Relationship between asthma status and antibody response pattern to 23-valent pneumococcal vaccination

Abstract

Objective: Asthma poses an increased risk for serious pneumococcal disease, but little is known about the influence of asthma status on the 23-valent serotype-specific pneumococcal antibody response. We examined differences in antibody titers between pre- and post-vaccination with 23-valent pneumococcal polysaccharide vaccine (PPSV-23) in relation to asthma status. Methods: Asthma status was retrospectively ascertained by the Predetermined Asthma Criteria in an existing vaccine cohort through comprehensive medical record review. Twenty-three serotype-specific pneumococcal antibody titers measured at baseline and 4–6 weeks post-vaccination were analyzed. Vaccine responses to PPSV-23 were calculated from pre- to post-vaccine titers for each of the serotypes. Results: Of the 64 eligible and enrolled subjects, 18 (28%) had asthma. Controls (i.e., subjects without asthma) demonstrated a statistically significant fold change response compared to their baseline for all serotypes, while those with asthma did not mount a significant response to serotypes 7F, 22F, and 23F. The overall vaccine response as measured by fold change over baseline was lower in subjects with asthma than controls. Conclusions: Poorer humoral immune responses to PPSV-23 as measured by fold change were more likely to be observed in subjects with asthma compared to controls. We recommend the consideration of asthma status when interpreting vaccine response for immune competence workup through larger studies. Further studies are warranted to replicate these findings.

Keywords:

• Epidemilogy
• immunopathogenesis

Acknowledgements

We would like to thank the staff of the Pediatric Asthma Epidemiology Research Unit for research support, the Antibody Immunology staff for generating the pneumococcal antibody data and the individuals involved in critical appraisal of the manuscript.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article. Part of this analysis was presented at the ERS meeting in 2015.

Funding

The authors have nothing to disclose that pose a conflict of interest. Funding Source: This work was supported by the National Institute of Allergy and Infectious Diseases (R21 AI101277), the National Heart, Lung, and Blood Institute (R01 HL126667) and the Scholarly Clinician Award from the Mayo Foundation (to YJJ). This study was approved by the institutional review boards at the Mayo Clinic and the Olmsted Medical Center.