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• W2909648140 abstract "Background Measurement of vaccine response may be used as a diagnostic tool to aid determination of antibody deficiency. The IgG response to pneumococcal polysaccharide vaccination (PPV) is currently used to assess T cell independent responses, however additional polysaccharide vaccines are under evaluation. In patients with rheumatic diseases (RD) treatment regimens can result in immunosuppression and subsequently secondary immune deficiency (SID). Objectives To measure the IgG response to Typhi Vi vaccination (TV) in RD patients presenting with antibody deficiency. To correlate immunosuppression with TV responses, as well as TV responses to clinical presentations, B cells and total IgG. Further, we interpret the responses in combination with the responses to PPV. Methods 35 RD patients were referred for immunological evaluation at Hospital Clinico San Carlos, Madrid, Spain. The responses to TV and PPV were measured using commercial human anti-Salmonella Typhi Vi IgG and pneumococcal capsular polysaccharide (PCP) IgG ELISAs kits. A TV responder was defined as achieving ≥32 IU/mL (lower limit of the normal range), a PCP IgG responder (>50 mg/L), B cells were measured by flow cytometry (responder ≥6.6%) and total IgG by nephelometric assay (responder ≥600 mg/dL). For all measurements (+) indicates a responder and (-) indicates a non-responder. Results A greater percentage of TV- patients previously received non-biological treatment (79% vs 43%), specifically steroid treatments (68% vs 28%) and biological treatments (particularly CD20 and TNF alpha targets; 46% vs 14%). At presentation, TV non-responsiveness was associated with a higher frequency of upper respiratory tract infections (75% vs 57%), serious bacterial infections (21% vs 14%) and required slightly higher antibiotic usage (93% vs 71%). Stratification of the RD patients using the response the TV and PPV identified four groups of activity: TV+/PCP+, TV-/PCP+, TV+/PCP- and TV-/PCP-. In the presence of a normal response to PPV, the failure to respond to TV (TV-/PCP+) correlated with a higher frequency of previous non-biological treatment (84% vs 43%), biological treatment (47% vs 14%), steroids treatment (68% vs 29%) and were currently undergoing treatment (84% vs 29%, p=0.01) compared those who responded to TV (TV+/PCP+). At presentation TV-/PCP +patients had a greater incidence of upper respiratory tract infections (74% vs 57%), serious bacterial infections (16% vs 14%) and antibiotic usage (95% vs 71%). Non-responders to both vaccinations (TV-/PCP-) had a higher incidence of serious bacterial infections (25% vs 16%) and pneumonia (50% vs 32%) when compared to the TV+/PCP- group. When correlated with B cell number, 58% of B cells had a concentration of TV antibodies Conclusions The response to TV correlated with underlying disease treatment and immunological presentation. Assessing the response to two polysaccharide vaccinations, TV and PPV, may provide a greater understanding of the T cell independent pathway and provide more clinical information for the clinician. Disclosure of Interest L. Williams Employee of: The Binding Site Group Ltd, G. Candelas: None declared, C. Tange Employee of: The Binding Site Group Ltd, J. Ochoa-Grullon: None declared, P. Macarron: None declared, C. Morado: None declared, K. Llano: None declared, C. Martinez-Prada: None declared, A. Rodriguez de la Pena: None declared, B. Fernandez: None declared, J.-A. Jover: None declared, S. Harding Employee of: The Binding Site Group Ltd, S. Sanchez-Ramon: None declared, A. Parker Employee of: The Binding Site Group Ltd" @default.
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• W2909648140 date "2018-06-01" @default.
• W2909648140 modified "2023-10-18" @default.
• W2909648140 title "THU0034 Salmonella typhi vi igg as a marker of immunosuppression in rheumatic disease" @default.
• W2909648140 doi "https://doi.org/10.1136/annrheumdis-2018-eular.5542" @default.
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