Pneumococcal vaccine response in cirrhosis and liver transplantation
Pneumococcal vaccine response in cirrhosis and liver transplantation
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DOI：
10.1086/315245
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发表时间：
2000-02-01
影响因子：
6.4
通讯作者：
Gentry-Nielsen, MJ
中科院分区：
文献类型：
--
作者：
McCashland, TM;Preheim, LC;Gentry-Nielsen, MJ
肝硬化是严重肺炎球菌感染的主要危险因素，接受肝移植评估的患者通常会接受肺炎球菌疫苗。这项研究跟踪了 45 名接受移植评估的成年人和 13 名年龄匹配的对照受试者的血清抗体水平。所有患者均接受23价肺炎球菌多糖疫苗（PPS），在接种前以及接种后1个月和6个月时通过ELISA测定血清抗PPS水平以及荚膜类型3和23特异性抗体。还在移植前和移植后 3 个月测量了 25 名接受移植的患者的抗体水平。对照受试者对整个疫苗有较高的 IgG 反应，而患者似乎产生更多的 IgM 和 IgA。患者中的 IgA（可能还有 IgM）水平也比对照受试者下降得更快。移植后 3 个月时，所有抗 PPS 水平均等于或低于疫苗接种前基线。这些数据表明，PPS 疫苗接种可能对肝移植期间和肝移植后的患者无效。
Cirrhosis is a major risk factor for severe pneumococcal infection, and patients evaluated for liver transplantation routinely receive pneumococcal vaccine. This study followed serologic antibody levels of 45 adults evaluated for transplantation and 13 age-matched control subjects. All received 23-valent pneumococcal polysaccharide vaccine (PPS), Serum anti-PPS levels and antibodies specific for capsular types 3 and 23 were measured by ELISA before and 1 and 6 months after vaccination. Antibody levels for the 25 patients who received transplants also were measured immediately before and 3 months after transplantation. Control subjects had higher IgG responses to the whole vaccine, whereas patients appeared to produce more IgM and IgA. IgA, and possibly IgM levels, also declined faster in patients than in control subjects. All anti-PPS levels were at or below prevaccination baselines by 3 months after transplantation. These data suggest that vaccination with PPS may not be effective for patients during and after liver transplantation.