title: Immune responses following meningococcal serogroups A, C, Y and W polysaccharide vaccination in C2-deficient persons: evidence for increased levels of serum bactericidal antibodies.
abstract: Complement C2 deficiency (C2D) is associated with immunological diseases and increased susceptibility to invasive infections caused by encapsulated bacteria such as Neisseria menigitidis. In this study we evaluate the immunogenicity of vaccination against N. menigitidis in C2D. C2D patients (n=22) and controls (n=52) were given a tetravalent meningococcal polysaccharide vaccine. Serum bactericidal antibody (SBA) titres (serogroups A, C, Y and W) were analysed using a rabbit complement source. Levels of IgG, IgM, and IgA, factor B, and factor H, polymorphisms of MBL and Fc-gamma receptors were determined. The C2D patients responded with an increased SBA titre to all four serogroups (p<0.001). The response rates define as SBA titres ≥8 were found to be between 85.7% and 92.5%. The post-vaccination titres for serogroups C, Y and W were equal to healthy controls. C2D patients with a history of invasive infection had a lower post-vaccination SBA titres both compared to healthy C2D persons (p=0.03) and compared to controls (p<0.0001). We found that the G2M*n/G2M*n genotype were associated with a higher SBA titres after immunization (p=0.03). None of the other investigated immunological factors appear to be important in influencing the vaccine responses. Autoimmune diseases in C2D did not affect the vaccine response. In general, vaccination against meningococci gave rise to antibody responses in the C2D patients that equal healthy controls. The response rate was lower to serogroup A and among C2D patients with history of invasive infections. The presence of G2M*n/G2M*n genotype was associated with higher SBA titres after immunization.
authors.affiliation: Department of Paediatrics, Skåne University Hospital, Lund, Sweden.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Brodszki
authors.affiliation: Department of Laboratory Medicine Section of Microbiology, Immunology and Glycobiology, Lund University, Lund, Sweden.
authors.forename: Lillemor
authors.initials: L
authors.lastname: Skattum
authors.affiliation: Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, United Kingdom.
authors.forename: Xilian
authors.initials: X
authors.lastname: Bai
authors.affiliation: Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, United Kingdom.
authors.forename: Helen
authors.initials: H
authors.lastname: Findlow
authors.affiliation: Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, United Kingdom.
authors.forename: Ray
authors.initials: R
authors.lastname: Borrow
authors.affiliation: Department of Infectious Diseases, Skåne University Hospital, Lund, Sweden. Electronic address: goran.b.jonsson@skane.se.
authors.forename: Göran
authors.initials: G
authors.lastname: Jönsson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000907:Antibodies, Bacterial / Q000097:blood*; D002648:Child; D003175:Complement C2 / Q000172:deficiency*; D005260:Female; D006801:Humans; D008297:Male; D022401:Meningococcal Vaccines / Q000008:administration & dosage / Q000276:immunology*; D008875:Middle Aged; D009345:Neisseria meningitidis / Q000276:immunology*; D011135:Polysaccharides, Bacterial / Q000276:immunology; D011817:Rabbits; D065288:Serogroup; D058248:Serum Bactericidal Antibody Assay; D014611:Vaccination; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial; D003175:Complement C2; D022401:Meningococcal Vaccines; D011135:Polysaccharides, Bacterial
keywords: C2 deficiency; Meningococcal disease; The complement system; Vaccination