Immunogenicity of 23-Valent Pneumococcal Vaccine in Children with Systemic Lupus Erythematosus.
BACKGROUND
Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease which is characterized by B-cell abnormality and auto-antibody generation. Since bacterial infections are the most important causes of mortality in these patients, pneumococcal vaccination is recommended for children with SLE.


OBJECTIVE
To investigate humoral immunity and specific-antibody formation in response to a 23-valent polysaccharide pneumococcal vaccination in SLE children and asthmatic control group.


METHODS
The case and control groups consisted of 30 children with the mean age of 13 years who were matched by sex and age. Anti-pneumococcal antibody titers were determined using Enzyme-Linked Immunosorbent Assay (ELISA) before the vaccination with the 23-valent pneumococcal vaccine and 3 weeks later in both groups. Also the correlation between anti-pneumococcal antibody titer and different factors including age, sex, lupus activity, disease duration, medications, history of recurrent infections, and laboratory data were investigated.


RESULTS
Both groups showed significant increases in anti-pneumococcal antibody level after vaccination (p≤0.001). The increase in antibody level were almost the same in both groups (p≥0.05) such that 77.7% of SLE children and 86.2% of control children showed at least 2-fold increase in anti-pneumococcal antibody titer following immunization. Significant correlations were seen between the level of post-immunization anti-pneumococcal antibody with the age of children with SLE (p=0.02) and their age of disease onset (p=0.02).


CONCLUSIONS
It is concluded that pneumococcal vaccination is generally immunogenic in children with SLE. However, a small group of patients show impaired response to the vaccine.
Department of Pediatrics, Division of immunology and allergy, Shiraz University of Medical Sciences, Namazee Hospital, Shiraz, Iran, e-mail: alyasins@sums.ac.ir.
Soheila
S
Alyasin
Marzieh
M
Adab
Asieh
A
Hosseinpour
Reza
R
Amin
Maryam
M
Babaei
D000293:Adolescent; D000907:Antibodies, Bacterial / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D056724:Immunity, Humoral / Q000187:drug effects; D008180:Lupus Erythematosus, Systemic / Q000276:immunology* / Q000517:prevention & control; D008297:Male; D011008:Pneumococcal Infections / Q000150:complications / Q000276:immunology* / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000276:immunology*; D012307:Risk Factors; D013296:Streptococcus pneumoniae / Q000276:immunology*; D014611:Vaccination
C414006:23-valent pneumococcal capsular polysaccharide vaccine; D000907:Antibodies, Bacterial; D022242:Pneumococcal Vaccines