title: Value of allohaemagglutinins in the diagnosis of a polysaccharide antibody deficiency.
abstract: Polysaccharide antibody deficiency is characterized by a poor or absent antibody response after vaccination with an unconjugated pneumococcal polysaccharide vaccine. Allohaemagglutinins (AHA) are antibodies to A or B polysaccharide antigens on the red blood cells, and are often used as an additional or alternative measure to assess the polysaccharide antibody response. However, few studies have been conducted to establish the clinical significance of AHA. To investigate the value of AHA to diagnose a polysaccharide antibody deficiency, pneumococcal polysaccharide antibody titres and AHA were studied retrospectively in 180 subjects in whom both tests had been performed. Receiver operating characteristic curves for AHA versus the pneumococcal vaccine response as a marker for the anti-polysaccharide immune response revealed an area under the curve between 0·5 and 0·573. Sensitivity and specificity of AHA to detect a polysaccharide antibody deficiency, as diagnosed by vaccination response, were low (calculated for cut-off 1/4-1/32). In subjects with only low pneumococcal antibody response, the prevalence of bronchiectasis was significantly higher than in subjects with only low AHA (45·5 and 1·3%, respectively) or normal pneumococcal antibody response and AHA (2·4%). A logistic regression model showed that low pneumococcal antibody response but not AHA was associated with bronchiectasis (odds ratio 46·2). The results of this study do not support the routine use of AHA to assess the polysaccharide antibody response in patients with suspected immunodeficiency, but more studies are warranted to clarify the subject further.
authors.affiliation: Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium; Department Microbiology and Immunology, KU Leuven - University of Leuven, Leuven, Belgium.
authors.forename: H
authors.initials: H
authors.lastname: Schaballie
authors.forename: F
authors.initials: F
authors.lastname: Vermeulen
authors.forename: B
authors.initials: B
authors.lastname: Verbinnen
authors.forename: G
authors.initials: G
authors.lastname: Frans
authors.forename: E
authors.initials: E
authors.lastname: Vermeulen
authors.forename: M
authors.initials: M
authors.lastname: Proesmans
authors.forename: K
authors.initials: K
authors.lastname: De Vreese
authors.forename: M P
authors.initials: MP
authors.lastname: Emonds
authors.forename: K
authors.initials: K
authors.lastname: De Boeck
authors.forename: L
authors.initials: L
authors.lastname: Moens
authors.forename: C
authors.initials: C
authors.lastname: Picard
authors.forename: X
authors.initials: X
authors.lastname: Bossuyt
authors.forename: I
authors.initials: I
authors.lastname: Meyts
mesh_terms: D000293:Adolescent; D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood / Q000276:immunology*; D001987:Bronchiectasis / Q000097:blood / Q000175:diagnosis / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000097:blood / Q000175:diagnosis* / Q000276:immunology*; D007223:Infant; D008297:Male; D008875:Middle Aged; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D011135:Polysaccharides, Bacterial / Q000008:administration & dosage / Q000276:immunology*; D014611:Vaccination
chemical_list: D000907:Antibodies, Bacterial; D022242:Pneumococcal Vaccines; D011135:Polysaccharides, Bacterial
keywords: allohaemagglutinins; bronchiectasis; isohaemagglutinins; polysaccharide antibody deficiency; specific antibody deficiency