F, and 23F) (P < 0.05 for both comparisons after adjustment for age). Ig titer ratios of <1 were predominantly noted in patients with serotypes with a thick capsule. In 8 patients with pneumococcal DNA detected in plasma, the three patients with the highest DNA load had the lowest Ig titer ratios. In conclusion, a high antibody response was associated with serotypes with a thin capsule and medium/high invasive potential, although a low antibody response was associated with serotypes with a thick capsule and a high pneumococcal plasma load.
authors.affiliation: Department of Infectious Diseases, Örebro University Hospital, Örebro, Sweden simon.athlin@orebroll.se.
authors.forename: Simon
authors.initials: S
authors.lastname: Athlin
authors.affiliation: Statens Serum Institut, Copenhagen, Denmark.
authors.forename: Margit
authors.initials: M
authors.lastname: Kaltoft
authors.affiliation: Statens Serum Institut, Copenhagen, Denmark.
authors.forename: Hans-Christian
authors.initials: HC
authors.lastname: Slotved
authors.affiliation: Section of Clinical Microbiology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Björn
authors.initials: B
authors.lastname: Herrmann
authors.affiliation: Department of Infectious Diseases, Örebro University Hospital, Örebro, Sweden.
authors.forename: Hans
authors.initials: H
authors.lastname: Holmberg
authors.affiliation: Statens Serum Institut, Copenhagen, Denmark.
authors.forename: Helle Bossen
authors.initials: HB
authors.lastname: Konradsen
authors.affiliation: Department of Infectious Diseases, Örebro University Hospital, Örebro, Sweden Department of Medicine, Division of Infectious Diseases, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
authors.forename: Kristoffer
authors.initials: K
authors.lastname: Strålin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood*; D000917:Antibody Formation; D016470:Bacteremia / Q000276:immunology / Q000382:microbiology; D016667:Bacterial Capsules / Q000276:immunology*; D058491:Bacterial Load; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011018:Pneumonia, Pneumococcal / Q000150:complications / Q000276:immunology* / Q000382:microbiology*; D011446:Prospective Studies; D065288:Serogroup; D013296:Streptococcus pneumoniae / Q000145:classification* / Q000276:immunology* / Q000502:physiology; D014774:Virulence
chemical_list: D000907:Antibodies, Bacterial